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What?  European style socialist healthcare is better than the healthcare we receive in the greatest nation on earth?  Well yes, yes it is, according to a study conducted by the National Research Council and the Institute of Medicine entitled "U.S. Health in International Perspective: Shorter Lives, Poorer Health."

“We were struck by the gravity of these findings,” said Steven Woolf, professor of family medicine at Virginia Commonwealth University in Richmond and chair of the panel that wrote the report. [...]

The report is the first of its kind to look at a range of illnesses, injuries and behaviors of people of all ages in the United States to run a comparison with counterparts in rich countries such as Australia, Canada, Japan and several countries in western Europe.

Among the countries studied, the United States was in last place or close to last in nine key benchmark areas.

They were: infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability.

And it's not just poor people or uninsured people who make our health care system look bad.  Even our white rich people are worse off than their counterparts in other countries:

However, the panel's research suggests that the U.S. health disadvantage is not solely a reflection of the serious health disadvantages that are concentrated in the U.S. among poor or uninsured people or ethnic and racial minorities.  Americans still fare worse than people in other countries even when the analysis is limited to non-Hispanic whites and people with relatively high incomes and health insurance, nonsmokers, or people who are not obese.  
Something is terribly wrong in this country and has been for some time when it comes to the health and well being of our people (other than those corporate persons who get to spend as much as they want to influence our elections and the laws Congress considers).  We came out of WWII and developed the most prosperous, best educated, healthiest nation on earth.  But that was over sixty years ago.

Today, among our peers in the developed world, we rank as the unhealthiest nation.  Coincidentally, we have the greatest income inequality in our history.  During the good old days - back when "union" was not a dirty word, teachers were paid a living wage and we led the world in government funded medical research and public health programs - we dramatically reduced income inequality to the lowest point in our history.  

Then came Reagan, deregulation, privatization, and the rise of the for profit health care industry.  Now we spend more per capita on health care than any other country in the world, and we get worse health care than our neighbor to the North, and the nations we defeated in WWII, Japan and Germany, among others.  As the author of the panel that issued this report stated, this level of suffering is unnecessary.  You know, when people take medical vacations to get dental care and other medical treatments in Mexico and Costa Rica because they can't afford the cost of those services in "the land of the free and the home of the brave" - well, need I say more.

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  •  Tip Jar (191+ / 0-)
    Recommended by:
    agnostic, ask, roseeriter, dance you monster, Naniboujou, Tinfoil Hat, sunny skies, jbob, Matt Z, DRo, RJDixon74135, Habitat Vic, jdld, Rogneid, twigg, GeorgeXVIII, Dr Erich Bloodaxe RN, ChemBob, howd, Cedwyn, pittie70, marleycat, tomephil, randallt, golem, blue speck, hlsmlane, Byron from Denver, sewaneepat, Dallasdoc, Dobber, OleHippieChick, IreGyre, triplepoint, Canuck in Ohio, a2nite, Bob Duck, MartyM, poliwrangler, marking time, Ian H, Bob B, theKgirls, RandomGuyFromGermany, Kim from Pgh PA, celdd, Iberian, beth meacham, Phoebe Loosinhouse, One Pissed Off Liberal, Liberal Thinking, psnyder, filkertom, Smoh, kerflooey, flowerfarmer, dotsright, zerelda, pixxer, asterkitty, Joieau, leonard145b, fallina7, US Blues, offred, cybersaur, caul, historys mysteries, FloridaSNMOM, Nina Katarina, elfling, wvmom, aufklaerer, inclusiveheart, phree, Preston S, anodnhajo, Heart n Mind, Methinks They Lie, sethtriggs, JDWolverton, Leftcandid, 57andFemale, J M F, mkor7, Lusty, Gary Norton, rasbobbo, don mikulecky, AmBushed, randomfacts, Dem Beans, Sun Tzu, Assaf, K S LaVida, slapshoe, NearlyNormal, linkage, OIL GUY, eru, 420 forever, sk4p, Publius2008, Brooke In Seattle, Mentatmark, RebeccaG, petulans, priceman, Matilda, Shockwave, ruscle, Captain Pants, Lily O Lady, zerone, phrogge prince, fuzzyguy, Robynhood too, Mr MadAsHell, atana, Railfan, cardboardurinal, wader, BachFan, Bisbonian, shanesnana, quill, Andrew C White, ichibon, sostos, Involuntary Exile, offgrid, letsgetreal, FogCityJohn, Linda Wood, ewmorr, Dreaming of Better Days, bleeding blue, sfgb, lcrp, MKinTN, WheninRome, seefleur, artisan, ExStr8, prettygirlxoxoxo, Mr Robert, mofembot, Mac in Maine, redlum jak, greycat, sailmaker, cwsmoke, Libby Shaw, divineorder, cslewis, WhizKid331, annetteboardman, alguien, rbird, Arahahex, cocinero, legendmn, ovals49, james321, tegrat, VTCC73, drdana, dkmich, toom, elwior, bloomer 101, ColoTim, 1BQ, Chaddiwicker, jennylind, Calvin Jones and the 13th Apostle, uciguy30, Batya the Toon, Ginny in CO, D minor, yoduuuh do or do not, Dolphin99, kyril, gmats, Williston Barrett, Johnny Nucleo, Calamity Jean, Danno11, splashy, No one gets out alive, Gorette

    "If you tell the truth, you'll eventually be found out." Mark Twain

    by Steven D on Thu Jan 10, 2013 at 03:43:39 AM PST

    •  Which is why (60+ / 0-)

      it won't happen in America.  Our lawmakers are bought and paid for by the health insurance industry, Ayn Rand fans, fundies who don't like women receiving adequate health care or all of the above.

      "If you tell the truth, you'll eventually be found out." Mark Twain

      by Steven D on Thu Jan 10, 2013 at 04:12:39 AM PST

      [ Parent ]

    •  You can do that (16+ / 0-)

      without a single payer as the health systems of many countries in that list demonstrate. It does require heavy regulation and control from the government something I don;t see happening here

      •  Right... (14+ / 0-)

        But the key is: remove the profit from the system.  Germany and France do not have 'single payer' per se, but any insurance company that sells health insurance in those country cannot do it for a profit.

        'Goodwill' between the GOP and the President is as abundant as unicorn farts - Me'

        by RichM on Thu Jan 10, 2013 at 07:23:17 AM PST

        [ Parent ]

        •  We have a for profit health care insurance (11+ / 0-)

          system in the Netherlands. It has a lot in common with Obamacare. It is not my preferred system, but when it is well regulated it does provide good, affordable healthcare.

          I think there are other social issues that play a role. Stress for example. We don't work three jobs, we have 5 weeks paid vacation, and paid sick leave.

          In the Netherlands we have a bike culture. We have 17 million people and 20 million bikes. The infrasructure has been planned in such a way, that you will take your bike instead of your car, because it is usually faster and more pleasant to take your bike instead of your car. Another benefit of course, is that we have less air pollution.

          Other countries probably have other cultural differences that may make a difference.

          When I was traveling through China and Vietnam, I was really surprised by the early morning activities. Between 5 and 7 am, parks and beaches were full with people of all ages, doing any kind of physical activity you can possibly think of.

          I ran into one group of women in a park in Beijing, who were waltzing on music blasting from a cheap portable cd player.
          People running backwards, playing hackysack, Tai Chi, Qi Gong.
          We were invited, with much hilarity, to join in by everyone. We even got some lessons in Qi Gong by an elderly man, who seemed to be convinced that we would be able to understand Chinese, if only he could speak loud enough.

          You start your work day like that, or ride your bike home after work instead of being stuck in traffic, gives a great relieve from tension.

          •  This is very, very true. (3+ / 0-)
            Recommended by:
            elwior, amsterdam, tardis10

            I've been in the American health care system since graduating (BSN) in '77.  16 of those years in critical care with a lot of cardiac. Ever since advocacy of the Mediterranean diet hit the airwaves, I have been pointing out that while the diet is good, the great stats are mostly from people who also live the Mediterranean life style. Much lower stress, more walking and physical activity, etc. True for The China Study to the same extent.

            There is no way the diet a vast majority of Americans eat can be anything but unhealthy. The FDA, Agribusiness, food industry and advertising have heavily contributed to our cultural and physical addiction to lousy diet.  It is extensively compounded by the high stress and lack of stress management rituals (including exercise) in our lives.

            Probably the worst part of America's exceptionalism was the loss of close family ties and the village. The corporate job and keeping up with the Jones' were substituted for our 20,000 year history of tribal support to not only survive, but thrive.

            Glad to see a very detailed study with the statistics that back up previous indicators of how lousy our health care system became under for profit management goals and practice. Including, but not limited to:

            - 2009: American health care was the 3rd leading cause of death. This did not include many missed diagnoses (some too late, despite early complaints by the patient) and mis-diagnoses with treatment. It did include a huge number of deaths from properly prescribed meds, properly taken. Lack of access to health care was the 11th leading cause of death that year.

            - Lies, Damned Lies, and Medical Science The 2010 Atlantic article on

            Dr. John Ioannidis, who says that as much as 90% of the published medical information that doctors rely on is flawed.
            The biggest percent of the flawed info is in pharmaceutical research (3rd leading cause of death). The guilty include the FDA and editors, in addition to big pharma. This is research used in establishing best practices protocols for treatment. One part of the ACA is to establish data bases that practioners can enter real world results to update the stats and refine the protocols.

            Personal anecdote on Tai Chi and public exercising. My now 28 year old daughter has had a life of medical, learning and sexual assault disabilities. Her fierce independence and obstinate effort to succeed in life has included college on paygo, learning and practicing Tai Chi on the commons at CO School of Mines. One day she started alone, expecting that a few others would join in as usually happens. It so happened a group of Chinese faculty and students were touring that day, came into the commons, saw her and immediately joined.

            Afterwards they had a great conversation about their shared exercise. The Chinese group, who had graciously discussed the difference in movements, were amazed to find out the physical disabilities she copes with that led to her adaptations of the movements so she could still benefit from the exercise. The Chinese are usually quite aware and develop these adaptations themselves, so I was just a little surprised to know that my daughter, yet again, came up with something knowledgeable others had not thought of. ;)  Primarily, I think it is very interesting that in spite of our national belief in fierce independence, the practice is often met with ridicule, isolation, etc.

            "People, even more than things, have to be restored, renewed, revived, reclaimed and redeemed; never throw out anyone. " Audrey Hepburn "A Beautiful Woman"

            by Ginny in CO on Thu Jan 10, 2013 at 03:14:53 PM PST

            [ Parent ]

            •  Love the story about your daughter (2+ / 0-)
              Recommended by:
              Ginny in CO, tardis10

              good for her.

              Best practice is common in more socialized health care systems, where the goal is to get the best results while keeping the costs as low as possible.
              One of the big differences I found between the US and the Netherlands, is medication. I was given anti-biotics so often in the US, it seemed like everytime I visited a doctor or a dentist they'd give me anti-biotics.

              And I like having a gp, who knows you and is very aware of your history. I may get a couple of sleeping pills in a special circumstance, but if you come back for more, they'll start digging in what else is going on in your life. Or they notice that you suddenly have frequent minor ailments.

              I like the communal excercise too. It is enjoyable, not another chore added to the list. And it is not competitive.

              Another "cultural" thing we do in the Netherlands, is to go out for a stroll at lunch time. I worked as an IT contractor, so I've been to more offices than I can remember all over the country. First day in a new office, you just ask who are the walkers here, and join them. It is fun, we make jokes, talk and walk for about a half an hour. While walking you pass all these other groups on their lunch time stroll.

              •  Yes, many of the other problems. (1+ / 0-)
                Recommended by:
                amsterdam

                Best practice protocols were fought by physicians all over the country because they perceived them as interfering with their independent practice. Nor did they like hearing the stats about how ignorant some of those practices were.

                Pharma has a very sick hold on our health care system. A large % of deaths caused by US health care are properly prescribed meds, properly taken. Antibiotics mess with the gut bacteria in addition to promoting stronger bugs.

                The gp that knows the patient is very important to me. The system really destroyed that because an employer can decide for fiscal reasons to change the insurance plan(s) offered to employees. If the new plans don't allow your gp to provide service, you start over. This really interferes with the long view knowledge and ability to identify new problems, discuss them and properly test/diagnose and treat.

                There were/are, by one insurance estimate, millions of Americans trapped in a job because they, or a member of the family covered by the health insurance, had a complicated illness with an extensive team of professionals involved in the treatment and care. Switch doctors? It's a massive change that puts the patient at major risk for significant information falling through the cracks.

                I don't know how long it will take to get the system into a beneficial, efficient and cost effective alternative. I just hope this lesson on how badly profit based business can (not) work will last a lot longer than a few generations.

                "People, even more than things, have to be restored, renewed, revived, reclaimed and redeemed; never throw out anyone. " Audrey Hepburn "A Beautiful Woman"

                by Ginny in CO on Thu Jan 10, 2013 at 07:05:21 PM PST

                [ Parent ]

                •  That's one of the strangest parts of our "system" (2+ / 0-)
                  Recommended by:
                  Ginny in CO, Steven D

                  Making you change doctors over and over again, so none of them know you and what you are dealing with, or what to pay attention to when you are talking to them.

                  Some people talk a lot about symptoms, others are quite shy about saying something. The doctor needs to know that.

                  Women create the entire labor force. ---------------------------------------------------------------------------------------- Sympathy is the strongest instinct in human nature. - Charles Darwin

                  by splashy on Fri Jan 11, 2013 at 12:24:11 AM PST

                  [ Parent ]

          •  Between 5 and 7 AM? (1+ / 0-)
            Recommended by:
            amsterdam

            I would have to just stay up to do that, being the night owl that I am.

            I am at my best when it comes to exercising between 4-12PM, or even later.

            Women create the entire labor force. ---------------------------------------------------------------------------------------- Sympathy is the strongest instinct in human nature. - Charles Darwin

            by splashy on Fri Jan 11, 2013 at 12:19:26 AM PST

            [ Parent ]

            •  Yes (0+ / 0-)

              And as tourist, if you'd never got out of your bed before 8 am, you would never know about it. We were passing a non tourist place in Vietnam, where we arrived after dark and would continue on our travel  the next morning. We were staying at a hotel at the beach, and I had a balcony looking out over the ocean. I have lived in the US on the west coast, and the Netherlands coast line is looking west, and I wanted the opportunity to see a sunrise over the ocean. So I got up at 5 am before sunrise, went onto my balcony, and I was hearing this noise of chattering and laughing people. When the sun came up I saw the beach was full with children playing and swimming, and adults amusing themselves. At 7 am the beach was empty.

               It fits into their daily lives. It was not uncommon to walk during the day into a small shop or restaurant, and see a person getting up from a bed, somewhere in a corner.

              I don't think you would see this in The Netherlands or the US, because it wouldn't fit into the rest of our lives.

              Here we use our lunch break to go out on a walk, and we use our bikes for most of our daily errants. My mom, who is 71, uses her bike everyday to get her groceries. She is not the exception, but more the rule.

              The US lifestyle has removed, as much as possible, physical exertion from regular daily life, and has replaced it with excercise as another difficult chore to add to an already heavy workload.

              When I grab my bike to go out on an errant, or to go to work, I don't think of it as excercise, it is my preferred mode of transportation. We use comfortable sit up straight bikes, that are suitable for shopping and city commutes. We don't wear special clothing or helmets. Our entire infrastructure is geared to keeping bikes seperated from cars. You use the same energy you would use, as if you are walking.

              People use their bike everyday, to bring their kids to school, get groceries, and go to work. It is quite normal to ride your bike for an hour each day. But if you would ask that person here, did you excercise today, they would probably say no.

              America needs to bring regular excercise in daily life. It will have to fit in with the natural surroundings, and climate of specific states. If you had designated safe bike routes from neighborhoods to the schools, people would start to accompany their children to school on bikes.

              If you had those same paths going to train stations, and safe places to store your bike, people may choose public transportation. You can remove a lot of stress, if instead of being stuck in traffic, you are in a train reading à book or a newspaper and drinking a cup of coffee. If you can combine it with a 20 minute bike ride each way, by the time you get home, you are not completely stressed out and too tired to go out to an expensieve fitnessschool and stil had some excercise that day.

      •  The argument in expanding Medicare (19+ / 0-)

        to all is that we would not have to start from scratch with a program like that.  Your point about regulations and control is important because we don't have any of that put together now after years of deregulation - but in Medicare we still do have a workable framework upon which to build.  That's one reason why the ACA never made sense to me as it was built from the ground up and it has problems largely because of that - and because it was in many cases more political than pragmatic.

    •  Absolutely right (10+ / 0-)

      And Single Payer is coming

      Watch California and Vermont.

      Daily Kos an oasis of truth. Truth that leads to action.

      by Shockwave on Thu Jan 10, 2013 at 08:50:38 AM PST

      [ Parent ]

    •  It could be just as much caused by corporate food (12+ / 0-)

      The statistics reveal a lot about what we eat compared to these other countries.  Having lived in France, there are big differences in each of our eating lifestyles - food addictions, snacking, processed/poison foods made by corporate giants and pushed onto Americans with clever packaging and advertising.  

      Our healthcare system, flawed as it is, isn't the sole cause and may be even less of the issue than the takeover of the American diet by multinational food companies.

      West. No further west. All sea. --Robert Grenier

      by Nicolas Fouquet on Thu Jan 10, 2013 at 08:57:54 AM PST

      [ Parent ]

      •  If every American had health care, (7+ / 0-)

        patterns could be established across the population showing that "profitable" and under regulated activities are causing massive health problems, such as a lack of paid sick leave for most Americans, leaded gasoline, or, if I'm correct in my prediction, the junk nonfood that so many of eat is killing us.

        If we ALL had healthcare, there would likely be much better data to look at what the health affects of eating processed rubbish non food are on individuals and the greater population.

        Making sure most Americans don't receive primary care is a feature of the "American" for profit system, not a bug.

      •  No question the diet of most Americans (1+ / 0-)
        Recommended by:
        Nicolas Fouquet

        contributes to the problem. The way our health care system addresses that is abysmal. Doctors, research and the FDA are very heavily influenced by groups like the American Dairy Farmers and the food corporations. Physicians have almost no nutrition education and what is offered, including to dietitians, is heavily influenced by the food industry.

        Other countries are seeing more of our health problems as the multinational food companies, especially fast food, become more prevalent and part of their cultures.

        Kossack Amsterdam also brings our stress component into the mix in a comment above.

        The human tendency to produce unhealthy food is not limited to America. Amusing experience during a life milestone 10 day visit to Japan, as a guest of my older sister - who had then lived in Tokyo 6 years.  Reveling in the incredible diet experience of both quality ingredients and fresh preparation, I was also introduced to the Japanese gifting tradition. Elaborately wrapped and presented, the gifts may be no more than a tasty treat. My brother in law came home one evening after a trip to an office in a nearby city with such a gift - containing a pastry with a bean paste stuffing. I think two bites were enough to put it down on the plate, describing it as "a Japanese Twinkie". They concurred and put the rest in the garbage.

        "People, even more than things, have to be restored, renewed, revived, reclaimed and redeemed; never throw out anyone. " Audrey Hepburn "A Beautiful Woman"

        by Ginny in CO on Thu Jan 10, 2013 at 03:41:58 PM PST

        [ Parent ]

        •  France battles with McDonald's, as well (0+ / 0-)

          Most rarely eat on the run or eat between meals.  And yet, there was McDonald's - chipping away at that with adverts in the Metro trains imploring people to try a hamburger at midnight (and the concept of "open 24 hours").  

          Seemed to be working with the immigrants, but not the native French.  At least not at that time (a few years ago).

          West. No further west. All sea. --Robert Grenier

          by Nicolas Fouquet on Fri Jan 11, 2013 at 09:34:05 AM PST

          [ Parent ]

    •  This is nonsense. If it were true, Medicare would (0+ / 0-)

      be cheap and effective.

      Insurers are just the frosting on a profit driven cake.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

      by samddobermann on Thu Jan 10, 2013 at 02:31:21 PM PST

      [ Parent ]

  •  Thank you for this diary (27+ / 0-)

    I'll be passing the link along to some of my physicians.

    “Social Security has nothing to do with balancing a budget or erasing or lowering the deficit.” -- Ronald Reagan, 1984 debate with Walter Mondale

    by RJDixon74135 on Thu Jan 10, 2013 at 04:47:39 AM PST

  •  I was hoping that you or Eve would push this story (33+ / 0-)

    I don't want to detract in any way from the current effort to curb gun violence in this country but the fact is that our Health Care System kills 20 times as many people everyday as recently died in Newtown.

    This is murder most foul and it is murder for profit and it is aided and abetted by a bought and paid for Congress and a "Free Press" which is dedicated to keeping Americans uneducated about how poorly they are being treated by their Government.

    The civilized world adopted Socialized medicine over 60 years ago and it is time for Americans to start demanding it here and now.

  •  A Million Flee US Every Year Seeking Health Care (15+ / 0-)

    and that figure came from 5-6 years ago, all destination countries included.

    It's a big enough industry to have a trade association.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Thu Jan 10, 2013 at 05:28:32 AM PST

  •  But we can't have socialism (25+ / 0-)

    it's unamerican because...well, I can't find it in the Constitution right now, but I'm sure our founding fathers would disapprove of equality, fairness, and a common sense health care system.

    ¡Cállate o despertarás la izquierda! - protest sign in Spain

    by gjohnsit on Thu Jan 10, 2013 at 05:38:52 AM PST

  •  I guess we'll see and hear a lot about this (10+ / 0-)

    in the corporate media.

  •  Part of the problem in discussing health care in (7+ / 0-)

    America is the reflexive racialisation that seems to be taken for granted when Americans try to discuss these kinds of social issues. When a study like the one diaried has to say this:

    However, the panel's research suggests that the U.S. health disadvantage is not solely a reflection of the serious health disadvantages that are concentrated in the U.S. among poor or uninsured people or ethnic and racial minorities.
    most Americans are so used to breaking down statistics by race (and apparently we have a "poor" race as well) that the pernicious consequences of doing so a largely ignored. I would suspect that the sentence above would have worked just fine had they stopped at "among poor or uninsured people".

    I wonder exactly what additional health disadvantage is supposed to accrue from belonging to a particular race or ethnic minority - apart from the disadvantage of being poor or uninsured. If there is an additional disadvantage then that sounds more like active discrimination and worthy of a separate conversation. The careless inclusion of "ethnic and racial minorities" serves only to allow too many Americans to dismiss a problem as belonging to a "foreign" subgroup that would never include them.

    I remember at the height of the ACA debate there was an article trying to unfavourably compare the US and Canadian health systems - and one of the key data points in the article was survey result that only 81% of Canadians were satisfied with their system versus 83% of Americans. Apart from numerous caveats that ought to have been made with respect to those numbers - the most glaring was that the US number was drawn from the "non-hispanic Whites" and used to compare with polling done amongst all Canadians - presumably of all backgrounds. When you consider that Canada is significantly more diverse that the US this tactic is even more outrageous.

    Unless someone's race or ethnicity is a demonstrated factor in an analysis (separate from socio-economic ones) then we must stop using these artificial constructs - and begin the see these problems as our problem, one that many of us might be one layoff or health crisis away from.

    •  Well I recall reading reports (6+ / 0-)

      that referred to differences in health outcomes among Americans by racial or ethnic status even when socioeconomic factors were controlled for.  So I'm not going to bash the people who wrote that press release or the study for that statement.

      "If you tell the truth, you'll eventually be found out." Mark Twain

      by Steven D on Thu Jan 10, 2013 at 06:11:42 AM PST

      [ Parent ]

      •  Agreed - and let's suppose there are cultural (4+ / 0-)

        factors in play (for example amongst the extensive Chinese population of Vancouver BC) - but these factors might equally improve relative health rather than the opposite. My objection is the the frequent and casual use of these terms without any attempt to explain why they might be causally related to the issue. I did look a little further into the link you provided, and noted a section where the authors begin with

        Compared with many other high-income countries, the population of the United States is more racially and ethnically diverse...
        really? London's population is now the most diverse big city in the world with 45% having been born outside the UK. The Chinese population in the boundaries of Vancouver city is at 30%.

        Further - if the authors felt this diversity was an issue in comparisons, they should have a section where the comparisons are limited to only those countries that have comparable diversity (such as Canada). Otherwise the reader is left with the familiar cop out - "but we're just so different". I understand and approve what the authors are trying to do - but we have got to stop trotting out the diversity angle unless there is a significant relationship - which I don't think there is here.

        •  I would add (4+ / 0-)

          that it's quite likely high stress levels among some groups and racial bias towards people in those groups may also have an impact on health:

          http://www.sciencedaily.com/...

          The consequences of psychological stress, resulting from racial discrimination, may contribute to racial health disparities in conditions such as cardiovascular disease, diabetes and other age-associated diseases. This is according to analyses of data from the epidemiologic study Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS), conducted by the National Institute on Aging (NIA), National Institutes of Health.

          Dr. Sarah Szanton from Johns Hopkins University, who collaborated with scientists from the NIA and University of California, San Francisco, in the US, put forward a new hypothesis to elucidate racial differences in disease prevalence: African-Americans who suffer psychologically from racial discrimination have higher levels of oxidative stress* in their bodies. Their study is published online in Springer's International Journal of Behavioral Medicine.

          The psychological stress of racial discrimination is thought to be one of the factors that explain racial health disparities, for conditions such as high blood pressure, obesity, cardiovascular problems, poor self-reported health and premature disease-related disability. There is some evidence that psychological stress increases oxidative stress.

          I'd like to say we should ignore racial disparities and focus strictly on socioeconomic factors, but I believe there is enough evidence to suggest racism does play a role in health outcomes outside merely economic factors such as income levels, etc.

          "If you tell the truth, you'll eventually be found out." Mark Twain

          by Steven D on Thu Jan 10, 2013 at 06:40:58 AM PST

          [ Parent ]

          •  And to be honest (1+ / 0-)
            Recommended by:
            elwior

            I have not read the entire report which is hundreds of pages long, only the summaries of it.  I do not know the methodology employed by the researchers.  However, considering the study was sponsored by the National Institutes of Health and U.S. Department of Health and Human Services, and authoring organizations included Committee on Population, Board on Population Health and Public Health Practice, Behavioral and Social Sciences and Education  and the Institute of Medicine, I'm willing to trust they did a thorough analysis.

            You can read the entire report online here:

            http://www.nap.edu/...

            "If you tell the truth, you'll eventually be found out." Mark Twain

            by Steven D on Thu Jan 10, 2013 at 06:50:49 AM PST

            [ Parent ]

      •  Yep (1+ / 0-)
        Recommended by:
        elwior

        One major one is the rate of premature births among black women, which seems to resist all efforts to control for other variables.

        "Let’s just move on, treat everybody with firmness, fairness, dignity, compassion and respect. Let’s be Marines." - Sgt. Maj Michael Barrett on DADT repeal

        by kyril on Thu Jan 10, 2013 at 02:55:29 PM PST

        [ Parent ]

    •  Actually, looking at the particulars of (4+ / 0-)
      Recommended by:
      Mr MadAsHell, Mr Robert, kyril, elwior

      gender and race health issues is really important.  

      At one time, most clinical trials were done primarily on white males and it is has only been in the last 30 years or so that the pharma and medical community have started to understand that discrete patient populations respond differently and present differently.  

      In addition, there are differences in risk for various ailments depending on gender and race - more subtle than say the fact that women can get ovarian cancer and men can't because they don't have ovaries.  Men's heart disease symptoms often present very differently than women's symptoms do - which resulted in a lot of women going untreated for decades for heart disease - many of whom simply died without ever having had anyone address their heart problems.  Typically, women were given indigestion medicine because women, for some reason, report indigestion-like symptoms often when they are actually having heart problems.  Now docs know this and don't automatically assume that it is just indigestion.

      Without the studies of the patient populations by gender and race, there are a lot of people who would not be receiving adequate and responsive care now.  I could go on with countless examples of why studying patient populations is better overall for our healthcare model, but I won't now.  Suffice it to say that it is research that is beneficial to everyone - investigating why one race has a much lower risk for a particular disease or ailment, for instance, may lead us to finding ways of helping prevent or curtail that disease state or ailment in other populations.

  •  So obvious...we have Medicare, Medicaid, the VA (17+ / 0-)

    kids health programs, exchanges, private employer plans, a mish-mosh that is breaking the bank and the solution is right in front of us

    this country is nuts

  •  Health v. healthcare (1+ / 0-)
    Recommended by:
    Ian H

    Really, this study is not about healthcare, i.e., the care one gets when one is ill. Instead, it claims that general conditions outside of anything to do directly with medicine result in poorer health than in other places. So, wealth results in, e.g. more cars and greater numbers of available calories. These in turn result in more car accidents and diseases due to obesity. Clearly, one solution to this sort of health problem would be to sabotage the economy so that there is little disposable income. I imagine that Socialism would be admirable suited to effect that oh-so-desirable outcome. Meantime, I'll stick with the sort of spillover of wealth that means that I could get a CT scan to verify my kidney stone and a procedure to alleviate my pain within days, not weeks (or longer) as was my cousin's case in one paradise of universal healthcare, Italy. I didn't see that in the report.

    •  I've heard thse same anecdotes before (13+ / 0-)

      This is why studies are done to review health outcomes for entire populations, not just single individuals. I could relate all my anecdotes about health insurance companies that have denied me treatments for my autoimmune disorder, but all that would prove is that I am one person who has had bad experiences with my health care insurers.

      "If you tell the truth, you'll eventually be found out." Mark Twain

      by Steven D on Thu Jan 10, 2013 at 06:15:25 AM PST

      [ Parent ]

      •  Anecdotes (0+ / 0-)

        The anecdote was, I hoped, actually illustrative of the fact that one of the fine things about U.S. healthcare generally is the abundant supply of certain kinds of technologies, such as CT scanners and lithotripsy devices. By way of contrast, Italy (or Britain, or various other putative models) ration (there is no better word) public healthcare. The delays in getting treatment result in a thriving private market for those who can afford to bypass the line.

        In any case, "health outcomes" are not the same as "healthcare," which was my primary point. It is not the case that healthcare in the U.S. is so terribly far behind some socialist model. The complaint would appear to be that wealth and the concomitant widened range of choice can lead to certain sorts of problems. But that is a very different kettle of fish.

        People can and do choose to do things that can adversely affect their health. Such things include eating more than strictly necessary and riding motorcycles on rainy nights. These are not problems of healthcare. And it may even be that, e.g., those motorcyclists are contributing to health outcomes—there's a reason emergency room personnel refer to their mode of transport as "donorcycles." Was that factored into the report—I didn't see it.

        •  My daughter lives in Italy..... (10+ / 0-)

          My 3 year old grandson has issues with growth.  He was seen this week by a pediatric gastroenterologist after a short wait, certainly less that one would experience here in the states! My daughter was pleased with the outcome,  the Doc actually spent a great deal of time getting history  and talking with her about his symptoms.
          Incidentally, she has had experience with healthcare systems in  Canada and Cuba also and had no issues with delivery of care in either place.
          We undoubtedly have some of the best care in the world and some of the best physical facilities, but the fact that so many go without even the most basic care is a disgrace.

          Sunlight is the best disinfectant

          by historys mysteries on Thu Jan 10, 2013 at 07:28:47 AM PST

          [ Parent ]

          •  My wife is from Italy (0+ / 0-)

            Her elderly aunt is once again waiting to be seen by a gastroenterologist. She made an appointment shortly before Christmas for early February, at which point she will travel about 15 miles to see the guy. She is not rich, but the mountain resort town she lives in certainly is. Nevertheless, there is no hospital, only a clinic that sets bones for injured skiers, and otherwise only GPs. At 95, I hope she makes it to the appointment.

        •  If motorcycles had that big an impact (7+ / 0-)

          Western Europe and Japan would rank way lower than they do, as many, many more people ride motorcycles in those countries than in America. Americans tend to be fair weather, weekend riders, whereas in other countries, motorcycles are seen as actual transportation, not just recreation.

          You need a license to drive, a license to run a business, but any idiot can buy a gun.

          by Hannibal on Thu Jan 10, 2013 at 07:29:38 AM PST

          [ Parent ]

    •  How much (10+ / 0-)

      do you pay yearly in health insurance and how much does your cousin pay?
      If you loose your job you keep your insurance like your cousin?
      How much did it cost you to have the CT scan + pain alleviation vs you cousin?
      how many people in the US have kidney stones and have to suck it vs people in Italy?

      •  Wrong question (0+ / 0-)

        The claim was supposedly about healthcare—not social policy. I pay about $18K annually insurance. My cousin probably pays something like the same, in part because of very high taxes (between income tax and VAT) and because when push comes to shove, and Italy doesn't come through fast enough for his wife's cancer, he picks up and flies to Houston with her, i.e., to a place where immediate treatment is possible. She's doing fine now, thank you. Did the report discuss how many Europeans seek treatment outside their own countries annually?

        •  Wrong you say? (10+ / 0-)

          My question are all related to the health system and you demonstrate that with the cancer question.

          Europeans do travel to other countries for treatment in a percentage way, way, way inferior than US citizens. No system is perfect and in cancer treatment the US is ahead in some hospitals from Europe, particularly the style of treatment here is more aggressive and if you can afford it you go a the top of line. I never said that this is a bad personal system for those wealthy enough to afford it, although in Italy you can buy private insurance and have private treatment for a fraction of what it costs here because they have to compete against the state run system.

          So you don't pay taxes in the USA? And on top of the taxes, slightly less than the ones your cousin pays you have to pay $18,000 in insurance that do not cover all your health expenses so the years you need it I bet you go well over $20,000 in health expenses.

          •  Once again (0+ / 0-)

            There is a very simple primary question—is healthcare in the USA inferior to that of socialist polities? The heading of the diary made that claim. Is that true? No, it is not. Instead, the claim is that some kind of social policy results in more desirable health outcomes. And that, as I have demonstrated, is a different question, and one that does not have a straightforward, univocal answer.

            •  Define "inferior"? (7+ / 0-)

              I agree with your broader point; the study looks at a range of contributing factors to mortality outcomes, not just medical care.

              But your comments point out some of the biggest problems (IMHO) about our medical care. You can afford to pay $18k annually, which gives you quick access to a CT scan to diagnose something as relatively minor as a kidney stone. A large swath of our population would never get that CT scan, though they might need it to identify a life-threatening illness.

              Are you arguing that this is a superior system to one where nearly everyone who needs it could get a CT scan, but might have to wait?

              •  Define "minor" (1+ / 0-)
                Recommended by:
                mahakali overdrive

                If you knew anything about kidney stones, you would know that their pain has often been described as on a par with childbirth. Not have borne children, I can't compare, but it was pretty goddam painful, and not just for 6-7 hours, but for days. I'll hope you never experience anything so minor.

                To the actual point, I am unaware of some vast swathe of our population that needs, but is unable to obtain, CT scans for life-threatening illness. In fact, the proliferation of machines and easy availability of scans means that their use has exploded, so that emergency room doctors are said to overuse them. And, as you know, emergency rooms see a disproportionate number of people without health insurance.

                But my reservations about the report cited are not about emergency rooms or CT scans. It is rather about factoring the large number of, e.g., auto accidents, fatal and otherwise, into a claim about healthcare.

                My own sense of the matter (no footnotes provided) is that if you simply look at medical treatment in the U.S., the overall system is pretty competent and care widely available.  I am not arguing that it is a perfect system, but neither is one where you trade for universality against timeliness and availability. The point is that there are, in fact, tradeoffs and, as I said, no  univocal, self-evident best solution.

                •  Didn't mean to belittle your experience (5+ / 0-)
                  Recommended by:
                  Mr Robert, fuzzyguy, kyril, elwior, sethtriggs

                  I understand the pain of kidney stones, but in the grand scheme of things they're less threatening than, say, a brain tumor.

                  I think you're overestimating the availability or affordability of treatment for the uninsured.  If care is as readily available as you say...how would a more socialized system cause any impact on timeliness or availability? If the new system wouldn't actually result in more people being treated, then why would there be a need for rationing?

            •  Yes (9+ / 0-)

              You are right for a single individual with all the money he needs at his disposition you can get equal , probably better, health care in the USA. As a SYSTEM, it is patently and demonstrably worse. More expensive and produces worse outcomes.

              By the way I don't get why you call the other option socialist polities? Germany, Japan and many other countries work within private although well regulated systems and in the USA the VA or Medicare or Medicaid could be construed as "socialist" so a goo part or our system already works that way.

              •  Coupla things (0+ / 0-)

                1) $18K buys annual coverage for myself and my wife.
                2) The health care system, in all-caps or not, is neither patently nor demonstrably worse than other places. nor does that health system produce demonstrably worse outcomes. Again, there are pluses and minuses.
                3) I used the term socialist polities because of the claim in the diary heading and then because of some of the countries looked at in the report (you did read all 424 pages, didn't you?). So far as health care is concerned, the setup in Italy, Germany, France, Spain and the UK, is largely government funded and directed; I call that socialist (in a straightforward, technical way). So, of course, is Medicare. Not so much the VA, as it is essentially a benefit of military service and unavailable to the society at large. And Medicaid is largely for the relief of the poor, also unavailable to all, but only to those who meet certain standards of impoverishment.

                •  Well (5+ / 0-)

                  1) Ok Still way over what most can afford. I pay about half that but it only covers 80% has big deductibles, copays and so on. By the way I'm not criticizing by any mean what you can or can't afford and I'm open to a system that mixes private and gov.

                  2)Clearly is A) more expensive than anywhere else, per capita and as a % of our GDP (link). B) It is worse because produces worse outcomes for the population. Measured by a wide array of data from life expectancy, to people dying for lack of treatment and so on.  

                  •  Very interesting discussion here! (4+ / 0-)
                    Recommended by:
                    hmi, Iberian, elwior, sethtriggs

                    A question:  I wonder what the trend in health care costs are in these other countries vs. US?  Here in the US, costs are still escalating, almost out of control, mostly because of the inherent structure of our health care system.  Are costs reined in elsewhere, or is this also an issue?

                    The most violent element in society is ignorance.

                    by Mr MadAsHell on Thu Jan 10, 2013 at 09:36:25 AM PST

                    [ Parent ]

                    •  Yes (3+ / 0-)
                      Recommended by:
                      Mr MadAsHell, elwior, sethtriggs

                      It's an issue everywhere. In many countries what I've heard, there were a very good series of documentaries about health care systems around the world when the ACA battle, was from medical professionals complaining of not earning enough or from institutions saying they have to cut a lot in services. Now with the world austerity many have cut services quite a bit or established copays where there where non.

                      Health care for everyone for everything is very desirable but really expensive, particularly now that we are extending life quite a bit, those last years are the most expensive of them all.

                •  Netherlands has for profit insurance (4+ / 0-)
                  Recommended by:
                  Mr Robert, fuzzyguy, elwior, sethtriggs

                  I pay €95 a month, all basic care and medication are included. If I need to see my gp, I call and usually have an appointment the same day or the next. If I am too sick to see my doctor, my gp will visit me at home.

                  All emergency care is provided immediately. We have waiting lists for non-emergency orthopedic surgery, but my insurance as do most will arrange and pay for transportation and care for those kind of surgeries in Germany or Belgium who have more orthopedic surgeons.

            •  The health outcomes are the entire point. (8+ / 0-)

              Otherwise you have a reactive health care model, only treating symptoms and traumas. A true health care system actually improves health outcomes across the board through access to preventative medicine and services. That is what these "socialist" systems do in our peer nations and that is why the people are living longer, no matter what the individual edge cases mean. And the edge cases are a bit of a distraction since anyone in a medical emergency is going to be treated right away, just like in the USA. But if your condition is non-fatal/non-terminal, you will probably have to wait...just like here. I've had to wait for surgery before, and I've never lived anywhere else in the USA.

              You would expect that normally people with means will always be able to get the care they desire, even in places like Somalia. So, for example, someone that can afford $18,000 a year just in insurance probably would be expected to have some sort of advantage. Someone who can afford to just up and fly somewhere, especially internationally, is pretty wealthy indeed.

              But those kind of things are edge cases. People that wealthy are in the upper levels of the income distribution and thus are rare.

              Now let's talk about an ordinary person, with an income of, say, $20,000/year. (And keep in mind, what you pay for insurance is higher than the adjusted gross income for a great many Americans)

              Would they have access to all that shiny technology and the high-end doctors? Of course they wouldn't, and you know it. This is one of the things that contributes to our lifespans decreasing here in the USA. On top of that, because of the way we tie healthcare to employment here, if you've gotten laid off during the Great Recession, or been otherwise unable to find work, you are a dead person walking.

              It's tiresome to see people make the claim about healthcare "rationing." All healthcare systems, whether they're public or private, ration care because doctors and equipment (as well as the beds in a hospital) are finite. This is why we have triage nurses in emergency rooms. Doctors can take only so many patients in a practice, because time is finite as well.

              •  True health care (1+ / 0-)
                Recommended by:
                Mr MadAsHell

                " A true health care system actually improves health outcomes across the board through access to preventative medicine and services."

                Fine, so far as it goes. Does it also mean outlawing foods for their fat, salt, and sugar content? Is that part of the health care system? If so, how about my other example of the motorcyclist? Would outlawing the riding of motorcycles on rainy nights be part of the health care system? Could or should we reasonably outlaw tackle football, amateur and pro, on grounds of health? Should we also outlaw skiing and snowboarding, to prevent 70,000 head injuries annually? Is that also part of healthcare? Or or these matters of social policy, all of which are subject to discussion on grounds other than simply whether or not they produce health.

                I agree that all scarce goods  must be rationed—which means healthcare must be, as well. The discussion moves on, then, to the principles on which the rationing is to take place. It is not simply a given that socialist models are the uniquely valid answers.

                •  Believe it or not, we address those things. (4+ / 0-)
                  Recommended by:
                  Mr MadAsHell, Mr Robert, kyril, elwior

                  This is why, for example, we have helmet laws, all sorts of safety practices that are adjuncts to the health care system. The nutrition guidelines are a way to address salts, sugars and the like. (Though those items are not innately fatal) We've done this with automobiles where we have greatly reduced the injury and death rate from crashes. We've done things like ban asbestos. There are numerous cases where social policy acts as an adjunct to the health care system.

                  Even given all that we've lost ground with our baseline health outcomes because of the pay-to-play system here in the USA. Part of the preventative care I'm talking about includes clinic access and that costs a lot of money (cash) if you don't have insurance.

                  Yes, preventative medicine includes regular checkups and health maintenance, not just the reactive emergency room model. Emergency rooms, of course, are the most expensive part of health care. It costs much less to treat problems in a proactive manner (by use of clinics) than it does in a reactive manner (emergency medicine).

                  I suspect we'll disagree on the way in which healthcare should be set up. The more egalitarian system would be to have the treatments scheduled with respect to level of injury (in other words, the existing triage system) and not ability to pay. I mean, goodness, we've had hospitals here in the USA that actually dump patients unable to pay on the street. But as I see things, the priority needs to be level of injury, how life-threatening the condition is. When people in the USA, the wealthiest society that has ever existed, are starting to have their lifespans shortened while people in other nations are living longer, that is a bad thing.

                •  More honest discussion (5+ / 0-)
                  Recommended by:
                  Mr Robert, fuzzyguy, sethtriggs, kyril, elwior

                  Lots of false dichotomies and straw men there.

                  As has been pointed out, and you have acknowledged, not all of these countries have socialist models.  Further, those that do also offer private options or expansions to those public services.

                  Societies offer advantages and incentives exerted by government, law, and social pressure.  Difficult and evolving problems require continuing evaluation and measured responses.

                  Motorcycles aren't outlawed, but there are laws and social pressures enacted to promote safe practices for pedestrians, fellow drivers, and the cyclist.  Dangerous sports have also evolved rules, uniforms, and public perception over the years to try and balance entertainment and reasonable levels of risk and safety.   And so on.  

                  It may be a fun exercise to dabble in imaginary absolutes.  Hyperbole may be easier for you to debate against, but it isn't really applicable to a society engaging in the continual debate about what is sound public policy that produces the best and most balanced outcomes for individuals and society.

                  In terms of overall fiscal efficiency and certainly when  desirous of making that comply with humanistic desire to decrease suffering and mortality rates- our system is a failure and these other systems are superior.

                  The question to me is whether we value human life and the minimization of the suffering of others.  As a whole, America doesn't and it is reflected in a great many aspects of our collective action.

                  •  Reasonable until (0+ / 0-)

                    you got to the "value human life" bit at the end. Instead, I would say that we value various aspects of human life, not all of which are perfectly compatible with each other, e.g., freedom to ride that motorcycle unencumbered and public responsibility for the consequences of accidents.

                    As for imaginary absolutes, I would maintain that they way we figure out how to apply our principles is precisely by putting up such examples (not "straw men," but instantiations of principles taken as far as they can go).

                    These are all, in fact, difficult questions of public policy, and it doesn't help to pretend that some part of the difficulty has been resolved in advance of the discussion. No one will argue against minimizing human suffering, but that bare desire does not loudly and clearly announce the best way in which to insure that outcome.

            •  Yes. (5+ / 0-)

              The simple answer is "yes."

              Now let's explain that yes.

              You can't take the qualitative state of US healthcare as the very best possible treatment available to anyone who has all the money that they can throw at it, because that's not "American health care." That's the health care available to the Romneys, etc., and to only a tiny fraction of the American population--call it the American Aristocratic Health Care System.

              That is, yes, very, very, very good. (And still not perfect--nothing is.)

              It's also not available to most Americans. A very large percentage of Americans have almost no access to health care, except through emergency room care (both hideously inefficient as a means of providing that care, and extremely expensive, too).

              You have to average those bitter realities into what "American health care" is, and what it really looks like qualitatively. The analysis can't rest on the anecdotal cases, but on the numbers that show outcomes for the whole of national populations.

              The "soshulist" systems in Europe provide a level of health care that is quite good, and it provides that level to the vast majority of their populations. And it does so far, far more cheaply than the system.

              The very well off in the rest of the world have access to medical tourism in any country they wish--and since the American Aristocratic System is very good, they'll frequently use it.

              And as to your last proposition, you're simply wrong. The overall health outcomes -- the desirable ones -- are better in other industrialized societies, all of which have social policies about health care that result in what gets called "socialized medicine" in the USA. Lifespan, infant mortality, you name it. The US only gets nice marks WHEN someone fudges the facts and looks at the American system WITHOUT including all the people who aren't included in it, and WITHOUT acknowledging that we in the US pay vastly more money to cover a smaller percentage of our population for what are, objectively, inferior results for the nation. Pointing out that individuals CAN get superior results (if they have endless money) in the US really doesn't have any legitimate bearing on the conversation.

              "Be just and good." John Adams to Thomas Jefferson

              by ogre on Thu Jan 10, 2013 at 09:35:44 AM PST

              [ Parent ]

              •  I would suggest (0+ / 0-)

                with respect that much of what gets written about lifespan and mortality is statistical mush, and that what you call fudging the facts is actually part of a very important discussion of how the statistics are to be understood. To revert to the study which began this conversation, I am unpersuaded that some of their measures of what counts as healthcare belongs either under that heading and as part of the statistically significant findings. And typing all caps is nifty emphasis, but does not carry the point.

        •  probably? (3+ / 0-)
          Recommended by:
          Hannibal, WheninRome, elwior

          IN fact Americans, on average, pay twice as much for worse coverage.  Except for the freeloading moochers who get a sweetheart deal.  maybe you are one of those?

          Frankly, I doubt your stories are anything but pure fabrications.  

          Hay hombres que luchan un dia, y son buenos Hay otros que luchan un año, y son mejores Hay quienes luchan muchos años, y son muy buenos. Pero hay los que luchan toda la vida. Esos son los imprescendibles.

          by Mindful Nature on Thu Jan 10, 2013 at 07:55:26 AM PST

          [ Parent ]

          •  I have my doubts (1+ / 0-)
            Recommended by:
            Iberian

            about you as well. What sort of mental condition should be ascribed to someone who calls someone a liar simply because they disagree with some position (that can be the only ground, as you have not got even the vaguest evidence that anything I said was false). Is "idiot" a recognized mental condition?

            •  I think (1+ / 0-)
              Recommended by:
              elwior

              your concerns and reservations are honest ones and merit a non derisive response. If we really want to change the present system we need to address them and make a good effort to convince people like you that are in the fence.

          •  That's not what I've been led to wonder. (3+ / 0-)
            Recommended by:
            WheninRome, Mr Robert, fuzzyguy

            Rather, hmi's touting how wonderful the insurance scheme has been for him and his wife, while happily ignoring the huge social defects of the system (the uninsured, the crappily insured), has a whiff, for me, of what I'd expect from a professional troll from the health industry.

            Which might not be true. But it feels that way, at the moment. And a few other factors might tend to support that.

            "Be just and good." John Adams to Thomas Jefferson

            by ogre on Thu Jan 10, 2013 at 09:42:48 AM PST

            [ Parent ]

            •  Professional troll (0+ / 0-)

              Where would one apply and what sort of health coverage is there?

              Instead, I teach university. My wife retired early from career in marketing because of illness. I have had years of close association with the health industry, not all of it happy. I have absolutely no brief for the healthcare industry—quite the opposite. But I can avoid the frying pan without having to embrace the fire or jump back into the pan.

              In this case, that means that I am extremely doubtful that the best alternative to current practice is further socialization. I have a laundry list of things I would have liked to see tried, beginning with the possibility of interstate sale of health insurance. E.g., in some states Costco is now offering health insurance plans—but from my enlightened state of NY, this is not permitted. It should be. And that's just one example of a non-socialized alternative to the present setup.

    •  funny (4+ / 0-)
      Recommended by:
      fuzzyguy, Mr Robert, kyril, elwior

      how the "socialist" countries are actually cleaning our clock economically these days also.  the French are now more productive, and Scandinavia fared reasonably well in the downturn.

      Indeed, health care isn't the only part of society where socialism ourperforms capitalism.  Except for minting billionaires among paupers, of course.  We win easily there.

      Did you miss the part about rich white performing worse here also?

      Hay hombres que luchan un dia, y son buenos Hay otros que luchan un año, y son mejores Hay quienes luchan muchos años, y son muy buenos. Pero hay los que luchan toda la vida. Esos son los imprescendibles.

      by Mindful Nature on Thu Jan 10, 2013 at 07:53:51 AM PST

      [ Parent ]

      •  The funny part is (0+ / 0-)

        if you think that Europe, where overall unemployment hit crisis levels this week, is cleaning any clocks.
        http://www.theatlantic.com/...

        •  It's lower than the US in much of Europe (6+ / 0-)
          Recommended by:
          ask, WheninRome, Mr Robert, fuzzyguy, kyril, elwior

          Germany: 6.5%
          Netherlands: 6.8%
          Denmark:  4.8%!
          Norway: 3.2% !

          Sweden:  7.5%
           Finnland: 7.3%

          Belgium: 7.5%
          UK:7.8%

          US: 7.8%

          The countries that are getting crushed aren't the socialist ones, they're the ones pursuing the Anglo American capitalist austerity model now.   As the Atlantic fails to note properly, the EU average is dragged up by the terrible capitalist disasters in Greece, Italy, Spain, and Irekand.  NONE of these countries spend as much of GDP on the social network as the northerners.  Several of these countries produce more per hour as well than the US.  If clock cleaning isn't right, they are certainly holding their own easily versus the US

          Hay hombres que luchan un dia, y son buenos Hay otros que luchan un año, y son mejores Hay quienes luchan muchos años, y son muy buenos. Pero hay los que luchan toda la vida. Esos son los imprescendibles.

          by Mindful Nature on Thu Jan 10, 2013 at 09:29:54 AM PST

          [ Parent ]

          •  It would be more persuasive (0+ / 0-)

            with the inclusion of Italy, France, Spain and Greece. I don't recall Greece pursuing the Anglo-American capitalist model, but maybe I was away from my desk or on the phone. I would probably have called it the "government employment for all" model. And I'm not quite clear why the UK or Germany would be a socialist country. They do have a socialist-model healthcare system (as do these all), but then that would suggest that socialism and unemployment stats might not be all that closely tied. Hmm.

            However, more to the real point—I did not put myself forward as attacking socialism per se. I confined myself here to the thought that socialized healthcare is not a slam-dunk desirable. And it isn't.

            •  And of course (3+ / 0-)
              Recommended by:
              Mr Robert, fuzzyguy, elwior

              It's pretty simple.  These northern european countries have MORE robust social safety systems and higher levels of social spending and more solid labor protections and generally greater levels of social cooperative action than either the US or southern Europe.  Indeed, instituting any reform that would make the US system more like a European one would be decried as "socialism" so the notion is pretty muddled.  In fact, arguably none of these are socialist countries at all.

              The point is that this notion that the great capitalist system is inherently better simply does not comport with the facts.

              Greece, Spain, Italy and Ireland have been left out for one very obvious reason.  All are subject to onerous and counter productive internationally enforced austerity programs that have nothing whatsoever to do with socialism either.  Including them is about like attacking New Orleans for its high unemployment rate a month after Katrina.  

              Hay hombres que luchan un dia, y son buenos Hay otros que luchan un año, y son mejores Hay quienes luchan muchos años, y son muy buenos. Pero hay los que luchan toda la vida. Esos son los imprescendibles.

              by Mindful Nature on Thu Jan 10, 2013 at 10:22:17 AM PST

              [ Parent ]

              •  Capitalism, great and otherwise (1+ / 0-)
                Recommended by:
                nextstep

                The inadequacies of market-based setups is not necessarily an argument in favor of a socialist alternative. Possibly better markets are a better alternative. It would need discussion, not simple derision.

                Greece et al. borrowed a great deal of money. Nobody made them do this. Their current straits are the result of their own impecunious foolishness. Ironically (given your animus), the borrowing was largely to fund these vast, unaffordable, social welfare schemes which are now causing so much pain. So yes, it has a great deal to do with socialism.

                However, there is little "internationally enforced austerity,' outside of basket-case Greece. The rest are or were facing limitations on expenditures as a result of negotiations with various banks and lenders, none of whom are under any obligation to continue lending.

                Of course, these countries do have a way out—they can leave the euro and default on their bonds. This will cause the same pain as austerity, but the hope would be that it would last a shorter time. After that they may possibly learn to first tax themselves adequately to pay for all those "European Social State" goodies.

                Your comment about New Orleans and Katrina is simply baffling.

                •  Ah (5+ / 0-)
                  Recommended by:
                  fuzzyguy, a2nite, kyril, elwior, Steven D

                  In fact, a tremendous portion of Greece's problems arise from the corruption and low tax receipts that have been endmic to Greece for decades.  This still leaves the question of if Greece is a poster child for how horrible socialism is, why even more socialistic countries are doing very well, and beetter than the US.  This notion that Europe is a total disaster and the US it sailing along doesn't comport with the facts, I'm afraid.

                  While there is a possibility that better markets might provide a solution, we must be skeptical of that, since the US has used free market health care system for decades, but under no iteration has it ever come close to the effiency or efficacy of the public systems of Europe.  It is possible, but the historical evidence is not exactly encouraging.

                  Hay hombres que luchan un dia, y son buenos Hay otros que luchan un año, y son mejores Hay quienes luchan muchos años, y son muy buenos. Pero hay los que luchan toda la vida. Esos son los imprescendibles.

                  by Mindful Nature on Thu Jan 10, 2013 at 11:14:03 AM PST

                  [ Parent ]

  •  At the mercy of Middle men profiteers... (5+ / 0-)

    nothing wrong with profits that a fair market supports... in the grand bargain customers are not dictated to and have some say in accepting the terms of the general agreements... informed shoppers, shoppers with a choice, consumers of any product or service who are not kept in the dark or lied to or given a choice of paying too much or not getting something that they could otherwise pool together with other consumers and get for less, all essentially at the mercy of divide and conquer stealth monopolies who have bought off the representatives of the average person and now are the victims of a class of middle-men who add extra stages of inflated profit without actually adding much in the way of value.

    And our health care is just one market that operates like this. Charging what the market can bear pays off big time if you can force the market to bear a lot more than it would normally by weakening anti competitiveness regulations preventing single payer health coverage, weakening, killing or neutralizing unions, buying up the media, politicians and even bankrolling astro-turf groups. And the best way is to do it away from public view and oversight... behind the scenes, off-shore, in think tanks and board rooms or ALEC conferences or the meetings that set the agenda for ALEC...

    Pogo & Murphy's Law, every time. Also "Trust but verify" - St. Ronnie (hah...)

    by IreGyre on Thu Jan 10, 2013 at 06:14:24 AM PST

  •  To add insult to injury (14+ / 0-)

    median health care costs in OECD countries are around $3,200 while the US spends roughly $8,000.

    Two and a half times more money for a crappy result.

    Reality is that which, when you stop believing in it, doesn't go away. -- Philip K. Dick

    by RandomGuyFromGermany on Thu Jan 10, 2013 at 06:21:12 AM PST

  •  You'd Have to Live in the U.S. (12+ / 0-)

    You'd have to live in the United States to think anything else. If we could magically transplant Britain's NHS to the U.S., making the least change to it possible, our healthcare would catapult from about 37th place to 8th. And it would cost about 50% less.

    Socialized medicine is the gold standard for healthcare. But I'd be satisfied with publicly-funded healthcare, where the federal government simply pays for all essential care out of a progressive tax.

    That would at least allow us to start to be competitive with other countries, something we desperately need if we are to ever balance our trade and compete globally.

  •  yep (9+ / 0-)

    Obamacare was a fart in the wind, feather in the cap, hollow victory, ultimately bound to the never-ending, insidious, elusive priority of protecting big money... with gaping loopholes of deprivation.

    sorry... time will tell... and it will tell.

    with aging pop and 47% drop in US net worth, we desperately need
    Full Socialized Healthcare.

    People who say they don't care what people think are usually desperate to have people think they don't care what people think. -George Carlin

    by downtownLALife on Thu Jan 10, 2013 at 06:49:47 AM PST

    •  Let's hope it was a beginning (5+ / 0-)

      and not a dead end.

      "If you tell the truth, you'll eventually be found out." Mark Twain

      by Steven D on Thu Jan 10, 2013 at 06:52:59 AM PST

      [ Parent ]

    •  Obamacare is the beginning of a framework (5+ / 0-)

      Maybe if people would start organizing around expanding it and building off of it...like, say, lobbying the government to expand Medicare even further (since there was such an expansion written into the PPACA already). Maybe by publicizing many of the less-known benefits, that might help?

      Let's not throw our hands up and say "OMG we can't do anything, we're doomed." We have a great foundation to build on here. Be the change you seek.

      •  thanks- i applaud your post (3+ / 0-)
        Recommended by:
        Steven D, sethtriggs, elwior

        Let's not throw our hands up and say "OMG we can't do anything, we're doomed." We have a great foundation to build on here. Be the change you seek.

        the older i get- the more i realize just how much more pervasive big money has become in penetrating all the decisions thrust upon us with up spin and manipulative media practice. conspiratorial?  yea- but entirely predicated by money.

        i want to be hopeful as you- i just want to target the true, insidious, elusive enemy-- for me the Beltway is a pawn- the real culprits have their moneys in luxembourg, singapore, etc
        the first entity on the globalisation train was the financial industry

        let us hope
        thanks- have a good day-
        m

        People who say they don't care what people think are usually desperate to have people think they don't care what people think. -George Carlin

        by downtownLALife on Thu Jan 10, 2013 at 08:13:38 AM PST

        [ Parent ]

  •  great diary (4+ / 0-)

    Thanks for bringing this report to our attention.

    Of course, some of the right wing will dismiss the NRC as being a bunch of "pointy-headed academics", therefore clearly biased towards socialism... It is great to see some real data.

  •  Keeping the current system helps in two ways... (9+ / 0-)

    First it allows those who see health care as a necessity for only those who can afford it to demonize the middle and lower classes for failing to make an extra $12,000-15,000/year to pay premiums.  Those who value greed over ethical health care policies maintain their sense of self-esteem and the "worhtless" folks they despise will die off.  They are killing the opposition literally by making healthcare a privilege rather than a right.  

    Second, since we already have worse health outcomes than every other country with running water, it will serve to cull the senior population, especially the Boomers and Gen Xers who do not have pensions, former union jobs or anything tangible to fund retirement.  Cut social security, medicare and healthcare and these people will do what Republicans want them to do: shut up and die quickly.  

    This is population control through denial of care.  It is fueled by greed and shows the United States is the most unethical democracy on the planet.

    Reaganomics raped the American worker & this depression is the result. When will we wake up & vote with our own financial interests?

    by phree on Thu Jan 10, 2013 at 07:39:46 AM PST

  •  until we get rid of our for profit health (2+ / 0-)
    Recommended by:
    Steven D, elwior

    care system, we will always rank low on quality of leaht care and the highest on cost of health care. I don't see any big change in my lifetime sadly. We will have to do the best we can forawhile until the Repugs get enlightened which could take decades.

  •  American exceptionalism is fatal (7+ / 0-)

    it keeps Americans from learning a damn thing.

    Hay hombres que luchan un dia, y son buenos Hay otros que luchan un año, y son mejores Hay quienes luchan muchos años, y son muy buenos. Pero hay los que luchan toda la vida. Esos son los imprescendibles.

    by Mindful Nature on Thu Jan 10, 2013 at 07:48:37 AM PST

  •  Yeah, but ... freedom. Those socialist systems (5+ / 0-)
    Recommended by:
    Steven D, Akronborn, Mr Robert, a2nite, elwior

    make you live longer & with better health. That's just un American.

    Who cares what banks may fail in Yonkers. Long as you've got a kiss that conquers.

    by rasbobbo on Thu Jan 10, 2013 at 08:03:32 AM PST

  •  As we have been saying for a long long (2+ / 0-)
    Recommended by:
    Steven D, elwior

    time!  I first experienced it in 1963.  Was sold then and still am.

    An idea is not responsible for who happens to be carrying it at the moment. It stands or falls on its own merits.

    by don mikulecky on Thu Jan 10, 2013 at 08:04:15 AM PST

  •  Isn't it amazing (3+ / 0-)
    Recommended by:
    Lily O Lady, elwior, Steven D

    how privileged white ***hole Republicans even vote against their own rational self-interest?

    "A good president does what's possible and a great president changes what's possible." --sterno

    by sk4p on Thu Jan 10, 2013 at 08:31:24 AM PST

  •  Painfully obvious (2+ / 0-)
    Recommended by:
    elwior, Steven D

    profiting from and maximizing profiting of everything has very bad results.  But those who profit won't be easily persuaded otherwise.  And they have and control power in this country.

    "To recognize error, to cut losses, to alter course, is the most repugnant option in government." Historian Barbara Tuchman

    by Publius2008 on Thu Jan 10, 2013 at 08:37:25 AM PST

  •  High fructose corn syrup is killing us. (8+ / 0-)

    Even rich, white people eat it, because it's in everything.

    If we took it out of everything, people would drop weight and consequently be healthier. Food would taste better too.

    And WHY doesn't health insurance cover dental and vision? Last time I checked, my teeth and my eyes affect my overall health levels because they are part of my body. That may be true for most of us.

    PS: I saw a story the other day about "jobs of the coming decade," and dentists were number 5. LOL. I know two dentists who have had to close their formerly high-performing practices because hardly anyone covers dental on employer insurance plans and people don't spend their own money going to the dentist unless it's an emergency. And HFCS is also bad for your teeth.

    "The difference between the right word and the almost-right word is like the difference between lightning and the lightning bug." -- Mark Twain

    by Brooke In Seattle on Thu Jan 10, 2013 at 08:41:35 AM PST

    •  Got an impacted tooth on Friday night? (5+ / 0-)
      Recommended by:
      WheninRome, Mr Robert, kyril, elwior, Steven D

      It could easily kill ya. Go to the ER, and find they have a dental chair and all the equipment, but no dentist. No dental coverage on the insurance either as it turns out.

      Doc says, here take these painkillers, and a butt load of antibiotics, make an appointment with a dentist for Monday morning, and don't die over the next couple days or suffer brain damage from 100+ fever. Also, call around and scrape up the couple grand you'll need for the dentist, since working retail doesn't give one the privilege to have "Cadillac" insurance coverage and the best medical care money can buy.

      'Merica, Number ONE!11!!

  •  It's a good thing we entrenched the for-profit (3+ / 0-)
    Recommended by:
    Mr Robert, fuzzyguy, elwior

    health insurance industry with ACA, then.

  •  The "something" is inequality. (3+ / 0-)
    Recommended by:
    fuzzyguy, elwior, Steven D

    There was a study out in the last year (or so) that managed to make that point; even for the very well off, living in a highly unequal society puts them at a health disadvantage compared to their equivalents in more equal societies.

    "Be just and good." John Adams to Thomas Jefferson

    by ogre on Thu Jan 10, 2013 at 09:13:42 AM PST

  •  And lack of coordination between doctors.... (2+ / 0-)
    Recommended by:
    elwior, Steven D

    Not just the money involved.   The patient is responsible for getting a diagnosis in many cases.    Our health care system is not good.   Our educational system is not affordable.   Our jobs are not good.   Our infrastructure is not good. They've destroy just about everything.

    What we need is a Democrat in the White House.

    by dkmich on Thu Jan 10, 2013 at 12:41:32 PM PST

  •  We have moldy crumbs because that's what we (1+ / 0-)
    Recommended by:
    elwior

    Like. It's called American exceptionalism. Another name for it selfishness.

  •  the healthcare crisis is not one of financial (2+ / 0-)
    Recommended by:
    elwior, Steven D

    unsustainability (as evidenced by these countries who pay, on average, half of what we do), but one of public confidence and understanding.

    Thanks for increasing our understanding!

  •  ACA killed universal healthcare for us. (0+ / 0-)

    Now that we have ObamaCare, the chances of getting single payer are slim to none for the foreseeable future.  If ACA is even marginally more successful than the shit we have now, it will remain the law of the land for generations.

    If you think about how difficult it was for us to get the ACA through the legislative and judicial branches, you can really appreciate how challenging it will be for Democrats to replace it with a single payer system.  

    "If the misery of the poor be caused not by the laws of nature, but by our institutions, great is our sin." Charles Darwin

    by Rockydog on Thu Jan 10, 2013 at 02:46:48 PM PST

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