Ten Reasons Why American Health Care Is so Bad

Nurses Activism

Published

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. 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.

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.

...

in just the past year, a full 25 percent of us didn't visit the doctor when sick because we couldn't afford it. twenty-three percent skipped a test, treatment, or follow-up recommended by a doctor. another 23 percent didn't fill a prescription. no other country is even close to this sort of income-based rationing.

...

4. most of us don't have a regular physician.

5. our care isn't particularly convenient.

6. our doctors don't listen to us.

7. we have high rates of chronic conditions.

8. ... but we're not treating them properly.

9. we're frequent victims of medical, medication, and lab errors.

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

source: http://prospect.org/cs/articles?article=ten_reasons_why_american_health_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?article=ten_reasons_why_american_health_care_is_so_bad .

Specializes in Community, OB, Nursery.

Friendly moderator note:

Obviously there are some strong feelings here on both sides, and guess what? I am no exception (news flash there). However, strong feelings do not need to parlay themselves into insults of those on the other side of the fence. This thread was brought to my attention by a member who felt things were starting to get out of hand.

In this thread there will be no attacking, insulting, nor name-calling on either side. We like to keep things nice around here. If you are upset by something someone says here, please report it rather than engage that poster. We will deal with it. If you have to walk away from the computer and count to 1000 before you post, then please do so. It's not worth ruining your good standing to post while angry. I have learned that lesson the hard way myself.

Thanks.

American health care is the best in the world. America doesn't have a health care provision problem. We have a health care FINANCING problem.

There IS a difference.

And.

It's a big one.

~faith,

Timothy.

Hmm, I think Timothy hit it on the head. We have to separate the issues. I will agree that the 'Care' can be quite outstanding.

Of course 'outstanding' care is irrelevant if no one can afford it...

Hmm, I think Timothy hit it on the head. We have to separate the issues. I will agree that the 'Care' can be quite outstanding.

Of course 'outstanding' care is irrelevant if no one can afford it...

This is exactly the point. There has to be a middle ground somewhere, where we can retain the standard of care we do provide, yet actually be able to provide it to people who often need it most. Having the nicest stuff is great, but at the same time, given our rankings worldwide with regard to life expectancy etc, it certainly isn't everything.

Specializes in Spinal Cord injuries, Emergency+EMS.
That was not a very nice post, and I cannot see that it added anything to the topic.

and your post did ?

it's a valid point that the people more likely to support their posts with credible references are those arguing that the US system is broken

Specializes in Critical care, tele, Medical-Surgical.

[color=#333333]breathing new life into health care

[color=#333333]here is a number easily understood by even the math-phobic: every 1 percent increase in the unemployment rate leads to another 1.1 million americans becoming uninsured--and causes still another million more children and adults to become eligible for state health insurance coverage.

[color=#333333]this means that over the past 10 months, as the hemorrhage of jobs began to push the national unemployment rate toward its october level of 6.5 percent, about 3 million americans were thrown off the insurance rolls or had their incomes fall so much that they became eligible for medicaid or the state children's health insurance program. ...

[color=#333333]...though the clinton plan is consistently derided as a failure, in truth, president-elect barack obama's campaign pledge to build a universal system based on the current, employer-based method of delivering insurance is in good measure modeled upon it. and that is the problem....

[color=#333333]...tightening regulation of the insurance industry and creating a new, government-based plan to make coverage available to those who cannot afford to buy it from private insurers--the essence of obama's campaign proposal--would only add another layer of complexity and, eventually, cost. only a single, government-financed system can eliminate the administrative waste, unfairness and economic burden of our current health insurance scheme.

[color=#333333]timidity is no longer an option.

[color=#333333]http://www.truthdig.com/report/item/20081204_breathing_new_life_into_healthcare/

Care to explain this? Any of it? If a great many people lack access to the care, then it is a failed system, regardless of how 'good' it may be. Consider how we rank in comparison with other countries, with regards to our quality of life, and where we rank in how much we spend per capita.
We also figure statistics differently than do other countries--if you think there is a commonly accepted system you are wrong.

For example, in the US, a premie is going to get everything available to resuscitate, support and heal. If the baby dies, it is a neonatal death.

In many other countries, that is not counted as a neonatal death.

So defining the "goodness" of our system compared to someone else's is not going to happen with any kind of surety.

Watch "Sicko" and then read the reviews and posts of fact checkers. Moore makes some good points, but he is no scientist, he controlled for nothing, he cherry-picked sad cases and made them out to be illustrative of the entire system, and he slanted the reports of health care in other countries to support his contentions (and maybe to sell more movies, who knows).

France is supposed to have the best and most available, and about 6 weeks ago or so, the news broke that their system is bankrupt. You cannot get something for nothing, someone has to pay for it.

If we were as cautious with our healthcare spending as we are with, say buying homes, cars and groceries (well, as some of us are), we could probably see a decrease in health care costs because it would bring some competition to the market.

I can give you a personal example. Less than a year ago, there was an "irregularity" on my mammogram. I was scheduled for a stereo-something or other biopsy, which involved a radiologist, x-rays during the placement of the probe, collection of the tissue at the site via needle biopsy (looked to be an 8 guage!), mammograms before, during and after to be certain the right place had been biopsied, and pathologist's exam of the tissue. My breast surgeon just referred us to where she normally sends her patients.

Thank God they called to let us know what our out of pocket would be! Nearly $5,000! I was more upset about that then I was the possibility that I had breast cancer!

I decided there had to be more than one place to get this done, and through talking with various and sundry people (the most helpful were also the most paranoid--they whispered and didn't want their names attached to the information), I learned of what turned out to be the best place in Dallas. I checked references, read up on the the doc, was very impressed, even before I went to see her.

The out of pocket? just over $1,100. The difference? Gee, I dunno, profit margin?

My point is, we are not savvy consumers. If we have insurance, we don't care, the insurance is paying for it. We go like lemmings wherever we are sent, and we never question about quality, cost, nothing.

It comes back to us (one way or another). We can be responsible fiscally, or we can pay more (and therefore afford less).

For myself, my personal attack on this problem is preparation toward my MSN/FNP. I'm opening a nurse run clinic with another FNP and two RN's. You can bet we will be much less pricey than the MD's down the street, and we won't be sending just anyone for admission to hospital.

I had a patient last week who was admitted for an MRI. She was there three days. We did nothing other than cover her diabetes with insulin and give her pain meds. Nothing. Medicare (aka, you and I) paid for that stay.

Anyway, that's the point I want to make.

And if care is bad, then stand up and say so!!! A bad car dealer, a bad grocer, a bad plumber, soon go out of business. Bad docs and bad hospitals need that same kind of check.

Simple.

Specializes in Critical care, tele, Medical-Surgical.

Is there a link or source for the French system being bankrupt?

I looked but couldn't find it.

I did find these articles:

http://healthcare-economist.com/2008/04/14/health-care-around-the-world-france/

http://www.businessweek.com/magazine/content/07_28/b4042070.htm

Specializes in Critical care, tele, Medical-Surgical.

[color=#a6192c]nurses reject ahip proposal as a "marshall plan for health insurers"

as stocks fall, insurance corporations look for backdoor bailout--

guaranteed customers and revenue

the nation's largest organization of registered nurses today rejected the new to healthcare reform proposal by america's health insurance plans as a "marshall plan for the health insurance industry."...

..."how ironic for ahip to call for a 30 percent cut, the same percentage of every healthcare dollar that is sliced off the top for insurance profits and administration, much of the latter devoted to denying care claims for insured patients. there's a much faster, more effective, less bureaucratic way to achieve that 30 percent cut - expand and improve medicare to cover all americans and eliminate the insurance industry bureaucracy and control over our health."

http://www.calnurses.org/media-center/press-releases/2008/december/nurses-reject-ahip-proposal-as-a-marshall-plan-for-health-insurers.html?print=t

Is there a link or source for the French system being bankrupt?

I looked but couldn't find it.

I did find these articles:

http://healthcare-economist.com/2008/04/14/health-care-around-the-world-france/

http://www.businessweek.com/magazine/content/07_28/b4042070.htm

I've spent some time googling and although I uncovered a lot about the frustrations of providers bailing out of the state program because reimbursement is low, I could not find the article about financial desperation.

I read it, on Yahoo. I know this because we discussed it in our policy class, and others, including the professor, had also seen the article.

Normally I am happy to provide a cite if asked, but I've already devoted time I didn't have to the task, so you can just ignore my earlier post if proof is needed.

But you cannot deny the question, where is the money coming from? Health care is a huge part of France's budget every year and granted they aren't spending much on defense, but still.....

Specializes in Critical care, tele, Medical-Surgical.
I've spent some time googling and although I uncovered a lot about the frustrations of providers bailing out of the state program because reimbursement is low, I could not find the article about financial desperation.

I read it, on Yahoo. I know this because we discussed it in our policy class, and others, including the professor, had also seen the article.

Normally I am happy to provide a cite if asked, but I've already devoted time I didn't have to the task, so you can just ignore my earlier post if proof is needed.

But you cannot deny the question, where is the money coming from? Health care is a huge part of France's budget every year and granted they aren't spending much on defense, but still.....

I'm not doubting you.

I was surprised not to find it.

Thought it may be in a source not available on line.

Or maybe Yahoo used the wrong word due to poor translation.

I'm not doubting you.

I was surprised not to find it.

Thought it may be in a source not available on line.

Or maybe Yahoo used the wrong word due to poor translation.

You may have a good point, the idea that Yahoo might have had a translation issue.

That would explain the inability to find the article, if it had been pulled or retracted or even corrected so that the standard googling would not find the original article....

And actually, although it is awfully nice of you to say, it's OK if you doubt me--I try to be dependable but even I (yes, even I) can be wrong sometimes. :smackingf

Take care,

Christine

Specializes in OB, HH, ADMIN, IC, ED, QI.
American health care is the best in the world. America doesn't have a health care provision problem. We have a health care FINANCING problem. There IS a difference. And. It's a big one.

Do physicians in other countries receive higher pay than in ours?

How many other countries have Health Insurance executives whose pay rates are higher than ours? Cut out the gouging that occurs in those 2 factors, and there would be no financing problems with our health care!

Have you seen any health care other than America's problem fraught one? Did you watch the movie "Sicko"?

How many countries other than third world ones, have a fetal morbidity and mortality rates as high as ours?

How many other countries have had the wrong body parts removed in surgery as we have?

How many countries have a medication error rate as high as ours?

Does our MRSA, Difficile, or other hospital acquired infection (HAI) rate approximate any other modern country's?

Do our Infection Control procedures and reporting compare well with that in other counties?

Do mental health and aging patient behavior conditions' coverage receive appropriate care that equals that given physical diseases?

Please substantiate your opinion with examples, as it appears to me that your chauvanistic attitude is based on brainwashing propaganda! :no:

I have worked in hospitals, infection control departments, employee health, home health, public health and nursing education in the USA and Canada, interviewed people in 26 countries around the world about their attitudes regarding their health care; and have seen first hand that the USA provides more inferior standards of care and has higher rates of noncompliance with the laws for healthcare providers than most "civilized" countries.

If we admitted the problems we have, we could improve healthcare provider performance here. As long as we sale euphorically along on your cloud of denial, we won't improve and more people will suffer and die unnecessarily.

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