This spun off of the "Are taxes theft?" (paraphrase) strand

Are national health care plans failing or working. I am relatively ignorant on this matter, but I see the plans put in place around the world (France, UK, Canada, and even Russia I believe) I hear good things from people in Canada and I know that our drugs generally cost less in these countries than they do here at home.

When assessing a program use evidence to support your claim that National Health Care is working or failing where it is being implemented.

The British NHS is suffering from poor management, ever-increasing public expectations, and chronic underfunding, (the last due mostly due to lack of political commitment).

Yet even in it's current state, I understand that it is the most efficient health system in the developed world on a value for money basis - based on clinical outcomes versus money spent on it.

By the same measures, the US system, taken as a whole (i.e. taking all of the people who can't afford to use it), is one of the least efficient - the USA spends a very high proportion of GDP on health yet has rather worse infant mortality, life expectancy, and other indicators of health than most of Europe.

Some of that is due to lifestyle, of course - we Anglo Saxons do like to work ourselves too hard then gorge ourselves on comfort food to ameliorate our stress. I reckon the French have a better beat than either of our countries, lifestyle-wise.

Their rate of productivity increase over the long term rivals that of the US (and makes the Brits look like knuckle-draggers), yet they choose to use their efficiency to work a MAXIMUM of 35 hours per week, rather than get over 60 like we're doing. They may be arrogant, but in this at least perhaps they have reason to be.

Here are some links to World Health organization statistics. I think they reveal that the United States has a more inefficient and ineffective system of health care than France (is Victoryland more appropriate or do they get to keep their country name over there? )

USA

France

Edited to add an informative link about other systems.
How Other Countries Do It
Amended once again to connect this to the EU's Maastricht Treaty and how that affects European Union nations
European Parliament Fact Sheets

I was under the impression that the US spent only 7% of its GDP on health care, while it spends 14% on military spending. I would harly call that 7% a "high proportion" considering Finland and Denmark spend on healthcare what we spend on defense, and have some of the best healthcare available.

The British system has major problems, but I am of the opinion thats because its constantly recieving cuts. It was at its best before Thatcher, when they spent 12% of their budget on NHS.

Actually the US has a very effective system, excepts its only for those who can afford it. The major drawback of a national healthcare system is that there are generally waiting periods, which is unfortunate, but I do think that its less serious if the program was funded properly. Canada and the UK are prime examples where the waiting lists are dangerous> But I still tend to think that a national healthcare system is the way to go, because everyone needs healthcare, and done properly (I hardly hear the French complain, nor the Swedes [who provide free healthcare for everyone under 20]) it would benefit society.

Actually, The United States spends more BY FAR on health care than any other country in the world.
healthcare costs world wide

Those are per capita costs, so they encompass everyone, to include the indigent. America spends 4271 as compared to the United Kingdom's 1675 (in US 1999 dollars).
Finland and Denmark don't come close to our healthcare expenditures, which are 1704 and 2785 respectively.

....So what youre saying is that all those other countries have a more efficient system AND spend less than we do on healthcare? OK, so why dont we have a national health program? (I actually did tons of research on all this stuff last year for a thread in this very forum[!], and found the same conclusions that if there was a national health system it would be less for everyone...)

While we spend more per capita, we still spend less in percentages, which I think has more relevance because we cant compare our budgets in dollars and population to other countries. Of course Canada has a smaller budget and population, but they spend more of their budget on healthcare than we do, allowing for all their citizens to have care. Saying we spend more per capita, I think, distots the numbers to making it seem like we are doing more, when we arent.

Another thing I think may have a factor in why we spend so much more than other countries, per capita, is because our health services and medicine tend to cost more than in countries with socialized healtcare.

Kim I think the disparity here is that on your figures you're comparing state spending on healthcare, which is indeed very low for the USA compared to the rest of the developed world.

However, as Mrs P points out, your overall health spending (public + private) is about the highest in the world, with health outcomes that are only comparable, if not poorer, with the develop world averages. Half the population doesn't get any healthcare, while the other half pays a fortune for it. The costs art so high because of factors like the huge numbers of tests and treatments the US medical establishment carries out is more driven by fear of litigation than clinical need; and the "leisurization" of healthcare to include recreational plastic surgery, self-perpetuating psychotherapy, and so on. The rest of the world seems able to survive and thrive without such things.

Most of the problems with the NHS are less dure to outright cuts by the Tories (much as I would like to imagine they were, being a partisan Labour supporter ), and more due to just failing to keep up with the high rates of medical cost inflation, and increases in patient expectations caused by new medical advances (e.g. transplant surgery, IVF, disagnostic scanners, anti-cancer treatments, and so on). Over time, the burden on NHS resources became progressive greater, stretching them further. Current overall spending levels are more comparable to the USA (overall), but it's all going on the public sector. It might be too little too late, and it might not be well directed, but few here think it's a bad idea in itself.

Well, in a word.... Yes. Scary isn't it?


IMO Letting the government take over isn't necessarily the answer. I have never seen a problem for which added bureaucracy posed a solution. Perhaps we should look at the reasons behind the ridiculously high costs and find a more efficient alternative?

Thats your opinion, while I happen to think a national health system is a more efficient alternative. As for added bureaucracy, do you think that we should get rid of insurance companies for that same reason? Let's face it, regardless of who it is, there will always be an unnecessary amount of crap to fill out and deal with in the medical field (and in some cases rightfully so, as to prevent abuse of the system).

I would disagree with you here. We should not accept unnecessary crap for the very reason it is unnecessary crap.

We do not need to ban insurance companies. However, the opposite, such as proposals to mandate insurance, would be taking away choice. Insurance should be a commodity like anything and be subject to competition. Competition in a marketplace is the best way to improve service, quality, and price. Insurance is not the only pay to pay for health care. People should have the right to pay for health care in whatever manner they choose.

If that were true, the most efficient type of health insurance would be the government run Tricare program. That is the military health insurance used for coverage in civilian hospitals. It is the very worst health insurance available, and many doctors have discontinued accepting tricare patients.

When I look at all the statistics via the links and within this debate, I am unable to draw any conclusions. There are too many variables between countries such as level of health care desired (demand variables), cost to individuals via various programs (supply variables), and other factors such as how much time it takes to receive health care(demand variable), which are not listed at all.

It would be better to compare health care delivery systems within a population to compare systems. If one person is exposed to various systems and give a testimonial, this would mean more to me, though even this could hide factors such as cost.

Mrs. Pigpen's testimonial on Tricare is valuable due to her personal exposure to various health care systems.

I only have my life experiences to compare health care. I am not impressed with our health care system compared to other services. I have no direct contact with National Health Care system within our country. Indirectly, my father will not touch his Veteran Health Benefits with a ten foot pole. I see the effect of government health care programs on health businesses I contact and it does not look good. Health care is slow, inefficient, poor at educating its clients so they can make practical decisions, and more concerned with appearances than providing cost effect medical care. How much of this can be attributed to National Health Care system is debateable. I believe it is contributing to "unnecessary crap" to quote a famous American.

Perhaps someone can use the statistics to show evidence National Health Care system are working well but so far I have not seen it. I guess I can not show evidence it is failing, either. All I can offer is my empirical observations.

Some interesting evidence to look at would be the cost of health care for animals versus humans. Health cost for animals is much less than for humans for similar services. That evidence shows the efficiency and cost for animals is much better by a wide margin. Life expectancy for pets is on the increase. Perhaps comparing the health delivery system for animals versus National Health Care might contain some of the evidence being sought.

Thw WHO in fact does a survey throughout all industrialized countries asking who is most satisfiedwith their healthcare system, along with another survey of services, workers, availibility etc. Im not sure if there are personal testimonies. Although I dont know if any of you will accept comparisons from outside the US. I will look up the info again.

Obviously the US healthcare system, public or private is sub-par, but just because it doenst work here RIGHT NOW, does not mean it will never work. If we improved upon the current system, and provided more funding, I dont see why national health service is not a viable option.




It seems I worded myself rather badly, I didnt mean that we should put up with unnecessary crap (even though I know thats what I wrote), but meant that regardless of what system is implemented (except for the old fashioned "pay the doctor" at the time of visit, sans insurance and government regulation) there will always be forms to fill out and rules to follow, which take up time and cause a hassle.

Link the WHO (PDF file) comparing the health care systems of the industrialized nations, mostly based on public opinion.
http://www.who.int/health-systems-performa.../ha_blendon.pdf

When I find some more links, I will post them here.

This does provide some information but still nothing which is conclusive. To exaggerate my point, let us say we wanted to find the best baseball game in the world. We went to various ballparks throughout the united States, Japan, Central America and asked the fans at each park how satisfied they were with their ballpark and the baseball games there. People were asked how clean the ballparks were? How good was the food and how were their prices of the food? Was it easy to get in and out from the ballpark? Did the players have fun? Did the fans have fun? From this report, the highest ranked ballpark in overall satisfaction was a Khoury League in west Arkansas. Does this mean all people should be watching Khoury League baseball and get rid of the adults playing baseball? Does this mean all baseball should be supported by the selling of candy? It would be difficult to make any specific conclusions from such a report.

It is an exaggeration but my point is that you will have a hard time comparing health care systems between one group and another when those groups have not had someway to compare their experiences.

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You have done an excellent job in describing in a succinct and direct manner up one of the major problems with National Health Care systems and also given an example of a means to solve it. I would challenge everyone to build a health care system based on this model without the unnecessary crap and provide people access to basic health care via this system.

Please do not dismiss off hand such an attempt as impossible. The truth in the simplicity of Kimpossible's statement is the means to indentifying how best to provide the opportunity for basic health care, a goal we all share.

Heres the other link that I used for information, although I think it may be slightly dated (by a few years):
http://www.who.int/whr2001/2001/archives/2.../statistics.htm

Working in the health care field, and public health at that, I have had the last 15 years of dealing with our system, and having dealt with European health care and Russian health care, I have had some time to come to some very strong opinions about American health care. I have also been a trustee on a union health care trust. Pure and simple, Amercians suck at health care! LOL

The main issue, and really the only issue outside of the actual management of health care, is "is the profit motive and good quality health care for the entire country mutually exclusive"- to which I would say a resonding "yes". The mission of a health care practisioner and the for profit management of same are mutually exclusive, profit has no business being in the health care sector. In order to get profit in the health care sector you HAVE to have completely un-ethical and immoral practises. Excluding care that someone has bought insurance for just in the hopes they will die before the appeal is done etc.

If I were made emperor tomorow, I would probably jail every board member of every drug company in America, all the officers of the AMA , every board member of every health care insurance company and every officer of the hospital accredidation agencies (JACHO etc) for murder, because, quite frankly, that is what they are. The wrong doing by these poeple are too long to list. They literally allow poeple to die so they can monopolize and lord over thier own fiefdoms. I have seen this with my own eyes, from frivolous patent extensions on life saving drugs (the national office of my union is actually sueing some drug companies over this now) to the intentional lowering the number of doctors by the AMA to keep thier salaries high, our system is completely unethical and immoral.

I read Hillary Clintons health care proposal front to back when it was given to me back when she proposed it. It was a giant step in the right direction. Because of insurance and drug companies and the AMA would lose considerable power and money over this plan, she was pilloried for it. It wasn't a perfect plan, but FAR FAR FAR better than the system we have now!