Anyway, came across this:  http://www.nytimes.com/2009/09/22/science/22tier.html?hpw - http://www.nytimes.com/2009/09/22/science/22tier.html?hpw  

 

Interesting read, if not exactly super-startling.

 

Reading about research is always interesting.

 

 

You keep saying that...

He will further argue that our overpriced healthcare system isn't as good as theirs because we are in worse health etc. etc. Unfortunately this article seems to dispute that, so perhaps he is wrong? I think we are less healthy because we are a bunch of lazy, no exercise having fat tubs of goo who eat too much bacon and fast food.

 

Skip to page 8 where FE jumps in and says Obamacare 5-6 hundred times in two paragraphs and quotes articles the contradict what he says and then OS says we are all a bunch of ungrateful slackers that should join the military.

 

PP and the others jump on him saying he only did it to avoid going to jail and than we all put our tin foil hats on and resort to name calling. Jmac than calls someone retarded and the thread gets closed.

 

Are we all caught up? ;)

 

 

 

Nicely done.

 

:)

 

Partially yes, and that is why I posted the link.

 

Seemingly, the cornerstone of your argument is that we spend more money per capita and are less healthy. Wouldn't this argument tend to show that perhaps our system isn't quite so bad and in fact keeps us competitive (healthwise) with other industrialized countries despite ourselves?

 

I do tend to point to life expectancy as evidence of our inferior system, and this study does make some very interesting points about the interaction between life expectancy and healthcare.  Absolutely.

 

But I have also made the point that other big contributing factors include lifestyle, particularly obesity.  I have also noted that the US system has an excellent record for early detection and treatment of some diseases, most notably cancer.  I certainly recognize that there are other factors.

 

But where this article and I part is that the article ONLY discusses life expectancy.  To me, that is only one issue.  Another I regularly bring up is infant mortality, for instance.  The US has higher infant mortality than almost every other industrialized nation.  That one is harder to blame on our lifestyle, but very easy to blame on insufficient access to healthcare.  I have gone through other examples as well - life expectancy is important, no doubt, which is why I found this article to interesting - but it is only one part of the puzzle.

 

 

The fact that we can be fatter and less active, but generally live nearly as long as other countries seems like it should show how good our system is, not how it is lacking....

 

This is only true if you define "healthcare system" in a self-serving fashion, as this author did.  As I have mentioned in other threads, a central failing of our healthcare system (IMO) is obesity.  The article views obesity as a cause of lower life expectancy - I view it as an effect of an inferior healthcare system.

 

Obesity is a healthcare problem.  The purpose of healthcare is to prevent healthcare problems.  The US healthcare system has completely failed to prevent what is arguably the biggest scourge to our health.  The US healthcare system is therefore failing at its mission.

 

Pointing to obesity does not excuse the healthcare system.  Rather the opposite.

 

 

If we were to continue our lifestyles under any other healthcare system, would we fair as well?

 

Every society is different, of course, and who knows how things would go, but in at least some other systems we wouldn't be as fat.  There would be more exercise in school, there would be no soda in school.  The healthcare system would provide dieticians and personal trainers.  Serious efforts would be made to combat obesity, rather than simply declare it a lifestyle choice.  Sure, culture is a major factor, but the healthcare system can do a lot to nudge the needle.

 

I realize this only focus' on the quality of the current system, not the affordability, but it also seems that if our focus was on living healthier, it in turn would lower heart disease, diabetes and other major health issues, which would lead to lower costs for insurers and their customers.

 

Absolutely.

 

So really, isn't the problem with the American society, not the insurance companies? Perhaps if we helped ourselves.

 

Sure.  But perhaps if the insurance companies would cover my personal trainer, I wouldn't need quadruple bypass.  Perhaps if the insurance companies would cover my routine bloodtesting during a routine physical I would stay more on top of my cholesterol. 

 

Remember - it is NOT in the interest of the insurance companies to reduce the absolute cost of healthcare.  It is only in their interest to reduce the cost of healthcare relative to the premiums they can collect.  And given the lack of a competitive market for healthcare, that leads to the mess we have now.

 

 

And to be honest, I have not read any of the healthcare plans that have been currently been offered, but do any of them truly address the situation? It seems to me the biggest discussions have been over cost and making sure it covers everyone, never mentioning what all is entailed as far as actual practices and policies.  I think its going to take more than changing our healthcare system to overcome our coutries issues. Reduction in the consumption of fast foods, intake of more fruits, vegetables and unprocessed foods, MORE EXCERCISE, and a general change of attitude are what are needed to make our country healthier. 

 

- Infant mortality is pretty easy to blame on the healthcare system. You say poor diet, I say lack of neonatal care.  Sure, some pregnant women will eat poorly regardless, but many would eat better if they knew how, and if they saw a couple of sonograms.  Day care?  I'm talking infant mortality, not toddler.  Most of these deaths are either directly from complications from birth (many of which could have been avoided with proper prenatal care) or are shortly after birth, again resulting from unknown-to-the-attending-physician problems.  At the birth of my first child, we had a neonatologist in the room because of a concern.  Nothing happened (thank goodness), but had it gone badly and the neonat hadn't been there, the boy would have died within minutes.  The neonat was only there because of prenatal care.

 

I agree that religious/societal issues play in - more American teens will cover up their pregnancies, for instance, than in Europe.  But that is only a small piece - the correllation between infant mortality and lack of health insurance is very strong (I have numbers here someplace...).  As with all these things, there are many contributing factors, but lack of access seems to lead the charge.  The US has excellent ob's and neonatologists - but they can only do so much if the mother hasn't seen a doctor since she got pregnant.

 

Clearly infant mortality is not only the fault of the heathcare system, but equally clearly the lack of easy and inexpensive access to prenatal care is killing our babies.

 

 

- Diet in general.  It isn't the healthcare system's "fault" that you choose to eat poorly.  But "fault" is also irrelevant.  A healthcare system shouldn't be about blame allocation, but about problem solving.  Poor diet is a major contributor to one of the biggest healthcare problems we have, therefore our healthcare system should address it.  Just like our healthcare system should (and does) address smoking and drinking.  When one person does something unhealthy it is his own problem.  When 100,000,000 people do something unhealthy, it is a systemic problem that requires a systemic solution.

 

A healthcare issue of this magnitude IS a societal issue.

 

Sure, if everybody was monogamous AIDS wouldn't be a real issue.  Their choice.  But the reality is that AIDS IS a big problem, and simply pointing fingers won't make the problem go away.  It is a healthcare issue, regardless of the choices that went into creating it.  Same for obesity, same for lung cancer, same for infant mortality.  In fact, virtually every healthcare issue intersects with personal choice and lifestyle.  Trying to separate the two is futile.

 

Yes, we are lazy, yes we eat poorly, and yes we are fat.  But YES, we can change, and the government can, and perhaps must, play a central role in that.  It is easy to find examples of similar events in the past:

 

Smoking in the US declined drastically over that past couple of decades (was this in the article?).  This was in no small part due to government action.  Endless PSAs, school curricula changes, taxes on cigarettes, warning labels...  The onslaught of "smoking is bad" was relentless through the 80s and 90s - and it worked.

 

Drinking and driving in Scandinavia (which used to be very common) experienced a similar drop in Scandinavia during that same period, for and for similar reasons.  PSAs, lessons in school, etc.

 

Recycling, in most of Europe and the US, during that same period of time - again, some rule changes, lots of public information and education.  Recycling went from goofy to standard in a very short period of time.

 

The government HAS the power to change our culture and our lifestyle.  Governments have been doing this for centuries.  That is one of the central functions of government.

 

Which leads to...

 

- Does society control the system, or vice versa?  The answer, of course, is that the system is PART of society.  You talk with horror about the prospect of the big brother healthcare system getting into our schools.  Hate to tell you, but the schools are the very definition of big brother, and they should be.  Moreover, the schools already are part of the healthcare system - there is only one "system." 

 

This does not mean that society controls every aspect of our lives.  But it does mean that we can shape society to our liking, and use society to shape ourselves.  Yes, some people will never exercise and will always be fat.  But for many, they eat poorly mainly because bad food is cheap and easy, and healthy food is expensive and difficult.  They don't exercise because it isn't convenient or fun.  If we remove obstacles to healthy behavior, healthy behavior will increase.  And this a healthcare system can do.

 

You are correct that the people in the hospital can't make us eat less and exercise more.  But that is not the limit of the healthcare system.  Those folks are the cleanup crew.  We need to think more expansively of health.  And yes, the schools have to be a major part.  We clearly need to mandate more exercise in school.  I continue to be astonished at how little exercising there actually is in US schools, and how easy it is to avoid altogether.  We need to educate more.  We teach all of our kids about stranger danger, about drugs, about looking both ways when crossing the street, and so many other non-academic-yet-socially-essential things - why should we not also instill in them the value of exercise and healthy living?

 

In grade school I learned how to build a shelter in a snow storm, using only my skis.  That has nothing to do with the three Rs, but they thought it was important for me to know.  I have yet to apply that skill, but I run into bad food every day.  Schools are in the business of teaching life skills - shouldn't they teach the life skills that most directly impact everybody?

 

So I agree completely that "Reduction in the consumption of fast foods, intake of more fruits, vegetables and unprocessed foods, MORE EXCERCISE, and a general change of attitude are what are needed to make our country healthier."  Absolutely.  I would just rather not wait around for people to figure this out on their own, because they won't.

 

- Lastly, I also have not read the various bills, but from what I gather they are all just picking at the edges.  They may or may do some good, but as far as I can tell none amount to the fundamental overhaul I think we need.

 

 

As for infant mortality, i haven't done a lot of looking around, but a quick google search put lack of healthcare as possibly a contributing factor, but premature birh rates that are considerably higher here than other countries seemed to be the biggest contributing factors. In fact, the second article I am going to reference states that over availability of NICU's seemed to contribute more to the problem than solve it. Also, ethnic diversity in our country seemed to have an effect on the numbers as well. Societal issues such as drinking/smoking during pregnancy, LWB as well as the higher rates of artificial ensemination were contributing factors as well. Neither of the ones I found quickly placed as much blame on the lack of healthcare as the main issue.

 

http://www.earthtimes.org/articles/show/6538.html - http://www.earthtimes.org/articles/show/6538.html

 

http://www.slate.com/id/2161899/ - http://www.slate.com/id/2161899/

 

And as for coverage, aren't low income pregnant women covered by medicaid?