Mortality and lack of health insurance

[cvictorg]

Science-Based Medicine

 

[Michael Scally MD]

Thanks for the link. However, their conclusion says is ALL!

The very term “science-based medicine” was chosen intentionally. Medicine itself is not a science. It can’t be. There are too many other factors that influence treatments, including patient preference, resource allocation, and level of skill of individual practitioners, to name just a few. Our central thesis is that medicine should be based on science and that the best health care is based on science. My purpose in writing this post was not to advocate for any specific solution to the problem of the uninsured, although people who know me know my politics and my position on the matter. Rather, it is to lay out the science studying the question of the relationship between health insurance status and health outcomes. While we do frequently say that correlation does not necessarily equal causation, in some cases the correlation is so tight that it strongly suggests causation. This is one such case. Given that there is no ethical way ever to do a randomized clinical trial in which people are randomly assigned to be insured or uninsured, much as is the case for examining health outcomes between vaccinated and unvaccinated children, we are forced to rely on observational and quasi-experimental data. Those data support the hypothesis that providing health insurance to as many people as possible is associated with better health outcomes and that lack of insurance is associated with poorer health outcomes. That is the science. When someone like Mitt Romney claims that no one ever dies from lack of insurance in the U.S., he is demonstrably wrong.

 

[james2012]

Thanks for the link. However, their conclusion says is ALL!

Oh good God please!!!! I have relatives, friends, blog followers in just about every Socialized medicine crap country you can think of. You want science. THIS is what every single doctor I have talked to is telling me we are heading. Not ONE SINGLE PRACTICING MD HAS SAID OTHERWISE. THIS IS WHAT WE ARE IN STORY FOR:

NHS death rates four times higher than US

Patients having major surgery in NHS hospitals face a much higher risk of dying than those in America, research has revealed.

Doctors found that people who have treatment here are four times more likely to die than US citizens undergoing similar operations.

The most seriously ill NHS patients were seven times more likely to die than their American counterparts.

Experts blame the British fatality figures on a shortage of specialists and lack of intensive care beds for post-operative recovery.

They also suggest that long waiting lists mean diseases are more advanced before they are treated.

Researchers from University College London and Columbia University, in New York, studied 1,000 surgery patients at the Mount Sinai Hospital, Manhattan, and compared them to nearly 1,100 people who had similar operations at the Queen Alexandra Hospital, in Portsmouth.

The results showed that just under ten per cent of British patients died in hospital afterwards compared to 2.5 per cent in America. Among the most seriously ill cases there was a seven-fold difference in the death rates.

The New York patients had paid for treatment through private medical insurance and were therefore likely to be "wealthier and healthier", whereas the NHS patients were from all social classes.

However, the study aimed to "iron out" these differences by rating each patient on their clinical status.

Portsmouth Hospitals NHS Trust is one of the largest in the country, providing acute and specialist care services for almost a million people throughout south-east Hampshire.

Professor Monty Mythen, head of anaesthesia at University College London and Great Ormond Street Hospital, said: "In America, after surgery, everyone would go into a critical care bed in a highly-monitored environment. That doesn't happen routinely in the UK.

"In the Manhattan hospital the care (after surgery) is delivered largely by a consultant surgeon and an anaesthetist.

"We know from other research that more than one third of those who die after a major operation in Britain are not seen by a similar consultant."

Prof Mythen said waiting lists in the NHS would "put patients at greater risk". He added: "We would be suspicious that the diseases would be more advanced simply because the waiting lists (in the UK) are longer."

The research is due to be published in medical journals later this year and is bound to reignite controversy over whether New Labour reforms in the NHS are having any impact on patient survival. Every year more than three million operations are carried out by the health service, including around 350,000 emergencies, which carry a higher risk of complications.

Nigel Duncan, spokesman for the British Medical Association, said: "The number of new doctors coming on line is far fewer than was predicted by the Department of Health and far fewer than the NHS needs."

The Department of Health said it would be "inappropriate" to comment on the research before it was published.

If you are seriously ill you are fu*$ed. Got a cold, hey its great, they will even visit you at your house. Just Google where the politicians used to go - and will until ObamaCare screws everyone while taking down the economy - when they needed the best service with the best outcomes.

Give me a break. Like Climate Change, pay someone for a predetermined report and they will twist it. Those of us smart enough and connected enough know better. But a fool will believe what a fool will believe.

 

[Dr JIM]

Oh please the slippery slope has returned BS. Welcome to my world where people come to the ED by ambulance for "sob" because of a cold. ED availability is undeniable in any reasonably sized community in this country, access to and understanding the importance of preventive care (for some that would require a brain transplant) not.

The primary problem IMO Dr S is some folk develop complications" in spite of themselves because they don't stop drinking, smoking, OR begin treating their BP med or insulin as PRIORITY like FOOD! Simply put they don't give a shit, and are more than willing to go on SSI disability once complications occur.

Because for many LIFESTYLE is what is "killing people" and not necessarily absence of "health insurance. For example folks if YOU REALLY BELIEVE providing health insurance to a schizophrenic, drunk, over dosed, homeless, morbidly obese, smoker with COPD, will make a damn bit of difference in the "health" of this country, the government will have all your money shortly, LOL!

JIM

 

[james2012]

Future Of Obamacare: Ontario, Canada Medical System In Chaos

And don't get me wrong here - this is a rosy picture of ObamaCare. Canada has 30 million people in the entire country. We have 10 times that amount and a behemoth bureaucracy even heh Canadians are starting to look sideways at and wonder what the hell we are doing. Thank God for Canadian Free Press.

One last thing that I am going to research, although I can tell you right now what the outcome will be: TRT IT OUT FOR COVERAGE. Your read it. Given the ad blitz for low T, look for gels like Testim, which cost 300-600/month (5g or 10g - same with Androgel) to NOT be covered. I hope you have money cause you are going to be one your own.

If Obamacare is not repealed, one may only have to look to Ontario, Canada to see the future of healthcare in America. In the Canadian province, the government unilaterally imposed over $300 million in fee cuts to try to close a $15 billion deficit, which has led to physicians fighting with the government -- and their own medical association -- over payouts, fees, hours, and what exactly constitutes a proper and appropriate salary for physicians and specialists.

It is pure chaos where government randomly picks winners and losers.

As the National Post reports, Ontario’s doctors are taking the province to court to fight the $340-million in proposed fee cuts, and some doctors are considering setting up an outside collective bargaining organization to negotiate with the province, claiming that the current group (Ontario Medical Association) that represents them is selling them out to government negotiators. The Ontario government unilaterally imposed these cuts, picking winners and losers

The Ontario government, according to the report, commissioned studies from outside experts and have determined "certain physicians earn too much relative to others, partly because technological changes have made some procedures — like cataract operations — easier and faster to perform."

Meanwhile, Ontario specialists "targeted for fee cuts, however, counter that their income has risen chiefly because they received additional funding to shorten wait lists — meaning they are working harder and longer hours for the extra pay."

David Jacobs, a Toronto radiologist, feels the medical association is sacrificing specialists like radiologists and ophthalmologists.

“We feel that the government’s belligerence and bullying is being rewarded,” he told the Post. “It’s like asking someone with a knife sticking out of their chest if they wouldn’t mind donating blood.”

Many of the speciality groups have publicly expressed their dismay at the government and the medical association, while others have been afraid to comment because they fear the government or the association will retaliate against them.

Radiologists:

“We have not received a clear answer as to why the OMA is sacrificing the interests of a minority of its membership,” the Ontario Association of Radiolgoists says in a toughly worded position paper. “The OMA is not delivering on its duty of fair and equitable representation of radiologists and other similarly affected physicians.”

Cardiologists:

The cardiologists’ association is reserving judgment as fee talks with the Health Ministry play out, said Dr. Bill Hughes, the group’s president.
“If, two or three weeks from now, it appears a few [specialty] sections are really being run roughshod over, then I think you’ll hear voices about (OMA) representation,” said Dr. Hughes.


Ophthalmologists:

Dr. Nav Nijhawan, chair of the opthalmology section of the association, also hard hit by the cuts, declined to comment.

Not to be outdone, the medical association has launched a constitutional challenge against the Ontario government regarding the unilateral nature of the cuts. With all this infighting, patients end up being the biggest losers, and this chaos awaits Americans if Obamacare is not repealed.

 

[cvictorg]

U.S. Health in International Perspective: Shorter Lives, Poorer Health - Institute of Medicine
The United States is among the wealthiest nations in the world, but it is far from the healthiest. For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This health disadvantage prevails even though the U.S. spends far more per person on health care than any other nation. To gain a better understanding of this problem, the NIH asked the National Research Council and the IOM to investigate potential reasons for the U.S. health disadvantage and to assess its larger implications.

No single factor can fully explain the U.S. health disadvantage. It likely has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions. Without action to reverse current trends, the health of Americans will probably continue to fall behind that of people in other high-income countries. The tragedy is not that the U.S. is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.

http://www.pnhp.org/news/2013/january/us-health-in-international-perspective-shorter-lives-poorer-health

The panel's inquiry found multiple likely explanations for the U.S. health disadvantage:

* Health systems. Unlike its peer countries, the United States has a relatively large uninsured population and more limited access to primary care. Americans are more likely to find their health care inaccessible or unaffordable and to report lapses in the quality and safety of care outside of hospitals.

* Health behaviors. Although Americans are currently less likely to smoke and may drink alcohol less heavily than people in peer countries, they consume the most calories per person, have higher rates of drug abuse, are less likely to use seat belts, are involved in more traffic accidents that involve alcohol, and are more likely to use firearms in acts of violence.

* Social and economic conditions. Although the income of Americans is higher on average than in other countries, the United States also has higher levels of poverty (especially child poverty) and income inequality and lower rates of social mobility. Other countries are outpacing the United States in the education of young people, which also affects health. And Americans benefit less from safety net programs that can buffer the negative health effects of poverty and other social disadvantages.

* Physical environments. U.S. communities and the built environment are more likely than those in peer countries to be designed around automobiles, and this may discourage physical activity and contribute to obesity.

The tragedy is not that the United States is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary. Superior health outcomes in other nations show that Americans can also enjoy better health.

http://sites.nationalacademies.org/xpedio/groups/dbassesite/documents/we...

"U.S. Health in International Perspective: Shorter Lives, Poorer Health" - Full 405 page report can be downloaded for free at this link:
U.S. Health in International Perspective: Shorter Lives, Poorer Health

Comment:

By Don McCanne, M.D.

The United States is sick, literally and figuratively. We have the most expensive health care system, yet the worst health outcomes of the wealthier nations. The failures are not only with our health system but with much broader sociopolitical institutions.

In response to these glaring deficiencies, this NRC/IOM report places an emphasis on further research to better define the problem and identify interventions that would help. Research is fine, but we do not need to wait any longer when so many of the deficiencies our already in our face.

The brief paragraph above on health systems confirms the pressing need for an effective universal insurance system, along with an expansion of our primary care infrastructure. Enacting the PNHP single payer model would finally set us in the right direction toward a high-performance health care system.

The social and economic conditions, physical environments, and health behaviors demonstrate a crying need for much more effective sociopolitical public policies. Not only do we need a reinforcement of our public health system, we also need greater public action in education, community planning, and especially responsible government policies to correct the gut-wrenching social and economic injustices that permeate our society.

From the opponents of reform we continue to hear that we have the greatest health care system in the world and that we have the very best health outcomes. Download this highly credible report so that you will have it readily available to expose these liars for what they are. Also use it to educate politicians on the broad spectrum of urgent public policies that we so desperately need.

And while we're at it, we need to fire the politicians who are promulgating these cruel lies.

 

[james2012]

It's called stress and poor eating habits. Learn how to look at data and see through the BS cvictor. Wealthy nation, strong work ethic, lots of stress, and poor health habits equals big problems. It does NOT equate to a healthcare system that is somehow failing. Until Obambicare we had the BEST healthcare system in the world. Why the hell do you think folks with the enough money and from all over the world came HERE to get the best treatment? Explain that one Einstein.

But you will learn soon enough. Won't be long before the huge premium increases are not just on the periphery anymore. The election next year is toast for the Dems and they know it. They are terrified of ObamaCare now - palpably so. When middle class American sees that basic coverage (the Bronze plan) under ObamaCare for a family of four is going to cost them $20,000 (and here you thought it was affordable), watch for the proverbial crap to hit the fan. ObamaCare is not going to last until the end of Obama's term. However, I have doubts the RINOs will create anything better. Socialized medicine or Fascist medicine? Hmm....I think they both suck. And before anyone goes all apes*it on my use of words, I use the word Fascist in its real sense, not the crap the Libs throw around without understanding what the hell they are talking about.

Oh, and you just wait until what I said above happens. As soon as the central planning committee figure out how expensive the TRT gels are then you can kiss any coverage of them goodbye Comrade. And just like Canada and Great Britain, look for Compounding Pharmacies to start disappearing - regulation is the new way Comrade. Forget about Armidex or HCG shots for off label use. Forget about Clomid or Nolvadex for off label use. You are about to learn what living under the boot of the overlord is really like. I have Canadian relatives whose provinces are moving away from government coverage and starting to privatize. They get one look at that chart shown during the debates on all the different bureaucracies and the lines connecting them and can't believe how stupid we are. What we have now dwarfs their public servant laden system.

AND they are drilling in the tar sands...like frigging crazy, and telling the environuts to go blow themselves. I'm starting to look North, as are a lot of doctor's. Corporate taxes are lower and once the healthcare system is fixed they can lower their taxes and get bloated on oil money. As someone with dual citizenship married to a Brit, getting back in while Rome burns down south is starting to look like an attractive proposition. Enjoy your slavery.

Standing in lines....it's what Comrades do.

 

[cvictorg]

It's called stress and poor eating habits. Learn how to look at data and see through the BS cvictor. Wealthy nation, strong work ethic, lots of stress, and poor health habits equals big problems. It does NOT equate to a healthcare system that is somehow failing. Until Obambicare we had the BEST healthcare system in the world. Why the hell do you think folks with the enough money and from all over the world came HERE to get the best treatment? Explain that one Einstein.

But you will learn soon enough. Won't be long before the huge premium increases are not just on the periphery anymore. The election next year is toast for the Dems and they know it. They are terrified of ObamaCare now - palpably so. When middle class American sees that basic coverage (the Bronze plan) under ObamaCare for a family of four is going to cost them $20,000 (and here you thought it was affordable), watch for the proverbial crap to hit the fan. ObamaCare is not going to last until the end of Obama's term. However, I have doubts the RINOs will create anything better. Socialized medicine or Fascist medicine? Hmm....I think they both suck. And before anyone goes all apes*it on my use of words, I use the word Fascist in its real sense, not the crap the Libs throw around without understanding what the hell they are talking about.

Oh, and you just wait until what I said above happens. As soon as the central planning committee figure out how expensive the TRT gels are then you can kiss any coverage of them goodbye Comrade. And just like Canada and Great Britain, look for Compounding Pharmacies to start disappearing - regulation is the new way Comrade. Forget about Armidex or HCG shots for off label use. Forget about Clomid or Nolvadex for off label use. You are about to learn what living under the boot of the overlord is really like. I have Canadian relatives whose provinces are moving away from government coverage and starting to privatize. They get one look at that chart shown during the debates on all the different bureaucracies and the lines connecting them and can't believe how stupid we are. What we have now dwarfs their public servant laden system.

AND they are drilling in the tar sands...like frigging crazy, and telling the environuts to go blow themselves. I'm starting to look North, as are a lot of doctor's. Corporate taxes are lower and once the healthcare system is fixed they can lower their taxes and get bloated on oil money. As someone with dual citizenship married to a Brit, getting back in while Rome burns down south is starting to look like an attractive proposition. Enjoy your slavery.

Standing in lines....it's what Comrades do.

It's always nice to hear from an ASSHOLE!!

 

[james2012]

What are you, 10? Great rebuttal there and a sign you have surrendered the argument. What's next? The dreaded na-na-na-ne-boo-boo? Please, not that. I don't think I could take that!

 

[zkt]

Just courious James, believe in evolution?

 

[james2012]

Just courious James, believe in evolution?

Um, yes. So what point did you have to make there? If I did not and was lets say a Creationist what difference would that make? I don't believe they are right, but I know some very intelligent Creationists who could with argue you with their eyes closed whiled wiping their arse and reciting the multiplication table under their breath.

Your point? What are you - an atheist? Interestingly a question I asked them during a recent conference here in Austin they could not answer - why is there something rather than nothing? Or more succinct, they thought they could answer but at some point they came up against a proposition they could prove neither true nor false (I had materialists, scientism followers, and others attempt, but fail). Their initial supposition they had to accept on faith - just to use one example (math exists in some Platonic realm that has always existed). Really? Okay, prove it. So they HAD to admit by reason alone that they were faith based, that ALL philosophical though is faith based. The only philosophy I have ever come across that is not is Kitaro Nishada's philosophy from the Kyoto school of Japan.

Pissed them off, but at least they were honest.

Favorite question though for a professor from England that stopped him in his tracks. He states there is no such thing as absolute truth and all truths are relative - a favorite of liberals everywhere and easily shot to pieces with one single question: "Are you absolutely true there are no absolute truths?". I'll let you figure out the trap they set themselves up for and guess what the look on his face was like. He went from sounding intelligent to mumbling like a 100 year old man with serious dementia.

Want to argue philosophy with me? Let's go. I can make a grown man cry - been doing this for decades now.