It's better in cancer than in other specialties since so much of the actual deliverable is prepackaged and uniform. The states show that unless a hospital does at least 200 open heart surgeries a year their odds of geting it right decline pretty quickly as the number goes down. Yet there are hospitals that do 50 a year with incredible bad outcomes that we can -- and have -- measured statistically. Imagine handing your life savings to someone to trade for you with very little actual screen time. And that's only money!
Thank you. Well said and my personal impression, as well. And yes I did understate. Incidentally my grandfather, my father, and three uncles were all M.D.s. One was President of his State's Medical Society, one was chief of staff at two of three hospitals in his home town and President of his County Medical Society, yet still found time to publish a handful of papers. One founded a Children's hospital in California. Together, before the second world war, they founded a Regional Clinic that today is an important medical provider for a large region of one of our Northern States. All begin their practices before wide spread insurance and before medicare. All adjusted their fees according to their patients ability to pay, and all worked pro bono when patients couldn't pay. My Dad delivered a baby for a chicken during the depression. During the war, when his three brothers were in the army, there was a shortage of M.D.s on the home front and he did whatever was needed, including nailing hips, general surgery, and delivering babies. After the war they moved to various regions of the country and were all in private practice, made house calls and visited hospitalized patients twice per day. They are all gone now, a country doctor who visited his patients in a horse drawn buggy and operated on farmhouse kitchen tables, two surgeons, one pediatrician, and one gastroenterologist. They would all be appalled at what has happened to American Medicine.
No, I don't see how. Wiki would be preferable to Cato, really? Did you actually read the Cato report in it's entirety? I ask because that specific point was addressed and explained. The WHO ranking is flawed. Ergo any premise drawn from said ranking is also flawed. What exactly is this conjecture based on? I'm certainly not "young" at 52. Maybe a little, but if you feel I'm better informed why are you arguing with me? LOL You're going to believe a career politician over say a research entity like Cato? Really? Think about that for a minute. So far Obama care has done nothing but RAISE insurance rate, significantly. Not that I and other realistically minded folks are surprised. "System" or not when ranked on an apple to apples comparison it's still among the best in the world. Do we have issues, could it be improved? Absolutely. Getting Washington even more involved though is like pouring gasoline on a fire. There can not and will not be any significant REAL improvement in our "system" so long as Washington is in control.
The WHO is a relatively neutral organization using objective, measurable criteria. The CATO institute is an American libertarian think tank founded as the Charles Koch Foundation in 1974. Of course I don't trust the Cato Institute to be objective. I recognize it for what it is, and I read the report you posted, which was interesting. As I have said all along, we are a nation of crises and sometimes we won't do much in the way of solving a problem until we are forced to. It looks as though medical care in the U.S. is ultimately headed for just such a crisis. If Obamney care is much worse, then that will help us toward that crisis and we may get a faster resolution than if we just limped along with our present miserable health care, or an only somewhat better Obomney care. On the other hand, I understand some of the parts, at least, of Obamney care left standing by the Republicans, and I can see how they could lead to a considerable improvement in both efficiency and cost. I think I pointed out to you previously that the goal is to reduce the per capita cost and bring most of the population under some kind of medical insurance plan. Naturally when you add another 38 million to the routine health care roles you have higher total cost. Everyone understands that. So when you hear some idiot saying Obamney care is going raise costs just smile and say, "of course you idiot." On the other hand if we were to adopt say the Swiss system including their reimbursement rates, hospital costs, insurance premiums, and of course prescribing pharmacists -- that's a critical element needed to bring cost down-- then of course we could bring another 38 million under coverage and reduce total cost, not just per capita cost. That's because the Swiss per capita cost is now half what ours is and 38 million is only about 11% of our population. That would be too simple, though, for the anarchists in the Tea party to accept. So instead they are going to force us into greater total cost. (You can't expect "higher" math from them, if they were capable of that they wouldn't belong to the tea party in the first place.) It's comical how they are their arch enemies, corporate America, best friends without realizing it. The Princeton graduates at Goldman are always going to be a lot smarter then the "Joe the Plumber" tea party folks. ____________________ By the way Lucrum, shouldn't it be "Romma care", or "Romboma" care, rather then "Obomney care", if we want to credit these guys in the order of their advocacy? I think I like like Romma care best, because the tea party folks won't be capable of figuring out where it comes from and it is shorter by two letters.
A libertarian think tank less objective than the WHO? Sorry pie, no sale. And if the WHO is so neutral why did they intentionally trash the US ranking with biased and faulty statistics? If not intentional, do they really know what they're doing? So you're OK with this disaster Obamacare because it's going to make things so much worse we'll finally get around to making them better? So if my third floor has a trash fire I should take a flame thrower to the rest of the house. Burning it to the ground so I can rebuild completely. Rather than just put out the trash fire and redecorate the third floor? Then according to you Obama is an idiot and or a liar. He specifically said Obamacare would lower costs. Like all those fancy bankers and their expensive degrees who nearly collapsed our economy several years ago, you know because they're so smart? While Joe and the rest of us live within our means and balance our check books? "Educated" and smart are too different things my friend. I've personally known some incredibly stupid "educated" people in my life. ____________________ I like "Obama disaster" better. To me it matters not where it originated. A bad idea poorly implemented is still a bad idea.
Quote from Lucrum "Then according to you Obama is an idiot and or a liar. He specifically said Obamacare would lower costs. Permit me to assume it is your characterization, not mine, that "Obama is an idiot and/or a liar." Obomney care very likely will lower costs --even in its crippled form. The best cost measure is, of course, cost per covered person, not total cost. We don't know for sure yet, but the CBO says Obomney care will lower cost. They are basing their statement on the total cost with and without Obamney care projected into the next decade. They say with Obomney care costs won't rise as much -- that, young whippersnapper, is "lower cost." But the most important measure is the cost per person covered, and that too should be lowered by Obamney care. So, we don't know yet if Obama is right or wrong yet. But I think he is right, and you think he is an idiot. I think you will be proven wrong on that count. (But take heart, he still might be a liar, and you could be at least be 50% correct!). Naturally, ceteris paribus, if you insure 10 people it will cost less than insuring 20. So yes insuring 38 million more will cost more. But you're way too smart not to have figured that out, whippersnapper.
1. It's not about insuring more people that's going to cost more. If the insurance model stays the same, costs per person shouldn't increase. the problem is you're changing the model. Ie, forcing companies to allow children on their parents plans until 26. Forcing insurance companies to cover pre-existing conditions (this is huge), etc. 2. If you're going to compare the cost per person, you have to do it apples to apples. You can't take a subsidized amount someone pays and consider that the cost. You have to include the subsidy as well for the total cost of the premium. Makes no difference if the poor person isn't paying it. Someone will be. 3. As for the CBO estimating, well...anything correctly, don't make me laugh. Costs have to go up. Play all the semantics games you want. It's all just bullshit.
You said:" Naturally when you add another 38 million to the routine health care roles you have higher total cost. Everyone understands that. So when you hear some idiot saying Obamney care is going raise costs just smile and say, "of course you idiot." Obama said it WILL lower costs. Just the opposite IS happening. Ergo YOU characterized anyone who thinks other wise including Obama as an idiot. Adding more to the insurance rolls should only cost more if those already insured are paying for it. The CBO? Seriously? You're "argument" is crumbling with every new post pie. I and millions upon millions of others know he's wrong, whether you've figured it yet or not. If it costs more, why is it insurance companies are always trying to sell more insurance policies?
Lucrum, as you know having read the Cato Institute report, Cato took exception to the WHO category labeled "Fairness". This category includes measures of how cost of care is distributed among the population relative to ability to pay. (The WHO takes the position that everyone no matter how poor should have access to at least routine health care. I realize that some Libertarians might consider this a flaw in WHO reasoning.) Specifically, Cato took exception to the weighting of this factor, which is weighted fairly heavily. I think Cato's criticism in this regard is fair, and I might even agree with it, though I think the WHO's "Fairness" category is an important measure of the efficacy of healthcare in a country because it bears heavily on access. It doesn't matter if you have very good routine care available to 80% of the population if there is 20% that doesn't have good access, you won't score well in this category. The U.S. could rank at the top with regard to some advanced surgical procedures for example, but if only a small percent of the population can access those procedures than your WHO ranking is not going to get much help from those remarkable accomplishments. The U.S. scored particularly low in the "Fairness" category. Had the weighting of that category been reduced some, something I might agree with, the U.S. would have moved up in the rating, perhaps as high as the top 20 nations or so.
I could give a rats ass about any world organization's "rating system". Free health care should not be an entitlement or right.