Friday, February 26, 2010

Tough Decisions

The US healthcare debate seems to have sparked even more debates in countries that have socialized medicine - such as England(Britain) and Canada. The debate has been there for eons, but it seems louder and stronger now. It's a pretty tough mess to sort out. This morning the Drudge report listed an article about a hospital is Staffordshire, England that is under investigation for the possible unnecessary deaths of between 400 and 1200 patients between 2005 and 2008. But what interested me most was reading through the comments (so far there are over 10 pages of reader comments). People are split, and it's tough to make future decisions based on what citizens want when it is so divided. What is the best course of action? All I can think is 'socialized medicine will only work as long as there are dollars to support it'. What happens when money is running low, if something happens where tons of people are out of work and businesses are closing? Where will the tax dollars come from to support these socialized systems? The whole thing could come crashing down, that's what concerns me. And if there is nothing in place to back it up (ie a proper two tier system where people could choose to get private insurance for basic health care).... well... then what??? I heard on several radio and tv broadcasts recently that within 5 years, 20% of Britains adults will have never worked a single day of their lives to date. Twenty Percent! That is a heck of a lot of people receiving aid, getting health care, getting their homes and food paid for - who have never put a pence of money into the tax system to help support it. Yikes.

Something else I have been thinking about --- I have heard several politicians in the US claiming that every year, 45,000 people die in the US because they do not have health care. I cannot find a good stat on that but will put it in here if I find it. I don't know if that truly means they died BECAUSE they don't have health care, or if they happened to die AND they don't have health care. I don't know what they died from (car accident, terminal disease, etc) so I don't know how to judge if they died BECAUSE of lack of health care or if that is just a twisted statistic. But what I do know is that a heck of a lot of people die each year who DO have health care. Should we then twist the statistic to say 'Look! Over 2 million people die each year in the US because they HAVE health care'? Seriously, think about it.

The Centers for Disease Control website updated it's death stats on Dec 31, 2009 and you can find it HERE. But here is a quick rundown of some stats they reported:
  • Number of deaths: 2,426,264
  • Death rate: 810.4 deaths per 100,000 population
  • Life expectancy: 77.7years
  • Infant Mortality rate: 6.69 deaths per 1,000 live births
Number of deaths for leading causes of death:
  • Heart disease: 631,636
  • Cancer: 559,888
  • Stroke (cerebrovascular diseases): 137,119
  • Chronic lower respiratory diseases: 124,583
  • Accidents (unintentional injuries): 121,599
  • Diabetes: 72,449
  • Alzheimer's disease: 72,432
  • Influenza and Pneumonia: 56,326
  • Nephritis, nephrotic syndrome, and nephrosis: 45,344
  • Septicemia: 34,234
So, while looking at that list, and throwing in the statistic being used by politicians and TV personalities lately, you can see that '45,000 deaths per year who don't have health care' would fall second last in the top causes of death list, and is a small fraction of the total deaths per year. I'm not trying to belittle the lives of those who do not have health care, but I do not like it when I see people throwing statistics around in order to try to better their cause. Almost 3 times as many people die from accidents. Over half a million people die each year from heart disease. Over half a million people die from cancer. Perhaps if someone REALLY wants to do something about the number of deaths in the US, they should concentrate on the top killers and try to ensure that the hospitals and science centers will have enough money to keep combating these illnesses, instead of trying to tie even more tax dollars down into a system that seems to suck the life out of so many other countries.

In a quick comparison, Stats Canada lists our deaths at 242,863 for the last fiscal year (July 1 to June 30 2008/09). Keeping in mind that Canada has about 10% of the population of the United States, it puts our death rate at almost an identical % of population (242, 626). Our top killers are heart disease and cancer as well. Shouldn't we have a BETTER death rate if we have socialized medicine? Afterall, all of our citizens can get health care at any time from any place (scratch that, you have to go through the channels, can't just show up at a specialist's office, but I digress)... So the US people that are throwing around this '45,000 people a year die because they do not have life insurance' figure must not really look around at other countries to check out their mortality rates and causes either. THAT is what drives me crazy.

At the end of the day, even Canada's socialized health care system does not improve on the mortality rate. We have 10% of the population, and 10% of their mortality rate. So let's just drop that 45,000 statistic, it does not accomplish ANYTHING. Over 2 million people die each year in the US who DO have health insurance.... so um.... what should be done about THAT statistic?

Eh?! Perhaps that is something Larry King could have asked Bill Maher last week. Maher is the latest person I heard use the 45,000 stat.

6 comments:

  1. We have a problem with adult conversation as special interest groups hijack the topic and change the goal.
    We should have the option for the best timely option and it may require a blended approach from private and public options.
    Have you seen the vitrol if we suggest allowing private to expand?

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  2. Excellent post Kez!

    Common sense and the ability to see thru BS is fast becoming a lost art.

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  3. What I find I am getting tired of too is the tit-for-tat game of who can find the worst medical stories to share. I play the game too lol, but I am always aware that it's a much bigger picture than that. You can find medical mishap horror stories in any country, under any system, at any given time. Some get media attention, some don't. But we hear about them from every direction. Public or Private does not seem to 'cure' that particular ailment, but you would *think* that in a govt controlled system, there would be FEWER horror stories.... at least theoretically there should be. But it does not appear to be so.

    I hear a lot in the US about doctors sending patients for treatment that is unnecessary just so they can make a fast buck - well guess what? It can happen here too. Let's say you are in a line at a walkin clinic, and the doc gets paid per patient (or service, the service being your 5 minute walk-in appt)... If you go in there and the doc rushes you out as quickly as he/she can and doesn't listen to half of what you say, and doesn't even do anything to help you - he/she still gets paid. At least, that is my understanding of it from my friend who just got her PHD in genetic something-or-other (sorry, big words fail me today LOL).

    Or we have docs who are already trying to get more cash for their services by offering more things that are not covered by basic health - such as cosmetic and weight loss procedures. There are at least 3 in my small city who have almost entirely changed over to this approach - offering laser treatments, electrolysis, weight loss needles and such, all for the cash job. I think it's up to them, I don't hold it against them. They got the training, it's their practice, they can do what they want because I'm not the one who went to school for 7 to 10 years.. however they are still classed as GPs by the province and new docs are not often brought in to pick up the slack, which does lead to even more people waiting for care. Appts are being filled by people paying cash for procedures unrelated to basic health care. That is a concern for me - but I don't put the blame on the docs, I put it on the system. It won't surprise me in the least if more turn down that road.

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  4. I've definitely seen the vitrol. In earlier posts I have talked about my boyfriend speaking to his uncle about wishing we could pay some private insurance for basic health care as well. His uncle said 'Don't you care about the guy down the street who gets sick?' and my bf said 'no, actually, I don't. I have 5 people in my house to take care of, and they come first'. Is that so wrong? He actually thinks he would rather keep paying some of his taxes to health care like he is currently, but at least have the OPTION to pay for some private as well. Maybe then we wouldn't be waiting 6 weeks for a simple hearing test for our son to see if that's why he is not talking yet (he is almost 2), or waiting 6 months for my tubal ligation because we are done having kiddos. Maybe if we had private options, we could get those things done sooner. It's not a wealth issue, we don't have much money, we earn in the lower middle-class bracket - but we would CHOOSE to put off buying a material item in order to CHOOSE to pay for more coverage.

    Like some recent famous words, it's OUR bodies, OUR health, so shouldn't it be OUR choice??? I just got prescribed a month's worth of blood pressure medication because my BP was a hideous 180/100 last week (im only 36), and was given a month supply to trial... well.... the next appt I could get for a checkup is AFTER my supply runs out. How on earth is my doc going to find out if it's working, when I will have been OFF them for a week before I see him? It's aggravating... I will have to try to sneak into one of his walkin clinics instead before I run out and just hope that he is there and not a fill-in.

    Yes that is me telling a medical story yet again lol, but it's not for 'worst case', it's for REALITY. I sit and listen to my US friends talk about getting doc appts within a week EVERY TIME, unless it's for a very specialized specialist (rare disorders, etc), and I can't figure out why we can't, if the system is supposed to be so celebrated.

    We get our money's worth.... if we even get that.

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  5. That is a lot of information! I think some of the most telling data in the differences in efficiency between the two systems is speed of treatment. If you get cancer or heart disease in the USA, you are diagnosed and treated in a fraction of the time. The socialized system may cover more people, but it reduced the speed of service for the overwhelming majority.

    If you get cancer in the USA, your chancing of surviving are significantly hire than if you get cancer in Canada.

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  6. Or if you are attacked by a cougar, your chances of survival are likely better in the USA. There are a lot of cougars surrounding Vancouver. If their territory is expanding, then their prey must be increasing in abundancy.

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