Ten Reasons Why American Health Care Is so Bad

Make up your mind

I'm sorry, but you are factually incorrect on your assumption that people are dying in Canada waiting for Heart Surgery. Its simply not true.
Here is a link on wait times for patients in the province of Ontario for cardiac surgeries.
http://www.ccn.on.ca/pdfs/st-sur-2006-11-2007-01.pdf

the question is why are they dying ?

if their case is truely clinically urgent why aren't they admitted as emergencies and optimised as inpatients before prompt transfer to a cardiothoracic centre?

people love to give these kind of meaningless quotes as to why the US system is 'better'

what happens in the US if you don't have insurance which hospital in their right mind is going to electively admit you for major surgery with a near enough mandatory ITU admission ?

the Emergency Department is for Emergencies ... the best primary healthcare is proper primary healthcare - primary healthcare where you build a relationship with a (relatively small) team of providers whether they are 'ordinary' Nurses , Advanced Practice Nurses, PAs or board certified primary care physicians


i think people are not looking at the evidence

98.5% of UK Emergency department attendances are dealt within within 4 hours - versus prolonged 'holds' in the emergency department in the USA

95% of UK emergency ambulance calls recieve a professional response within 19 minutes , 100% of Uk lower urgency Ambulance calls recieve a response within an agreed time frame - the longest of which is 1 hour for calls initiated via 999 vs. vast swathes of the country who rely on helimed for their ALS cover , assuming of course the fire monkey volunteers are actually available to respond and provide BLS and prep an LZ

all suspected cancer referrals are seen within 14 days and 90 % + have had diagnostic tests completed within a month, similar figures are mandated for Cardiac sounding chest pain where emergency admission is not warranted in the opinion of the referring practitioner.

Source: http://prospect.org/cs/articles?arti...care_is_so_bad accessed 11/4/2007.

Each of these points addresses health care disparities that are driven through a poorly designed system. The full text of the article is available here: http://prospect.org/cs/articles?arti...care_is_so_bad .

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[quote=HM2Viking;2478335]From The American Prospect:
Indeed, we have brand new data. The Commonwealth Fund just released a broad survey collecting health care attitudes and experiences from patients in Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States. Here are summaries of some of the findings: 1. We spend the most. We spend more than any other country in the world. In 2005, our per capita -- so, per person -- spending was $6,697. The next highest in the study was Canada, at $3,326.


Reply by lamazeteacher
That Canadian figure includes medications, mental health care, home care and senior care as well as rehab hospital care.(They don't give their equipment to individiuals to take home after, e.g. knee surgery, as the cost is far less by keeping them in a rehab facility with multiple patients using the same equipment - monitored for correct use, without increased incidence of nosocomial infection, as post op wounds are monitored several times a day by IC)

And remember -- that's "mean" spending, so it's the amount we spend divided by our population. But unlike in Canada, about 16 percent of our population doesn't have insurance, and so often can't use the system. These facts should set the stage for all numbers that come after: Every time you see a data point in which were dead last, or not leading the pack,
remember that we spend twice as much as any of our competitors.


Reply by lamazeteacher
The figure I read last in the newspaper in Nov08, was over 30% uninsured, (? increase due to higher unemployment figures?) or could have Medicare (I found that out when folks over 65 came to multiple public flu shot clinics I staffed for over 5 years - they wanted no trace of their existance by the government).


2. We don't pay doctors according to the quality of their care.
3. Our wait times are low because many of us aren't getting care at all.
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Reply by lamazeteacher

Oh please (nothing personal here)! We pay doctors for quality of care, or (hopefully) QI and IC committees look into their suitability for being on staff of their hospitals; and we are more likely to sue them for negligence here, which results in exhorbitant malpractise premiums, which results in huge fees, doctors earning over $1,000,000 per year, and bills that are runinous for unemployed/underinsured individuals, and our doctors boasting of their incomes in front of doctors from other countries. The result of that, is that those non USA doctors return to their countries demanding more money, which if granted causes depletion of health care funding.
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In just the past year, a full 25 percent of us didn't visit the doctor when sick because we couldn't afford it.

Reply by Lamazeteacher

It pays (literally) to explain in public education programs, on TV when, where, why, and what symptoms require medical and/or nursing intervention. For example: Many people have no idea that anemia can occur after taking even a small quantity of ibuprophen,which causes gastric hemorrhage in some, and what the sx of it are. All of us have seen children and infants wrapped to the ears and head in thick blankets, while having fevers over 102.
Most patients don't look at their poop and have no idea what melena can mean........
What I mean is, early treatment for chronic diseases or acute infections circumvents hospital / doctor visits.


-three percent skipped a test, treatment, or follow-up recommended by a doctor. Another 23 percent didn't fill a prescription.


Reply by Lamazeteacher


In Los Angeles in the mid-sixties, Dr. Barbara Korsch, a pediatrician at Children's Hospital there, led a study called "Doctor-Patient Communication", (I was a researsh assistant for her), in which 1,000s of lower, middle, and wealthy parent(s) (I dislike calling them "high class") parent(s) were interviewed before, taperecorded during, interviewed immediately after taking their acutely ill children to their doctor. They all also received a home visit by the nurse-interviewer 2-3 weeks after that office/clinic/ED visit.


Then the researchers listened to the "tape" recordings which evidenced overwhelmingly that miscommunication occurred, with either the doctor and parent(s) talking at the same time, or understanding was assumed, despite language difficulties (interpreters were used). We howled laughing upon hearing some tapes that were reminiscent of vaudeville comics.

The conclusion was that when patients come to the doctor with their own ideas about what is wrong with them, and what treatment the doctor was likely to give (which almost all of us do); and the doctor takes a different tack, (e.g. like ordering decongestants or anti-allergy medications instead of expected antibiotics), we become antagonistic and noncompliant - even with our sick babies!
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No other country is even close to this sort of income-based rationing.


Reply by Lamazeteacher (not in "bold")


4. Most of us don't have a regular physician. - we lose trust in them if they don't make a good case for their disagreement with our expectations, in words we understand.

5. Our care isn't particularly convenient.- we go to friends' doctors, rather than those recommended by professionals (only on TV are MD home visits done, which could influence expectations among the medically naive


6. Our doctors don't listen to us. FOR SURE - MUTUAL DISTRUST exists, born of different schools of thought (not everyone understands medical terms).

7. We have high rates of chronic conditions. increasing rates? I don't think that's economically driven....except for genetic (many would benefit from genetic counselling before pregnancy occurs(lost after the '70s);and exacerbations of some chronic conditions can be due to financial stress

8. … But we're not treating them properly. - unless their expectations, needs, and capabilities are considered/factored in.

9. We're frequent victims of medical, medication, and lab errors.
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Reply by lamazeteacher

This can be corrected by carefully spoken (not hurriedly) and legibly written instructions, (which a nurse goes over with patients and checks lab slips) for patients and considers their state of anxiety, calling the next day to follow up (using their language or level of understanding/education). No matter how perceptive, intelligent, etc., patients' comprehension is diminished by anxiety, crying or otherwise distracting others, and yes, financial worries about medical costs.

10. Most of us are dissatisfied with our current system.

Reply by lamazeteacher

When lack of understanding and distrust issues exist, satisfaction goes out the window.
The distribution of sample meds is poorly done, as some patients feel insulted that the doctor would think they're not capable of getting them themselves (needs to explain that after diagnostic tests reveal a different need, medication might need to change and it's necessary to avoid waste.
Physicians, PAs and NPs need increased, current awareness of access to med programs for economically challenged patients, to refer them for lower cost meds, giving them samples for the time intervening (possibly a month).
I've begged for the highest priced med samples I'm prescribed, only to be blatantly told by the provider (a PA) that he takes them himself! Grrrr (and to make matters worse, he was a new employee where I had been the Employee Health Nurse, and when I was asked to pass him as having had a negative drug test - even though he "found it inconvenient", and didn't have one. I refused to sign him off, and I was terminated, since his spouse is a physician. They make more than I could ever hope to have! Yet he needs samples of his med?????)

Liberals embrace change; conservatives want everything to stay as it was, and don't recognize the need for change. Therefore liberal thought and action catalyzes conservatives recognition of the need for change. (illustrating an angry conservative beeing kicked by a positive, cheerful liberal)

actually there is only one number one reason


As a nation, outside of giving lip service to the problem.

"We Do Not Care"

America's Looming Health Care Disaster

Rising Unemployment Threatens Health Care of Even Those Who Keep Their Jobs

http://abcnews.go.com/Health/SmallBi...6309491&page=1

Ever notice how in these threads the only ones who cite their sources and prove what they claim are the ones who are supporting UHC? It's the neo-cons and Ayn Rand bots who claim a bunch of ridiculous hyperbole and scare-mongering, and contribute a grand total of zero to the debate. (by the way, citing a website called 'laughatliberals' has got to be one of the most laughably terrible attempts at proving a point that I have ever seen, and I'm INCLUDING the dumb arguments I've seen on the internet).

I'm glad you types are becoming increasingly irrelevant. I hope I live to see the demise of your failed ideology. Have a great day!