HEALTH CARE IN THE US
IS IT GOOD AND CAN IT BE IMPROVED?



(to be added to, but adequate overall to make the point and add thinking, facts)
CONTENTS

Generally believed:  US 37th
Looking deeper and being more factual: US is top
Analysis and facts summaries
The Cuba assertion
    _____________________________________________________________


GENERALLY BELIEVED:   Not so good, 37th in the world

This conclusion is another example of lack of deeper thinking and an example of  Unwarranted.Conclusions.


LOOKING DEEPER AND BEING MORE FACTUAL

Highest normalized (for accidents, homicides) life expectancy  US Looks Good 
Higher survival rates for cancer patients in the U.S. compared with other developed countries US Vs. Europe


ANALYSIS AND FACTS SUMMARIES

FACTORS AFFECTING THE FACTORS

Life expectancy (when normalized and adjusted, it's the highest among the OECD countries)

Items outside of the control of the medical care system:
    American diet - The American culture is hazardous to our health.  And, as it is exported, life
        expectancies elsewhere decline
    Fatal accidents and homicides - Just adjusted out the higher rates here causes a normalized life
         expectancy to rise above that of any OECD country.  US Looks Good
    Entry of illegal immigrants who have a lower life expectancy and higher poverty rates
    How the rates are determined - US reports more infant deaths as it uses a more inclusive
        categorization, where other countries do not.  (many "infant mortality" cases in the US are counted
         as "stillbirths" in most of the world, as those countries choose not to engage in expensive heroic
         efforts to save premies and other very sick infants.)

Medical research

Over half of the world’s spending on medical research is in the US.

Higher costs

The higher demands of the US public for services (vs. controlled systems restrict access, do rationing)
Input costs:
    Physicians earn alot more, due to competitive rates in this advanced economy
    Drugs are not more expensive on average, despite selective examples of advocates

Responsiveness

Only 4 percent of the American seniors reported long waits for serious surgery. The rate was 11 percent in Canada and 13 percent in Britain. For non-serious surgery the differences were more obvious: 7 percent in the United States, 40 percent in Canada, and 51 percent in Britain.  Ranking The US Health Care System.


Medicine As A Business: The Diagnosis, The Cure

Cost of health care: 

Residents of other OECD (developed) countries might spend more on health care if their governments allowed them to do so.
Drug prices are not actually too high in US, on average.




THE CUBA ASSERTION

Excellent focus on primary care at critical times, but abominable availability of services.  Cheap doctors and a good supply of them.  Preventive care.  But not superior to US by any stretch of the facts. 

CUBA IS SUPERIOR TO US - REALLY?

Cuba is ranked 39th by WHO compared to 37th for the US, with a cost 4% of that of the US.  (Doesn't that last number suggest that there must be something amiss?  For 4% does it make sense you can get better health care?)

Maybe if our watchdog media repeats this laughable lie often enough it will become true. Health Care In Cuba
Although Cuba has achieved free access to healthcare for 100% of the population, the means by which health professionals have to diagnose and treat the Cuban population is minimal and still not adequate.  Most information on Cuba’s health care system is often unreliable and reliant on anecdotal evidence. Challenges Of Health Care In Cuba.

Average Cubans suffer long waits at government hospitals, while many services and technologies are available only to the Cuban party elite and foreign "health tourists" who pay with hard currency.  Moreover, access to such rudimentary medicines as antibiotics and Aspirin can be limited, and there are reports that citizens excluded from the foreign-only hospitals often must bring their own bed sheets and blankets while in care.

"Even if I diagnosed something simple like bronchitis...  I couldn't write a prescription for antibiotics because there were none."

See False View Of Cuba's Health System.   

Sanjay Gupta: 
Technologies are available in certain place in the world, but you can't import them here.

Injured man on beach: The young man turned out to be all right, but that ambulance never came. But even if it did, the question remains. In a system with scarce resources, could this man have gotten the treatment he needed? It's also part of the reality Cubans face every day.

I hear stories about Cuban doctors who also have to take jobs, side jobs, in order to make ends meet because they're not getting paid enough. True?

ESTEVEZ: Yes, it's true.

GUPTA: Does that -- does that make it hard to actually incentivize people to go into medicine?

When Jose Luis Cabrera had coronary by-pass surgery after a heart attack five years ago, his wife had to bring food and clean sheets to him in the hospital. The operation itself didn’t cost the Cuban couple a cent.

an underlying problem is a health care system that also favors the rich, without providing adequate care for Cuba’s poor.

Strengths of system:  What is now known as the primary health care(PHC) model in Cuba is based on targeting at-risk groups, including pregnant women, children and the elderly.  


THE QUESTION OF THE UNINSURED

The uninsured should not delay screenings and treatments, though current resources are backlogged so  that you may need to wait longer for an appointment than if you were privately insured.  See A Survival Guide For The Uninsured

Care is available, but there must be vastly greater education to assure that all avail it.

Many are eligible for some form of public health insurance but do not take advantage of it.
21 percent on the uninsured are immigrants.  Factcheck.org 
Delaying care for fear of medical bills causes higher health care cost for all of us.
20% Of the uninsured have family incomes of greater than $75,000 (1999) Factcheck.org

Recommendations:

Increase public health clinics funding so that more people know of availability.
Provide a "cheap care" alternative, where preventive care but no luxury care (we'd have to list those items), as it is the extra expensive care options that Americans often demand which drive up alot of the cost.

Making The World A Better Place Contents/Links 

Observations Related To My Medical Care 


Since about 90% of office visits are due to self-induced health problems, the insurance rates should be greater for those who keep on being unhealthy - people should pay for costs they cause, out of basic responsibility.  Start with a higher rate for everyone but with reductions for those who maintain higher health standards:  a lower BMI, breaking at 30 and then again at 25; lower blood pressure, breaking at 140/90 and 120/80.