Notice the great effort they go to in this article to downplay the most obvious difference between Europe and the U.S. - our healthcare systems

Europe healthier than U.S.

Older Americans have higher rates of serious diseases than aging Europeans, a study says.

By Lisa Girion, Los Angeles Times Staff Writer

October 2, 2007

Costly diseases, many of them related to obesity and smoking, are more prevalent among aging Americans than their European peers and add as much as $100 billion to $150 billion a year in treatment costs to the U.S. healthcare tab, a new study says.

The study by researchers at Emory University's Rollins School of Public Health found higher rates of several serious diseases -- including cancer, diabetes and heart disease -- among Americans 50 and older as compared with aging Europeans.

..."We expected to see differences between disease prevalence in the United States and Europe, but the extent of the differences is surprising," said lead author Kenneth Thorpe, a public health professor at Emory and former deputy assistant secretary of the U.S. Department of Health and Human Services.

Thorpe said the findings suggested that "we spend more on healthcare because we are, indeed, less healthy."...

...Physicians such as Rob Blackman, a Los Angeles internist, already counsel their patients to take a cue from Europeans in the way they eat -- less fast food -- and the way they pace their lives. Six-week vacations and afternoon siestas help reduce stress that makes people vulnerable to disease, he said.

Such conventions are commonplace in Europe but unheard of in the U.S., so the advice is often easier given than taken.

"Last year I took a 15-day vacation -- first time I took more than 10 days in 30 years," Blackman said. "I couldn't believe how much better I felt. It's like the old saying, 'You don't know how sick you are until you get better.' "...

...The U.S. healthcare system -- driven by when and how providers get paid -- does not promote prevention or effective and efficient disease management, Thorpe said.

Instead, he said, "We wait for people to get sick. They show up. We treat them. And doctors and hospitals get paid. That's not a very good way for managing disease."...

http://www.latimes.com/business/la-fi-healthspend2oct02,1,5022308.story

I was also watching the evening news not too long ago. The broadcast was about height as an indicator of a nation's health. It seems that Americans are getting shorter and shorter every year, whereas some of our European counterparts are growing taller as the time passes. I believe the height of the average American man was 5'10, whereas the average height of men in the Netherlands was 6'2.

I saw this firsthand in college -- I had lots of int'l friends, many of whom were from Europe. They were all in better shape than I was/am.

They did/do not diet (I still keep in touch with them, so I know). They eat whatever they want. But they eat mostly fresh foods, and they do not eat when they're not hungry. They do not deprive themselves of sweets but neither do they gorge on them. Lots of fruit & veggies.

They walk or bike wherever they go. No driving or even taking the bus unless you're going over 15mi one way. Seriously.

They can afford preventive healthcare because their healthcare is paid for.

They can afford healthy nutritious food because they have been able to get good educations....because their education has been paid for.

They have gotten good information about their bodies, sex, and birth control and do not (at least not the friends I have) feel the need to have more babies than they can care for.

I could go on, but suffice it to say this article is not news to me. We could learn a lot from our neighbors across the pond.

This article is written for public service workers in the UK (Northern Ireland)

“A case for radical surgery” Published by the Northern

Ireland Public Service Alliance

While we all have legitimate criticisms of the NHS, access to health care is free at the point of use in Northern Ireland as it is in the rest of the UK. However we have witnessed over the last number of years an increased interest in introducing

private sector ethos and principles into the health service in this country.

There is also a growing private sector health sector, the principal aim of which is to generate profit for private individuals and the Government is bent on introducing Foundation Hospitals across the UK. Foundation Hospitals are regarded as the basis for creating a two-tier health system in the UK which gives preferential access to those who can afford to pay for proper health care while the less well off receive second class treatment.

How would you like your access to health care and that of your family being dependent upon a health insurance scheme negotiated with your employer?

What happens if you are in a non unionised workplace or if your employer cannot afford to pay? What happens if you get the sack or are made redundant?

In any event what a crazy system that the state does not shoulder responsibility for ensuring that its citizens have access to proper health care without them being dependent on their employer agreeing to an adequate health insurance scheme or having to cover the costs of health insurance themselves from their own resources if indeed they are fortunate enough to have such resources!...

http://www.nipsa.org.uk/uploads/news/Web%20September%20NIPSA%20NEWS%20.pdf

Article begins on page 12:

The U.S. healthcare system -- driven by when and how providers get paid -- does not promote prevention or effective and efficient disease management, Thorpe said.

Instead, he said, "We wait for people to get sick. They show up. We treat them. And doctors and hospitals get paid. That's not a very good way for managing disease."

That's it in a nutshell. Our system is based upon crisis management. Putting out fires.

With anything else--- our homes, transportation, infrastructure... whatever--- it's accepted as fact that preventative maintenance is more cost efficient, maintains function, and increases longevity; why some fail to recognize this also applies to our healthcare system is astounding to me.

France best, U.S. worst in preventable death ranking

Tue Jan 8, 12:21 AM ET

WASHINGTON (Reuters) - France, Japan and Australia rated best and the United States worst in new rankings focusing on preventable deaths due to treatable conditions in 19 leading industrialized nations, researchers said on Tuesday.

If the U.S. health care system performed as well as those of those top three countries, there would be 101,000 fewer deaths in the United States per year, according to researchers writing in the journal Health Affairs....

http://news.yahoo.com/s/nm/20080108/ts_nm/deaths_rankings_dc

That's it in a nutshell. Our system is based upon crisis management. Putting out fires.

With anything else--- our homes, transportation, infrastructure... whatever--- it's accepted as fact that preventative maintenance is more cost efficient, maintains function, and increases longevity; why some fail to recognize this also applies to our healthcare system is astounding to me.

I don't think the system is based on crisis management. It's the consumers who wait until a crisis to go to their doctor. I work in PACU and see people every week who have huge bowel resections because they didn't bother with screenings that could have detected CA when it was small. Other people come in for outpatient surgery to remove a polyp that was found during screening. If folks could see the difference, they might call their doctor for a checkup.

Perhaps we need better incentives to get people to have annual checkups. Apparently enjoying healthier lives are not enough. Maybe if the doctors offered half price drinks or had a $5 buffet they'd get more patients in for screening/prevention.

Honestly, I think people need to be proactive and take responsibility for their health rather than depend on the government to do it for them. The only way to have preventive medicine is for the people to make their appointments before they are symptomatic. The guidelines are out there. Most people can recite them chapter and verse but still don't schedule their pap smears, mammograms, DREs, colonoscopies, and bloodwork. We can't just drag them in off the street....or can we? :innerconf

How about doctors and nurses persuading people to be screened?

I know when I changed insurance companies I suddenly needed tests I didn't need before.

Maybe it would be good for them to say, "With your family history I think you should have a yearly mammogram. Your insurance will only pay every other year but I want you to have one."

A friend paid only $80.00 for her mammogram.

Certainly the doctors should suggest screening tests when the patients come in. It doesn't hurt to be your own advocate either.

The first problem is getting people to go in for an exam. That's where individual responsibility comes in. I have seen televised public service announcements for screening but I think most Americans use that time as a break to leave the couch to get more chips and beer, or high fructose soda pop.

How about doctors and nurses persuading people to be screened?

I know when I changed insurance companies I suddenly needed tests I didn't need before.

Maybe it would be good for them to say, "With your family history I think you should have a yearly mammogram. Your insurance will only pay every other year but I want you to have one."

A friend paid only $80.00 for her mammogram.

Many insurance companies will waive the every-two -year rule if you have a first-degree family history. Insurance companies are spending large amounts of money trying to get members and providers on board with preventive medicine and health screenings. Most provide their providers with Standards of Care when signing a contract. Getting these docs to order standards of care is bad enough, but getting most patients to comply is an even greater challenge. I like the ADA commercial that tells us,"Diabetes won't kill you, failing to control your Diabetes will". If I can get my patients to get an A1c every 3 months, I feel like I have achieved a major victory......

My friend was denied payment for a mammogram because she was under 50. Her mother and aunt had died from breast cancer and her sister a surviver. She paid for hers. Her insurance did pay for the needle biopsy, surgery, and continuing treatment.

She is going through the process of arbitration for them to reimburse her for the "unecessary" procedure her doctor recommended.

She is a fine nurse and kind person. I am very glad her doctor told her it was called for. Her prognosis is excellent.

I hope your friend is able to get reimbursed for the mammogram. A little extra $ for the trouble would be nice too.

My wife has had mammograms approved and paid by insurance even though she was under 50 at the time. It may vary with the insurance company and maybe even within the insurance company.

On another blog, I posted a poor experience I had trying to get BCBS to pay for an operation. Another poster, who I know and respect, had nothing but praise for BCBS for the way they helped her thru detection and treatment of breast ca.

I wish there were reputable statistics we could reference rather than anecdotes. Evidence based practice is the best way to go, imo.