Scandinavia - working socialist economies?

[jcx]

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Part of why medical care is so good in the US is because it is privatised. There is more incentive for people to become doctors or open hospitals here. Also, most new drugs are deeveloped here because we offer them generous patents and prices.

To my knowledge, there is a shortage of such services and R+D in Europe. In general I feel universal healthcare is often a way of partying now at the expense of tommorrow. For instance, if you won't pay drug makers alot for a new drug then they will stop developing them.

America basically subsidizes most advances in healthcare, as these would not take place in the European framework because of the incentive scheme.

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We have commercial drug making industry and a few private hospitals as well, in addition to resultsbased research funding etc.; so there are some incentives. However, I think you are right they are stronger in the US.

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Lehighguy has hit on the most important issue. The rest of the world is freeriding on the back of the American consumer, who is paying the tab for R&D whilst Europe and Canada set price controls on drugs. Private European drug companies certainly exist but they're not investing billions to develop new treatments because of demand at home, but the gold mine across the Atlantic. The day that US medicine goes completely socialized will be a day for the sick to truly weep.

Note that "privatized" healthcare does not imply our healthcare industry, both suppliers and consumers, has any economic freedom.

[sam h]

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When people say we have the best healthcare in the world they mean we have the best drugs, hospitals, doctors, equipment, and facilities. We also have shorter waiting lists and more healthcare options.

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I am not sure that drugs in America are any better than drugs anywhere else. They might be made primarily by American companies, but are still available elsewhere.

The big point is that the only sensible way to measure the quality of a health care system is to assess it based on two figures - the cost per capita and the quality of care averaged over the entire populace. I don't have figures at hand and can't be bothered to dig them up right now, but we have a very costly system that doesn't provide coverage to a huge swath of the population. If you are covered and cost isn't really an object for you personally, because you are employed somewhere with good benefits, then the system is great because at the top end the doctors and facilities are the best in the world. If you don't happend to be one of those people, the system sucks because you can't even get things like pre-natal care, which is ridiculous.

[Cyrus]

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The only sensible way to measure the quality of a health care system is to assess it based on two figures - the cost per capita and the quality of care averaged over the entire populace.

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The end-result measurement (such as infant mortality rate) is the most important statistic.

What good is it to have "low cost per capita" or "good quality" (however that is pre-determined!) and have infants dying off in significant numbers?

[Cyrus]

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The American consumer ... is paying the tab for R&D whilst Europe and Canada set price controls on drugs. Private European drug companies certainly exist but they're not investing billions to develop new treatments because of demand at home, but the gold mine across the Atlantic. The day that US medicine goes completely socialized will be a day for the sick to truly weep.

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You are ignoring the factor of greed, here. I submit that the human race is consuming far more drugs than are actually needed, as a whole, and I mean far, far more!

I further submit that this excess is more pronounced in the United States than in the other industrialised democracies.

If pharmaceutical companies have a market to plunder, in Europe or America, they will go right ahead and do it. Why are you surprised or upset that the European pharmas are getting rich by giving the American consumers the fix they crave? If the drug habit was more pronounced in Europe than in America, the argument against "greedy Americans riding off the bak of Europeans" would be equally meaningless.

The problem is too much drug use.

Pharmas create demand, control R&D, promote incessantly higher drug use, corrupt MDs into promoting drug use (sometimes to the detriment of the patient's health), maintain expansive, possessive and aggressive networks of salesmen & distributors -- and they over-price like street drug dealers.

...Those guys are a cinch to take over the heroin, crack and cocaine trade when it will be legalised! They wrote the book.

[lehighguy]

Dude, how exactely is taking medicine that helps with a variety of diseases "excessive use". I'm not talking about Ritalin here, but the myriad of effective drugs that have been developed in the last 30 years to treat any number of diseases and conditions.

When I was in Japan I got sick and was having diareah every 15 min. I went to the Japanese doctor and he basically just gave me a few vitamins and told me to wait it out. Well, after two weeks I was back home and I was tired of still having diareah every 15 min. So I went to me American doctor, got a preserciption, and I was fine in a day.

Maybe that is excessive to you, but I'm glad I don't still have the shits.

[sam h]

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The end-result measurement (such as infant mortality rate) is the most important statistic.

What good is it to have "low cost per capita" or "good quality" (however that is pre-determined!) and have infants dying off in significant numbers?

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Quality was just referring to some kind of metric that would aggregate things like infant mortality rate, extent of coverage, etc. Obviously aggregating a variety of measures poses its own problems, but using only one dimension like infant mortality rate does not make sense either.

My words were a bit carefless RE cost. You shouldn't put cost into the equation if you are just interested in some absolute level of quality of health care. If you want to compare the efficacy of different ways of organizing health systems in different societies, however, then you need cost as a fundamental variable.

[ACPlayer]

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Who controls the publishing of statistics in Cuba? What impartial organization verified these findings

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Good questions.

The post was from the CIA. I presume they have some mechanism to verify the numbers. But of course the questions are valid.

[ACPlayer]

I would submit to you that we are taking too many drugs, specially for those conditions that are long term. These are driven by the drug companies.

Take two points:

1. In the 80's the drug companies fought for and had the law passed that allowed them to market directly to consumers rather than by educating doctors. This has resulted in an explosion of ads for conditions that before that people generally ignored. Now people go to doctors having seen a 30 second commercial about a symptom they "recognize" and ask for a drug. Neither the consumer nor the doctor has any disincentive from using this drug as the costs are simply borne by the insurance companies. Those marketing costs are of course built into the cost of the drugs.

2. Take cholestrol. Used to be that the threshhold considered high was 240 then 220 then 200 then 160. Each of these numbers comes from drug company sponsored research. Each of these adds a large swath of the population to the market so that the meat, cake, and Haagen Dazs consumers can get there "free" lipitor and stave of heart disease. Hah!

Drugs are sold to us like deoderant and are not offered to us by knowledgeable doctors treating our conditions anymore.

Now an informed consumer is a good thing, but the drug companies are pushing ritalin, lipitor, prozac as the solution to all sorts of problems real and imagined.

[hetron]

Try asking some middle class swedes or norwegians if they would trade their lifestyle for that of a middle class person in the US. Go ahead, ask them.