Presidential Race and National Health

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An article on the news caught my attention last night. Rudolph Giuliani, having recovered from prostate cancer, was proclaiming how good the American (private) health service was, and slamming the British National Health service.

Now I understand that a national health service is a bit of a hot potato for Americans, but Giuliani is claiming he had a 82% chance of recovery in the US, compared to only a 44% chance on the UK NHS - presumably in order to back the Republican position. I am sure there are many ways of attacking the idea of a national health service, but straight-faced lies is a bit much - the official UK recovery figure is actually at 75%. Even having been told this, Giuliani is refusing to chance his numbers.

Some interesting figures also given on the news bulletin:

As it happens, about 50% of amercian medical center/hospital costs are centrally funded - i.e. through the Amercian tax-payer. Can anybody corroborate this?

Also, 45 million Americans don't have health insurance - much higher than i had imagined.

I also found this quote from the telegraph online:

http://www.telegraph.co.uk/global/main.jhtml?xml=/global/2007/11/01/american-culture.xml

Oops.

Mind you, Mitt Romney also had an interesting take on things. Apparently any nation with a national health service is a second tier nation with no power in world affairs. Way to start alienating people folks.

 

I do not know one way or the other whether 50% of hospitals are centrally funded or not, so I can't give you an answer there.

The number of uninsured Americans varies depending on where you look, but I have consistently seen numbers of around 40 million, so the number you presented of 45 million doesn't seem far fethced to me. A good chunk of the uninsured Americans are children (their parents don't have jobs that provide health insurance, so neither they, nor their parents have health insurance).

That Bush and Giuliani both believe that the U.S. has to best health care system in the world - that doesn't surprise me at all. They both think the U.S. is the best irrespective of the criteria - and who really cares about the research anyway?

To be fair, as far as Giuliani and Bush are concerned - their statements are factual. If you are wealthy or have good health insurance, you can go to the best hospitals and see the best doctors. I'm sure Giuliani went to the hospital with the best prostate cancer treatments in the country. If you don't have health care insurance, or have some not-so-great HMO, you may be forced to go the cheap route. HMOs require you to pick a doctor from a list, and if the list of doctors doesn't happen to include anyone particularly proficient in given area of experitse, tough luck.

I guess all I'm saying is that for the average American, the U.S. does not have one of the best health care systems in the world, but for the rich, we've got to be close to the top.

 

I'm not sure I agree with this statement. There are plenty of working people who have health insurance and have access to a terrific health care system. Now I can't speak for the rest of the country, but living near Boston, I have access to some of the top physicians and specialists in the world.

We also have laws that prohibit hospitals from refusing care based on lack of insurance. Of course, this is what is killing our inner city hospitals as the poor use emergency rooms and hospitals for everything as they won't have to pay.

I agree the "working poor" are probably screwed, but to simplify our system and say it is only great for the rich is "class envy" in my opinion.

 

Incorrect. The law prohibits the refusal of emergency care, which is not the same thing at all.

 

Not only that, but the law doesn't stop hospitals from billing you for it. Sure, the hospital will help you after the three car pileup leaves you in critical condition and in need of 100K worth of medical care, but that doesn't mean you won't have to declare bankruptcy after they release you.

 

Exactly - you live near Boston - you have access to some of the top doctors in the world. If you lived in the back woods of West Virginia, things would be different. However, if you were rich and living in the backwoods of West Virginia, you'd hop a plane and travel to Boston or New York for treatment.

 

But wouldn't this be true in any system and any location? If the best heart surgeon in the world is in Paris and you are sick in Berlin you are just as screwed.

 

Snook, by your own admission, a homeless man or an impoverished family in Boston isn't going to have access to the great medicine to which you have access. To some of us, how we take care of our poor is more important than how we take care of the wealthy, and that makes our medical system a dismal failure.

The arguments against socializing medicine are silly, in my opinion. Cited as reasons to not give everyone medical care is the fact that wait times to see specialists and get certain advanced treatments will go up....that the system will be spread too thin. Right on it's face, the problems with this type of argument are obvious. Of course wait times will go up if everyone who needs to see a Doctor sees one! That much is obvious. What should also be obvious, though, is that denying people medical care is not going to solve the problem. That would be like solving world hunger by denying people food. Localizing a problem or restricting it to only a select group is not the same thing as actually solving it.

 

I believe people like Bush and Giulani confuse 'best health care system' and 'best medical professionals'. The US has managed to attract a large portion of the best doctors from around the world. Money does that. In America, the best can command a premium price for their services.

Quite often, the 'best money can buy' means exactly that. Only those who can afford the treatment are even allowed in the offices of these specialists. There are a few notible exceptions (such as St. Jude's Children's Hospital), but for the most part the best physicians are associated with the best hospitals.

Mediocre physicians are far too common in low income areas. Hospitals in inner cities are almost like war zones -- and it's quite difficult to keep good physicians there. Compounding this problem is the lack of a good background check agency for doctors. We read nearly every day of a substandard doctor who gets in trouble in one area, only to move to another -- typically the low income patients are the victims.

 

Especially since they often refer to cost, never mind that the US' system is one the most cost inefficient in the developed world.

 

Ironic, isn't it? Efficiency is supposed to be the reason we usually opt for market solutions, for crying out loud. If they end up as efficient as state-subsidized options, or even less so, then they are doing more harm then good. People's health and lives is a field where imo it doesn't pay to choose suboptimal solutions.

 

I don't understand what you mean. If you're poor, you have to accept whatever is available, and sometimes receive no care at all. In the example you site, if the person from Berlin is wealthy, he'll hop of plane or a train to Paris and get treated by the best.