the salt makers

Ladies and gentleman,

As a US medical student fed up with the rampant myths, lies, and exaggerations with regard to our health care system, I've decided to compile a list of facts with relevant citations that every American citizen should know before they decide what they believe in relation to government-provided health care. Read this before you decide to believe our President when he says "there are countries where a single-payer system works pretty well." Read this before you endorse a government provided "public option" with regard to which even President Obama acknowledges a real, legitimate concern that a government plan will inevitably lead to single-payer health care. Read this before you embrace President Obama's greatly exaggerated claim that “the cost of health care now causes a bankruptcy in America every thirty seconds," when the true numbers tell us that in 2007 about eight-tenths of one percent of Americans lived in families that filed for bankruptcy as a result of medical costs.

This compilation is not intended to respond to the criticisms of the American health care system. These critiques are plenty, and some are worthy of serious reflection. The trade-offs, however, are not equivalent and will likely put us into a "real" health care crisis.

Does the US health care system need serious reforming? Absolutely. Is government the answer? Absolutely not.

Please send this to everyone you know.

BTW, Blogger won't allow me to copy and paste hyperlinks to my posts. Every claim in this blog is substantiated with a citation. You may visit the link at the end of the post to download a word file with all of the citations.

Facts:

Americans have more access to new medical technologies than Canadians and United Kingdom residents, and are responsible for most health care innovations.
The argument that American health care is lacking is usually based on rankings compiled by the World Health Organization, which places the U.S. 37th out of 191 nations in its "World Health Report." It's a mistake, though, to put much into the WHO's grades. "They are not," says one expert, "an objective measure of the relative performance of national health care systems." That expert, Glen Whitman, an associate professor of economics at California State University Northridge, has looked at the WHO rankings and found that they "depend crucially on a number of underlying assumptions — some of them logically incoherent, some characterized by substantial uncertainty, and some rooted in ideological beliefs and values that not everyone shares." For example, the WHO study puts much emphasis on infant mortality rates, which are a poor indicator of a health care system's effectiveness.

Another commonly cited study from the Commonwealth fund finds that the US scores number one in "right care," but concludes that American health care is among the worst in the world. "Right care" is the most important criterion because it includes things like how often women have mammograms and whether diabetics get proper treatment. Much of the rest of the Commonwealth fund study is subjective and as biased as the WHO study. Michael Cannon, the Cato Institute's director of health policy studies, summed up what's wrong with the study: "The report does nothing more than reveal which nation does the worst job of satisfying the subjective preferences of the people who conducted this study."

The US has more MRI and CT machines, performs more Cardiac Catheterization Procedures, Percutaneous Transluminal Coronary Angioplasty Interventions, Coronary Bypass Procedures, and Knee Replacements, has the highest Number of Patients Undergoing Dialysis Treatment, and has better cancer survival rates than the UK and Canada.

Overall, the US has the highest cancer survival rates in the world, in addition to better Coronary Heart Disease Death Rates and fewer Ischaemic Heart Disease Deaths than the UK. The UK has the lowest cancer survival rates in Europe.

A study in the journal Circulation found that Canadian patients whose histories were followed from 1990 to 1993 had a 17% higher risk of dying from heart attacks than did U.S. patients. The five-year mortality rate was 21.4% among the Canadian study participants and 19.6% among U.S. participants. The authors attributed this to the greater use of invasive procedures in the U.S. and to the organization of the Canadian health care system, where specialized procedures are only available in central hospitals. Almost a third (30%) of American heart attack patients received an angioplasty, versus 11% of Canadians, and more than 13% of Americans had bypass surgery, compared with 4% in Canada.

"Americans have better survival rates than Europeans for common cancers." Breast cancer mortality: 52% higher in Germany and 88% higher in the United Kingdom than in the U.S. Prostate cancer mortality: 604% higher in the U.K., 457% higher in Norway. Colo-rectal cancer mortality: 40% higher among Britons.

"Americans have lower cancer mortality rates than Canadians." Rates for breast cancer (9%), prostate cancer (184%) and colon cancer among men (10%) are higher than in the U.S.

"Americans have better access to preventive cancer screenings than Canadians." Nine of 10 middle-aged American women have had a mammogram; 72% of Canadian women have. Almost every American woman (96%) has had a pap smear; fewer than 90% of Canadian women have. Roughly 54% of American men have had a prostate cancer test; fewer than one in six Canadian men have. Almost a third of Americans (30%) have had a colonoscopy; only 5% of Canadians have had the procedure.

"Lower-income Americans are in better health than comparable Canadians." Nearly 12% of U.S. seniors with below-median incomes self-report being in "excellent" health, while 5.8% of Canadian seniors say the same thing.

"Americans spend less time waiting for care than patients in Canada and the United Kingdom." Canadians and Britons wait about twice as long, sometimes more than a year, to see a specialist, have elective surgery or get radiation treatment. And even these statistics can underestimate the time NHS patients spend waiting for care.

"People in countries with more government control of health care are highly dissatisfied and believe reform is needed." More than seven in 10 Germans, Canadians, Australians, New Zealanders and Britons say their health systems need either "fundamental change" or "complete rebuilding."

"Americans are more satisfied with the care they receive than Canadians." More than half (51.3%) of Americans are very satisfied with their health care services, while 41.5% of Canadians hold the same view of their system.

8 out of 10 Americans are happy with their health care coverage.

"Americans have much better access to important new technologies like medical imaging than patients in Canada or the U.K." There are 34 CT scanners per million Americans. There are 12 per million in Canada and eight per million in Britain. The U.S. has nearly 27 MRI machines per million. Britain and Canada have 6 per million.

"Americans are responsible for the vast majority of all health care innovations." The top five U.S. hospitals conduct more clinical trials than all the hospitals in any other single developed nation; the most important recent medical innovations were developed here.

The end result of socialized medicine is the rationing of care. The U.K. board approves or rejects treatments after dividing the cost of the treatment by the number of years the patient is expected to benefit. In 2006, for example, a U.K board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other. After all, how many years would they be needing two good eyes?

Even though we hear the stories over here in America, we don't hear that some in the UK are forced to sell their cars and remortgage their houses to afford cancer treatments rationed by the government.

More than half of NHS doctors say that their patients have suffered due to medical rationing while 15% say patients have died early as a result.

Americans have access to state-of-the-art treatments that are not available to their British counterparts, and the UK has banned chemotherapy shown to slow the progression of cancer and extend life.

The Swedish government system is no better. It also refuses to provide some expensive medication and, inhumanely, refuses to let patients buy the drugs themselves. Why? According to a Journal of American Physicians and Surgeons article, bureaucrats believe doing so "would set a bad precedent and lead to unequal access to medicine."

Like Canadians, Swedes are subjected to long waits. They also have denial-of-care problems that sometimes lead to death.

The claim that 46 million Americans are uninsured is exaggerated. The uninsured are not always the same people, and many are without coverage only for a relatively short time. Devon Herrick, senior fellow with the National Center for Policy Analysis, notes that "Being uninsured is a transitory state, since most uninsured Americans are only without coverage for a short time." Herrick is backed up by the Census Bureau's Survey of Income and Program Participation, which found a few years ago that only 19 million Americans go without insurance for a full year.

A close look at "Income, Poverty, and Health Insurance Coverage in the United States," a Census Bureau report, shows that of the 45.6 million persons in the U.S. that did not have health insurance at some point in 2007, 9.7 million, or about 21%, were not U.S. citizens.” Furthermore, Government statistics show 45 percent of those without insurance will have insurance again within four months after job transitions. Also, many of the uninsured are young and healthy (40% are between ages 18 and 34) and at this point in their lives, particularly in this economy, choose to put their dollars elsewhere. Bottom line: "Many Americans are uninsured by choice," writes Dr. David Gratzer.

Almost 18 million of the uninsured make more than $50,000 a year. And almost 10 million of them have an income of more than $75,000 a year.

In Great Britain, where the government is in charge of health care, as many as 1 million people are waiting to get into hospitals at any given time, says the National Center for Policy Analysis.

In Canada, another country where the government metes out care, roughly 900,000 are waiting for hospital beds, the Fraser Institute reports. The New Zealand government says that 90,000 are on hospital waiting lists there.

In order to keep health care prices down, European countries enact pharmaceutical price controls. These price controls are precisely the reason why the US has established itself firmly as the key innovator in pharmaceuticals since 2000. "That dominant position continues to expand... [and] a disproportionate share of pharmaceutical R&D is performed in the US..."

Another problem is that European health care systems do not reimburse the high prices charged for new drugs, as do U.S. health care providers. The result: patients do not have access to the drugs.

Stanford University professor Scott Atlas points out that from 1998 to 2002 nearly twice as many new drugs were launched in the U.S. as in Europe. According the U.S. Pharmaceutical Industry Report, some 2,900 new drugs are now being researched here. America's five top hospitals conduct more clinical trials than all the hospitals in any other developed country, according to Mr. Atlas. And a McKinsey Co. study reports that 40% of all medical travelers come to the United States for medical treatment.

Roughly 56% of Americans who could benefit are taking statin drugs. Only 36% of the Dutch, 29% of the Swiss, 26% of Germans, 23% of Britons and 17% of Italians who could benefit receive them.

One in four NHS hospitals is still not meeting hygiene targets and hospital-acquired infections appear to be epidemic in some areas. In one hospital, dehydrated patients were forced to drink out of flower vases, while others were left in soiled linen on filthy wards.

Medicare, often touted as a government health care success story, is hardly "successful": Since 1970 — even without the prescription drug benefit — Medicare's costs have risen 34% more, per patient, than the combined costs of all health care in America apart from Medicare and Medicaid, the vast majority of which is purchased through the private sector. And they want us to believe that government is the answer?

Health care is the most heavily regulated portion of the US economy. The net burden of health services government regulation in the US is considerable, amounting to $169.1 billion annually. In other words, the costs of health services regulation outweigh benefits by two-to-one and cost the average household over $1,500 per year.

The CBO says a government-run health care system would cause 23 million Americans to lose private coverage, cost $1 trillion dollars and still leave 30 million uninsured. This figure doesn't even include the cost of a proposed "public plan" option.

The Department of Health and Human Services said in its 2002 report "Confronting the New Health Care Crisis": "If reasonable limits were placed on noneconomic damages to reduce defensive medicine, it would reduce the amount of taxpayers' money to the federal government by $25.3 billion to $44.3 billion per year."

The increase in medical malpractice lawsuits and the associated costs that keep going up have forced insurance companies to raise premiums for malpractice coverage. Doctors, in turn, pass the added costs on to patients. The litigation and malpractice insurance problem raids the wallet of every American..." Doctors alone spent $6.3 billion last year to obtain coverage. Hospitals and nursing homes spent additional billions of dollars.

HHS has further said that reasonable limits placed on noneconomic damages in malpractice cases would save $60 billion to $108 billion a year. "These savings would lower the cost of health insurance and permit an additional 2.4 million to 4.3 million Americans to obtain insurance," the department said.

Long waits and reduced quality. In Britain, over 800,000 patients are waiting for hospital care. In Canada, the average wait between a general practitioner referral and a specialty consultation has been over 17 weeks. Beyond queuing for care or services, single-payer systems are often characterized by strict drug formularies, limited treatment options, and discrimination by age in the provision of care. Price controls, a routine feature of such systems, also result in reduced drug, technology, and medical device research.

Funding crises. Because individuals remain insulated from the direct costs of health care, as in many third-party payment systems, health care appears to be “free.” As a result, demand expands while government officials devise ways to control costs. The shortest route is by providing fewer products and services through explicit and implicit rationing.

New inequalities. Beyond favoritism in the provision of care for the politically well-connected, single-payer health care systems often restrain costs by limiting surgeries for the elderly, restricting dialysis, withholding care from very premature infants, reducing the number of intensive care beds, limiting MRI availability, and restricting access to specialists.

Labor strikes and personnel shortages. In 2004, in British Columbia, Canada, a health worker strike resulted in the cancellation of 5,300 surgeries and numerous MRI examinations, CT scans, and lab tests. Canadians have a shortage of physicians, and the recruitment and retention of doctors in Britain has become a chronic problem.

Outdated facilities and medical equipment. Advances in medical technology are often seen in terms of their costs rather than their benefits, and investment is slower. For example, an estimated 60 percent of radiological equipment in Canada is technically outdated.

Why is our health care so expensive? Perhaps no one has explained this more clearly than Dr. David Gratzer, a practicing Canadian physician and senior fellow at the Manhattan Institute. In his excellent book, The Cure: How Capitalism Can Save American Health Care, Dr. Gratzer uses the example of cardiac care. The clot-busting drug tPA costs thousands of dollars per use; bypass surgery costs tens of thousands of dollars; and a pacemaker roughly $20,000 to $25,000. It costs money to keep people alive. But it’s money well spent. “Let’s put this figure in perspective,” Dr. Gratzer notes. “The little box in the chest of [Vice President Dick Cheney] costs more than fifty times what the average American spent on health care (adjusted for inflation) for an entire year in 1950.”

The typical American family spends just 5.4 percent of its income on health care, as opposed to 40.8 percent on housing, 18.3 percent on transportation, and 18.2 percent on food. In fact, the nearest comparable expense for families is the 4.5 percent of income spent on clothing. And yet, we don’t hear politicians calling for sweeping legislation to put price controls on textiles because every American has a right to designer fashions.

As many as 14 million of the 45.7 million uninsured— poor and low-income Americans—are fully eligible for generous government assistance programs like Medicare, Medicaid, and SCHIP.


http://uploading.com/files/HDSJJXGV/Health Care Crisis.doc.html


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Zachary Sonnier