Sunday, August 12, 2007

USA: The World's Best Medical Care?

I seldom read the New York Times, because I pretty much know what I'm going to get even before picking up the paper. (image credit) But, in this morning's editorial section, there is an essay called, "World's Best Medical Care?" Here's the opening paragraph:
Many Americans are under the delusion that we have “the best health care system in the world,” as President Bush sees it, or provide the “best medical care in the world,” as Rudolph Giuliani declared last week. That may be true at many top medical centers. But the disturbing truth is that this country lags well behind other advanced nations in delivering timely and effective care.
Groups like the World Health Organization and the Commonwealth Fund have ranked the US low in certain areas. The NYT piece goes on to outlines eight areas in which the US could do better which include areas like lack of universal health care, high infant mortality rate, low life expectancy at age 60, poor patient satisfaction, and being slow to adopt electronic medical records.

I'm not going to dispute most of this article. There are some good points and it is a decent analysis of how the American health care system could improve. But, like most things in the New York Times, I took it as a political commercial as opposed to an informative piece of journalism.

After throwing the US health care system under the bus for two pages, the NYT does try to make a comeback with this kind of backhanded compliment - or maybe it's not a compliment.
Top-of-the-line care. Despite our poor showing in many international comparisons, it is doubtful that many Americans, faced with a life-threatening illness, would rather be treated elsewhere. We tend to think that our very best medical centers are the best in the world. But whether this is a realistic assessment or merely a cultural preference for the home team is difficult to say. Only when better measures of clinical excellence are developed will discerning medical shoppers know for sure who is the best of the best.
Is health care the most important issue in the upcoming US presidential election? Some people think yes and this editorial is proof of that. For me, it's just too early. It's a long 15 months until the election. However, I do appreciate that health care issues are probably getting a little more press than they did a year or two ago. Nothing will change without getting the public's attention. As I always say, we'll just have to see how this all plays out....


intoku said...

Good to read it. Means that no more self-glorification anymore?

Let's wait and see...


SeaSpray said...

Hi Dr A - I wonder where the author of that NYT article would like to go for his health care?

It is a complicated issue for sure. I am still paying off medical bills after hitting catastrophic with my insurance last year and of course this year's med bills are getting added into it all. I feel for the people that could lose their homes over health issues, even if they do have insurance.

I feel for the doctors, especially surgeons who seem to have their salaries dictated by the CEO"s of the insurance companies while their wallets get fatter. ER docs getting their payments slashed by MDCR.

The 1st time I saw the disparity between my surgeon's bill and what my ins co allowed, I called the ins co thinking it was a mistake! It wasn't. Then I thought their billers made a coding mistake. They didn't.

The doctors that don't participate with the insurance definitely get paid more! I am just grateful mine participates.

Yet all those years of training and sacrifice.

It's not right that the insurance companies are set up so that if they deny claims, etc. then they profit.

I did a post "Socialized Medicine the Pros and Cons" or something like that and I linked other doctors discussing this.

Panda Bear posted something about this and he talks about the stats being skewed when comparing us to other countries because we (the US) goes out of their way (maybe even when they shouldn't)to save lives that other countries in the socialized systems would not see as cost effective. I don't want to misrepresent what he said. I may have linked that in my post or better yet just check his June or July posts. he had interesting comments too.

Sorry so long DR A but it is both an interesting and important topic to which no one seems to have the answers.

Also, can you please tell me again what I am supposed to do to join blogaholics anonymous?

Thank you! :)

Rositta said...

I know that the system in the US in not great with Insurance Companies as part of the equation, having said that, If I was diagnosed with a serious illness, I would mortgage, beg and borrow and leave Canada to be treated in the US. Why you ask? I think you have better doctors (lots of ours left for better pay in the US) and importantly, there are no WAITING LISTS. I waited 3 months for a heart monitor, I now have a heart problem and have to wait 6 months to see a specialist. Fortunately, I don't think I'm going to die any time soon (I hope), so I will wait. What's better, yours or ours, I don't know. Maybe you need a little of ours and we need a little more of your system, just my opinion...ciao

Empress Bee (of the high sea) said...

funny i was just talking about how we are in this little podunk town in the summer and just how state of the art their hospital is and what wonderful treatment you get in it.

and i was also telling someone you never visit any more. hint hint...

smiles, bee

Anonymous said...

I will never recover financially from medical bills and loss of income from extended missed work due to health problems.
I once got a "Dear John" letter from Humana 'divorcing' me from my PCP, after the surgeon who did my shoulder surgery complained, because I had complications from the surgery. When I called my PCP's office to find out why, they knew nothing about it. It had not been done at his request.
There's nothing like fighting the system that supposed to be taking care of you when you're sick. They kick you when you're down. If there is a heaven and hell, there's got to be a special place in hell for those in health insurance who deny benefits and try to make the system nearly impossible to navigate. I could write a book on the healthcare system in the U.S., and it wouldn't be pretty. Michael Moore barely touched the tip of the iceberg.

Anonymous said...

My point remains, and it has not been swayed, that the best 'fix' for our system it to get government LESS involved in health care, not more involved. While true that other countries have higher lifespans and lower infant mortality, I am not sure if it is comparing apples to apples. In what other countries do they birth a baby at 22 or 23 weeks gestation and use all available means to save the baby? The chances of this baby surviving are quite small, but it's chances are getting better and better everyday. So here, we can keep this 'micro-preemie' alive for days to weeks and as we keep them alive longer, their chances of living a full life increase. Once we get them to their full gestational age (when they should have been born), they have a very good chance of living a normal life. So, a number of these babies do not make it this far despite our best efforts. Do they then become an infant mortality? Most other countries, I think, would not put forth the effort and would count it as a miscarriage, not an infant mortality. This doesn't seem, to me, to be a fair comparison.

Now, consider the children born here with many congenital conditions. I will use an example I know, congenital cardiac defects. Many of these children are full term babies. We do many, many surgeries on these children to repair their defects. These are open-heart surgeries on infants and not without significant risks. A common defect, hypoplastic left heart syndrome, requires a minimum of 3 open heart surgeries by the age of 2. Some of these surgeries are performed in very few places around the world except for the US. People from all over the world come here for treatment for just this reason. These children have lifelong issues because of their condition. The statistics are just being developed as the very first babies to have this series of operations are just now in their 20's. Of course, a good number of these children have not made it past their teens for a number of reasons. So, when they succumb to their condition as children, these then impact our life-expectancy numbers. Add to this mix the vast number of experimental surgeries being performed everyday, most only here.

Based on these examples, I believe I have shown where using these stats in any argument are not telling the whole story. I do know what I am talking about as I am a practicing RN in the specialty of Pediatric Critical Care.