Most experts agree that the United States has set the standard for
health care innovation. Thousands of people from around the world
travel to the U.S. each year for medical treatment not found anywhere
else. But many analysts say America's health care policy needs drastic
reform. Will patients, doctors, insurance companies and the government
see eye-to-eye on health care reform?

To read this news feature, please go to:
http://www.contactomagazine.com/arti...crisis0907.htm

More News Features:
http://www.contactomagazine.com/index2.htm

"Joe" wrote in message
ups.com...

Most experts agree that the United States has set the standard for
health care innovation. Thousands of people from around the world
travel to the U.S. each year for medical treatment not found anywhere
else.

You are right: traveling patients are one indicator of
the popularity of American medicine. But other relevant
indicators a
1. Longevity (age at death), infant mortality, morbidity
(incidence of hospitalized disease) etc. The USA usually
ranks about 30th of the 150+ countries in the world.
2. Personal coverage by health insurance. The USA is
the only "advanced" country to have no comprehensive
system of health insurance, so that a significant part
of the population (20 or 15 per cent) has no coverage at all.

--
Don Phillipson
Carlsbad Springs
(Ottawa, Canada)

In article ,
says...
"Joe" wrote in message
ups.com...

Most experts agree that the United States has set the standard for
health care innovation. Thousands of people from around the world
travel to the U.S. each year for medical treatment not found anywhere
else.

You are right: traveling patients are one indicator of
the popularity of American medicine. But other relevant
indicators a
1. Longevity (age at death), infant mortality, morbidity
(incidence of hospitalized disease) etc. The USA usually
ranks about 30th of the 150+ countries in the world.

These are not good indicators of the health care system at all. For
example, infant mortality is biased by the inner-city population who
doesn't seek health care, druggies, and pregnancies that are so
troubled that they wouldn't get as far (or be counted) as birth
elsewhere

2. Personal coverage by health insurance. The USA is
the only "advanced" country to have no comprehensive
system of health insurance, so that a significant part
of the population (20 or 15 per cent) has no coverage at all.

This is no measure of anything other than the obvious (and the
politics of "health care"). Most of those uninsured choose not to
have health insurance (or care) or are inbetween. Do note that
"health care" insurance.

--
Keith

"krw" wrote in message
t...

1. Longevity (age at death), infant mortality, morbidity
(incidence of hospitalized disease) etc. The USA usually
ranks about 30th of the 150+ countries in the world.

These are not good indicators of the health care system at all. For
example, infant mortality is biased by the inner-city population who
doesn't seek health care, druggies, and pregnancies that are so
troubled that they wouldn't get as far (or be counted) as birth
elsewhere

Just remind us please which of the other top 30 countries
of the world leave the poorest people out of national
statiistics of infant mortality.

2. Personal coverage by health insurance. The USA is
the only "advanced" country to have no comprehensive
system of health insurance, so that a significant part
of the population (20 or 15 per cent) has no coverage at all.

This is no measure of anything other than the obvious (and the
politics of "health care"). Most of those uninsured choose not to
have health insurance (or care) or are inbetween. Do note that
"health care" insurance.

Yes, we are sometimes told "Most of those uninsured choose not to
have health insurance (or care)." The point is that in civilized
countries arrange beforehand to cover the unforeseeable. We
know X hundred people will be injured in road accidents next
week, but we do not know which individuals: so we prearrange
health care for all X00 accident victims whoever they may turn
out to be. The USA seems to be almost the only jurisdiction that
deliiberately avoids doing this. This may be one reason why,
after the fact, health care costs Americans more (as a percentage
of income) than it does Frenchmen, Australians, Brazilians etc.

--
Don Phillipson
Carlsbad Springs
(Ottawa, Canada)

In article ,
says...
"krw" wrote in message
t...

1. Longevity (age at death), infant mortality, morbidity
(incidence of hospitalized disease) etc. The USA usually
ranks about 30th of the 150+ countries in the world.

These are not good indicators of the health care system at all. For
example, infant mortality is biased by the inner-city population who
doesn't seek health care, druggies, and pregnancies that are so
troubled that they wouldn't get as far (or be counted) as birth
elsewhere

Just remind us please which of the other top 30 countries
of the world leave the poorest people out of national
statiistics of infant mortality.

Simple, really. If they aren't born alive they aren't counted.
Often if they don't live for a certain time they aren't counted as
live births. Not all countries spend the resources the US does on the
most premature. You can't use raw statistics like the above to draw
such broad conclusions.

2. Personal coverage by health insurance. The USA is
the only "advanced" country to have no comprehensive
system of health insurance, so that a significant part
of the population (20 or 15 per cent) has no coverage at all.

This is no measure of anything other than the obvious (and the
politics of "health care"). Most of those uninsured choose not to
have health insurance (or care) or are inbetween. Do note that
"health care" insurance.

Yes, we are sometimes told "Most of those uninsured choose not to
have health insurance (or care)."

Only because it's true.

The point is that in civilized
countries arrange beforehand to cover the unforeseeable.

Civilized countries don't run their citizen's lives for them. Choice
is important to some.

We
know X hundred people will be injured in road accidents next
week, but we do not know which individuals: so we prearrange
health care for all X00 accident victims whoever they may turn
out to be.

....and if it turns out there are X01 victims, it's tough be be the
one standing when the music stops.

The USA seems to be almost the only jurisdiction that
deliiberately avoids doing this. This may be one reason why,
after the fact, health care costs Americans more (as a percentage
of income) than it does Frenchmen, Australians, Brazilians etc.

There are many reasons why it costs more, but it's not because the
French know how many traffic accidents there will be.

--
Keith

On Sep 16, 9:01 pm, krw wrote:
In article ,
says...





"krw" wrote in message
et...

1. Longevity (age at death), infant mortality, morbidity
(incidence of hospitalized disease) etc. The USA usually
ranks about 30th of the 150+ countries in the world.

These are not good indicators of the health care system at all. For
example, infant mortality is biased by the inner-city population who
doesn't seek health care, druggies, and pregnancies that are so
troubled that they wouldn't get as far (or be counted) as birth
elsewhere

Just remind us please which of the other top 30 countries
of the world leave the poorest people out of national
statiistics of infant mortality.

Simple, really. If they aren't born alive they aren't counted.
Often if they don't live for a certain time they aren't counted as
live births. Not all countries spend the resources the US does on the
most premature. You can't use raw statistics like the above to draw
such broad conclusions.

Then why are our life expectancies at one year of age lower than every
other civilized country? and two years of age? and 5? and 10? and 20?
and 30? and 40, 50, 60? But we do catch up at 70, and keep getting
better as you get older.

I don't suppose that could be because geriatric medicine is heroic and
pays extremely well, but the younger you are the more medicine becomes
boring routine and a low priced commodity?

It's like saying Italy is the foremost automotive manufacturing
company on earth, because people from all over the world come to buy
Ferraris.

On Sep 15, 1:35 pm, Joe wrote:
Most experts agree that the United States has set the standard for
health care innovation. Thousands of people from around the world
travel to the U.S. each year for medical treatment not found anywhere
else. But many analysts say America's health care policy needs drastic
reform. Will patients, doctors, insurance companies and the government
see eye-to-eye on health care reform?

To read this news feature, please go to:http://www.contactomagazine.com/arti...crisis0907.htm

More News Features:http://www.contactomagazine.com/index2.htm

The trouble is medical innovation costs money, and patient care is in
an era of saving money.

Used to be, one of the explicit goals of Medicare was to fund medical
schools. That got cut out.
US pharmaceutical prices are higher, as everybody points out that
funds pharmaceutical research. But insurers are getting tired of
having to carry the world's pharmaceutical research needs on their
backs, and passing them on to you.
Federal funding for basic biological research in universities, without
which there would be no pharmaceutical research, is way down.

And medical innovation doesn't translate into patient care. Folks in
Canada get access to the same medicine that Americans do, even though
they "don't pay their fair share" of the research costs. Or the
marketing costs.

On Sep 15, 2:19 pm, "Don Phillipson"
wrote:

You are right: traveling patients are one indicator of
the popularity of American medicine.

Indeed:
"In 2005, for example, Bumrungrad Hospital in Thailand served more
than 50,000 American patients, a 30 percent increase from the previous
year."
http://abcnews.go.com/Business/Indus...2320839&page=1

Northern US residents have been crossing the border to get cheaper
drugs and cheaper medical care for years, and southern US residents
have been going to Mexico for years. But now Americans and their
insurers are finding it pays off to send patients overseas.

In article .com,
says...
On Sep 16, 9:01 pm, krw wrote:
In article ,
says...





"krw" wrote in message
et...

1. Longevity (age at death), infant mortality, morbidity
(incidence of hospitalized disease) etc. The USA usually
ranks about 30th of the 150+ countries in the world.

These are not good indicators of the health care system at all. For
example, infant mortality is biased by the inner-city population who
doesn't seek health care, druggies, and pregnancies that are so
troubled that they wouldn't get as far (or be counted) as birth
elsewhere

Just remind us please which of the other top 30 countries
of the world leave the poorest people out of national
statiistics of infant mortality.

Simple, really. If they aren't born alive they aren't counted.
Often if they don't live for a certain time they aren't counted as
live births. Not all countries spend the resources the US does on the
most premature. You can't use raw statistics like the above to draw
such broad conclusions.

Then why are our life expectancies at one year of age lower than every
other civilized country? and two years of age? and 5? and 10? and 20?
and 30? and 40, 50, 60? But we do catch up at 70, and keep getting
better as you get older.

Murder, bad diet, lack of exercise, primarily.

I don't suppose that could be because geriatric medicine is heroic and
pays extremely well, but the younger you are the more medicine becomes
boring routine and a low priced commodity?

Don't you work for someone with money? You do work?

It's like saying Italy is the foremost automotive manufacturing
company on earth, because people from all over the world come to buy
Ferraris.

Don't be stupid.

--
Keith

In article .com, z says...

It's like saying Italy is the foremost automotive manufacturing
company on earth, because people from all over the world come to buy
Ferraris.


Ooo - I like that.

Banty

On Sep 20, 9:12 pm, krw wrote:

Then why are our life expectancies at one year of age lower than every
other civilized country? and two years of age? and 5? and 10? and 20?
and 30? and 40, 50, 60? But we do catch up at 70, and keep getting
better as you get older.

Murder, bad diet, lack of exercise, primarily.

Which all mysteriously improve to best in the world, as you grow
older? Gee.


I don't suppose that could be because geriatric medicine is heroic and
pays extremely well, but the younger you are the more medicine becomes
boring routine and a low priced commodity?

Don't you work for someone with money? You do work?

??? so you agree that the current US healthcare system is designed to
generate the most profit, rather than deliver the best healthcare for
the same money?

On Sep 20, 8:12 pm, krw wrote:
In article .com,
says...





On Sep 16, 9:01 pm, krw wrote:
In article ,
says...

"krw" wrote in message
et...

1. Longevity (age at death), infant mortality, morbidity
(incidence of hospitalized disease) etc. The USA usually
ranks about 30th of the 150+ countries in the world.

These are not good indicators of the health care system at all. For
example, infant mortality is biased by the inner-city population who
doesn't seek health care, druggies, and pregnancies that are so
troubled that they wouldn't get as far (or be counted) as birth
elsewhere

Just remind us please which of the other top 30 countries
of the world leave the poorest people out of national
statiistics of infant mortality.

Simple, really. If they aren't born alive they aren't counted.
Often if they don't live for a certain time they aren't counted as
live births. Not all countries spend the resources the US does on the
most premature. You can't use raw statistics like the above to draw
such broad conclusions.

Then why are our life expectancies at one year of age lower than every
other civilized country? and two years of age? and 5? and 10? and 20?
and 30? and 40, 50, 60? But we do catch up at 70, and keep getting
better as you get older.

Murder, bad diet, lack of exercise, primarily.

I don't suppose that could be because geriatric medicine is heroic and
pays extremely well, but the younger you are the more medicine becomes
boring routine and a low priced commodity?

Don't you work for someone with money? You do work?

It's like saying Italy is the foremost automotive manufacturing
company on earth, because people from all over the world come to buy
Ferraris.

Don't be stupid.

--
Keith- Hide quoted text -

- Show quoted text -

Just so you know Canadians pay just as much as Americans for the
research of drug companies. What we do is standerdise the price across
the nation. I know that our system is not perfect but I know I will
get help when I need it. Can all Americans say the same

jim wrote:

Just so you know Canadians pay just as much as Americans for the
research of drug companies.

Excuse me? Certainly not on an absolute dollar basis. In the decade that ended
in 2002, Europe's R&D spending was $21 billion, while U.S. expenditures were $26
billion and rising. How much did Canada spend?

And not on a per capita basis either.

What we do is standerdise the price across the nation.

Right. It's called socialized medicine. The Canadian government is dictating the
price they will pay drug companies. That works fine as long as the market is big
enough to provide some marginal income for the drug companies and someone else
is willing to shoulder the costs for developing new drugs. It breaks down when
the country paying the majority of the costs decides they can't afford it any
longer, which is what's happening with the US.

I know that our system is not perfect but I know I will
get help when I need it. Can all Americans say the same

Now you are moving from drug research to health care approaches.

No individual in the US, legal or otherwise, can be denied emergency healthcare
in the US. That's the current law and has been for years. Compare waiting times
for non-emergency care and diagnostics between the two countries and you might
be surprised.

It surprises me that the same people who are so quick to point fingers and yell
"monopoly" when they see a company with the majority of a market seem to be the
same people who want monopoly in health care.

--
"Tell me what I should do, Annie."
"Stay. Here. Forever." - Life On Mars

On Sep 23, 10:10 pm, Rick Blaine wrote:
jim wrote:
Just so you know Canadians pay just as much as Americans for the
research of drug companies.

Excuse me? Certainly not on an absolute dollar basis. In the decade that ended
in 2002, Europe's R&D spending was $21 billion, while U.S. expenditures were $26
billion and rising. How much did Canada spend?

Unless I miss I guess, you are talking about government R&D spending,
not how much each person in each country contributed towards total R&D
in the entire human universe.

z wrote:

Unless I miss I guess, you are talking about government R&D spending,
not how much each person in each country contributed towards total R&D
in the entire human universe.

Governments do not make money, they take money. Where do you suppose that
Government R&D spending comes from?

--
"Tell me what I should do, Annie."
"Stay. Here. Forever." - Life On Mars

On Sep 23, 10:10 pm, Rick Blaine wrote:

Right. It's called socialized medicine. The Canadian government is dictating the
price they will pay drug companies. That works fine as long as the market is big
enough to provide some marginal income for the drug companies and someone else
is willing to shoulder the costs for developing new drugs. It breaks down when
the country paying the majority of the costs decides they can't afford it any
longer, which is what's happening with the US.

??? Free market or unfreemarket, in any system the seller and buyer
have to agree on a price. If the Canadian government decides it can't
afford to pay a hundred dollars for some erection drug, it offers $3.
Nothing's stopping the drug company from saying no. The Canadian
government can't compel an American or German or Swiss company to sell
them a drug at a loss. The drug companies continue to sell in Canada
because that's still making money, although not as much as if they
could get as much as they asked. For example, see how the drug
companies weren't selling AIDS drugs in Africa, since they weren't
making money selling those drugs at what those countries could pay,
until they got kind of shamed into it by PR.

In general, most companies or individuals would make more money if the
buyer would just pay whatever the seller asked; and quite often, that
would indeed lead to a higher quality of product, or more diverse
product, etc. However, for whatever reasons, the market does not work
that way, and buyer and seller settle on a price that each of them can
accept, or there is no sale. That's hard on the folks who do pay
whatever price the seller charges without bargaining, but the answer
to that is not to compel the folks who do bargain to stop that and
just pay whatever the seller charges. In that case, they would just
not buy the stuff at all.

Of course, this whole question of who pays for research ignores the
nature of companies like pharmaceuticals, or chip designers, etc.,
where fixed costs like research are huge, while the actual variable
costs (i.e. per pill) are tiny, so that assiging what portion of the
research cost is correct for each individual pill is just arbitrary.
See the ongoing debate over whether pharma research costs are actually
more or less than advertising costs. If you want to look at actual
costs, the first sample of a pill (or chip) produced costs
$1,000,000,000, and all samples after that
cost $1. Which brings us back to that reference I made above; if the
drug companies weren't making money in Canada, they wouldn't sell
there.

The simple answer would be to explicitly fund pharmaceutical research
by the government(s) as something that needs to be done for society,
but is a money loser for whoever gets stuck paying for it, rather than
bury it in the overall budget and try to parcel it out per pill, but
that would change the whole pharma biz greatly.



No individual in the US, legal or otherwise, can be denied emergency healthcare
in the US. That's the current law and has been for years.

right:

"People have access to healthcare in America. After all, you just go
to an emergency room."
- George W. Bush, July 2007

"Bush polyps benign
WASHINGTON, July 23 (UPI) -- White House spokesman Tony Snow Monday
said the five polyps removed during U.S. President George Bush's
weekend colonoscopy were benign.
....
"They represent the various -- very earliest cellular changes," Snow
said. "Left untreated, they can progress to larger, more advanced
lesions and a small percentage could become cancerous."
http://www.upi.com/NewsTrack/Top_New...s_benign/2751/

Better for the patient, cheaper than treating the patient for cancer
later.

So, the only thing that I'm wondering is.... at which emergency rooms
can you get a colonoscopy so your precancerous polyps are removed,
saving you a bunch of grief and the "system" a ton of money?

This is a perfect example of what's wrong with the US healthcare
system. At an absolute minimum, there's 10% of the population who
cannot get a cheap and simple and low risk procedure with a big payoff
for them and the finances of the system; instead, they get told "come
back when you get cancer, we'll treat you for free then, and vast cost
to the system (i.e. everybody else) and a lot of misery and high risk
of death for you". How can this possibly NOT end up giving the stats
we see: higher death rate/lower life expectancy, and double the cost
of any other country? And this is just one example of many such. The
only possible advantage to anybody is that those who do have health
insurance or can afford to pay virtually unlimited sums for their
healthcare can feel superior to those who can't and don't. The price
for that is too damn high.

On Sep 25, 9:24 am, Rick Blaine wrote:
z wrote:
Unless I miss I guess, you are talking about government R&D spending,
not how much each person in each country contributed towards total R&D
in the entire human universe.

Governments do not make money, they take money. Where do you suppose that
Government R&D spending comes from?

Well, thank you for the rightwing pedagogical tautology, but the
question I apparently failed to make clear is, when you say
"Excuse me? Certainly not on an absolute dollar basis. In the decade
that ended
in 2002, Europe's R&D spending was $21 billion, while U.S.
expenditures were $26
billion and rising. How much did Canada spend? "
given that that's presumably government R&D spending, what the flying
donut does that have to do with the question of drug company research
being stifled by Canada's paying less for drugs than the US does?

z wrote:

what the flying
donut does that have to do with the question of drug company research
being stifled by Canada's paying less for drugs than the US does?

As another poster described very clearly, pharma drug prices are a prime example
of where R&D costs dramatically outweigh production costs. When you get in a
situation like that, you have to allocate some portion of those research costs
(and that includes a portion of all the drugs that didn't work out) to each and
every pill sale.

Canada and other countries that manage costs by making the government procure
the drugs get lower prices are essentially saying that they want to pay less for
the R&D costs than a country like the US.

As long as countries like the US continue to fund the majority of R&D through
higher drug prices, that system works fine. If Hilary Care II gets implemented,
that funding drops off.

Nothing happens the day after, but over time there's less money invested in new
drugs and less progress towards new ones...

--
"Tell me what I should do, Annie."
"Stay. Here. Forever." - Life On Mars

On Sep 25, 3:17 pm, Rick Blaine wrote:
z wrote:
what the flying
donut does that have to do with the question of drug company research
being stifled by Canada's paying less for drugs than the US does?

As another poster described very clearly, pharma drug prices are a prime example
of where R&D costs dramatically outweigh production costs. When you get in a
situation like that, you have to allocate some portion of those research costs
(and that includes a portion of all the drugs that didn't work out) to each and
every pill sale.

Canada and other countries that manage costs by making the government procure
the drugs get lower prices are essentially saying that they want to pay less for
the R&D costs than a country like the US.

As long as countries like the US continue to fund the majority of R&D through
higher drug prices, that system works fine. If Hilary Care II gets implemented,
that funding drops off.

Nothing happens the day after, but over time there's less money invested in new
drugs and less progress towards new ones...

Absolutely. A big hole in the system. Similar to 'who pays for medical
schools?" as I mentioned the other day. used to be Medicare, paying
teaching hospitals more than other hospitals for the same services. no
more, they're doing the Canada thing.

Socialism or no socialism; things which society needs which cannot
adequately be funded by a profit making entity need to be funded by
taxes. That includes the military, firemen, and basic research, for
starters.

Even with the current system, how do you fund R&D "fairly"? when a
drug company has a drug fail in the late stages of clinical trials,
that's a fortune down the drain, billions of dollars. How do you
apportion that? Add it to the price of every aspirin or similar they
sell? Why is it fair that every time I have a headache I have to pay
for their failed effort to aid HIV victims, but it's not fair that
taxpayers pay for it? Add it to the price of the next drug they
succeed with for the same problem? Then you'll see some really
expensive drugs.

You just can't apportion research costs in any such fashion. Let alone
basic research costs; that's why universities do basic research, not
private companies. do you think all the basic research that led to the
current genetic technology boom came from private corporations? No. It
was a completely unpredictable byproduct of a very esoteric research
into bacterial genetics called DNA restriction which never in a
billion years could be expected to be commercially profitable, and
never became so; except for this odd little byproduct that has
generated billions of dollars of business. no sane company would ever
have wasted a dollar researching DNA restriction. And none did.