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Ethicist: Health care system is 'a mess'

Old 05-15-07, 05:50 PM
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Ethicist: Health care system is 'a mess'

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The U.S. health care system is "a dysfunctional mess" and politicians who insist otherwise look ignorant, according to a medical journal essay by a prominent ethicist at the National Institutes of Health.

"If a politician declares that the United States has the best health care system in the world today, he or she looks clueless rather than patriotic or authoritative," Dr. Ezekiel Emanuel wrote in Wednesday's Journal of the American Medical Association.

Emanuel, who supports sweeping health care reform, said the U.S. spends $6,000 per person per year on health care, an amount that is more than 16 percent of the nation's gross domestic product and more than any other country.

He also said Americans' average life expectancy of 78 ranks 45th in the world, behind Bosnia and Jordan. And the U.S. infant death rate is 6.37 per 1,000 live births, higher than that of most developed nations.

President Bush frequently has said Americans have the world's best health care system, but Emanuel stopped short of calling Bush clueless in his essay and during an interview with The Associated Press.

"I work for the federal government. You can't possibly get me to make that statement," Emanuel said in the interview.

Emanuel's proposal involves phasing out Medicaid, Medicare and employer-sponsored health insurance. Under his plan, all Americans would get a basic package of insurance, would choose their insurance carrier and could buy upgraded coverage. The program would be funded by a value-added tax of about 10 percent on businesses.

Democrats and Republicans alike have made the "world's best" claim. Democrat John Kerry did so when he ran for president in 2004, as did Republican Rudy Giuliani on the presidential campaign trail this year.

David Hogberg, senior policy analyst at the National Center for Public Policy Research, said a strong case can be made that the U.S. health care system is the best.

"It depends on what measures you use," Hogberg said. Life expectancy is influenced by many factors other than health care, he said, and nations measure infant death rates inconsistently. Other measures show the United States performing well, he said.
bhk: rebuttal?
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Old 05-15-07, 05:53 PM
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At least we don't have to wait a year before a medical procedure (hello Canada!!!)

[Elitist]If you have good health insurance, you can get great healthcare![/Elitist]

-p
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Old 05-15-07, 05:58 PM
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Emanuel's proposal involves phasing out Medicaid, Medicare and employer-sponsored health insurance. Under his plan, all Americans would get a basic package of insurance, would choose their insurance carrier and could buy upgraded coverage. The program would be funded by a value-added tax of about 10 percent on businesses.
which means an additional 10 % tax paid by the end consumer (unless he plans on changing the sales tax law as well).

additionally, he makes no mention as to reimbursements to providers - are they supposed to take an across the board wage reduction to the level of and medicare/medicaid reimbursements?
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Old 05-15-07, 06:15 PM
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And the U.S. infant death rate is 6.37 per 1,000 live births, higher than that of most developed nations.
Haven't we been over this stat time and time again... isn't this usually because the US tries to save more babies that other countries would have given up on and not even included in their live birth death rate stats. The fact that he's pulling this out as evidence makes the whole thing seem a little skewed IMHO (not to mention the 10% tax is not a very realistic idea).
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Old 05-15-07, 06:18 PM
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i say double the co-pays on all the lifestyle drugs like lipitor where most people taking it can prevent it by lifestyle changes and see what happens
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Old 05-15-07, 06:18 PM
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How do I get a job as an "ethicist?"
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Old 05-15-07, 06:20 PM
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i want to know how bosnia got such a large life expectancy after the war in the last decade. did they not count the ethnic cleansing?
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Old 05-15-07, 06:22 PM
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Originally Posted by Duran
How do I get a job as an "ethicist?"
A Ph.D. in Philosophy might be a start.
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Old 05-15-07, 06:36 PM
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Originally Posted by wendersfan
A Ph.D. in Philosophy might be a start.
I guess those degrees have to have some worth.
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Old 05-15-07, 06:40 PM
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I just talked to a rich executive with who is fully insured, and he ensures me that the healthcare system in this country is just fine.
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Old 05-15-07, 06:48 PM
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Originally Posted by Groucho
I just talked to a rich executive with who is fully insured, and he ensures me that the healthcare system in this country is just fine.


But seriously...

Let's see how he feels if he twists his ankle this weekend and needs to go to the ER.

He'll enjoy the 12 hour wait, behind all the uninsured clogging up the system.
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Old 05-15-07, 06:53 PM
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Originally Posted by Lord Rick


But seriously...

Let's see how he feels if he twists his ankle this weekend and needs to go to the ER.

He'll enjoy the 12 hour wait, behind all the uninsured clogging up the system.

Yeah ER sucks. I sit with my good insurance, while people with fucking colds and no money get seen.
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Old 05-15-07, 06:56 PM
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Originally Posted by nemein
Haven't we been over this stat time and time again... isn't this usually because the US tries to save more babies that other countries would have given up on and not even included in their live birth death rate stats. The fact that he's pulling this out as evidence makes the whole thing seem a little skewed IMHO (not to mention the 10% tax is not a very realistic idea).
i thought this as well. btw, as an interesting side note, dr. emanuel's brothers are none other than super agent ari emanuel and congressman rahm emanuel (D - IL).
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Old 05-15-07, 07:31 PM
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Originally Posted by superdeluxe
Yeah ER sucks. I sit with my good insurance, while people with fucking colds and no money get seen.
Nah, they wait, too.
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Old 05-15-07, 07:33 PM
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Originally Posted by Duran
How do I get a job as an "ethicist?"

I was going to ask the same thing. What kind of bullshit profession is 'ethicist?'
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Old 05-15-07, 07:40 PM
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Originally Posted by Lord Rick
Nah, they wait, too.

Yeah but they get it for free heh. While I have to pay. Maybe next time I will just lie.
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Old 05-15-07, 07:55 PM
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Originally Posted by Vandelay_Inds
The same kind as 'lawyer'. They pay you according to the number of people you can fool.

That's what Rudy is counting on.
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Old 05-15-07, 08:40 PM
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Originally Posted by Duran
How do I get a job as an "ethicist?"
I hereby deem Duran as an Ethicist.

Congrats, Duran. You past the difficult test.
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Old 05-15-07, 08:45 PM
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Originally Posted by crazyronin
I guess those degrees have to have some worth.
But serving french fries loaded with trans-fat doesn't sound very ethical.
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Old 05-15-07, 08:52 PM
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Originally Posted by nemein
isn't this usually because the US tries to save more babies that other countries would have given up on and not even included in their live birth death rate stats.
First you need to prove this is actually true. Then prove that it is actually true to such a degree that it would skew the statistics. Otherwise, you're not really explaining the difference - you're just theorizing.

Besides, that is not the point of the article. It is used merely to point out deficiencies in our health care system. And if you don't think there are any, then you clearly haven't been to a hospital with a serious illness or received a bill for treatment of a serious illness (yes, even if you're insured, it's a pain in the ass).

Last edited by hahn; 05-15-07 at 09:00 PM.
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Old 05-15-07, 09:01 PM
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Whether the US actually tries to save babies more than other countries may not be the issue. Technology would be. Poorer countries cannot afford the doctors or the equipment and the US can.

So, technology is actually skewing the results.
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Old 05-15-07, 09:04 PM
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Originally Posted by hahn
First you need to prove this is actually true. Then prove that it is actually true to such a degree that it would skew the statistics. Otherwise, you're not really explaining the difference - you're just theorizing.

Besides, that is not the point of the article. It is used merely to point out deficiencies in our health care system. And if you don't think there are any, then you clearly haven't been to a hospital with a serious illness or received a bill for treatment of a serious illness (yes, even if you're insured, it's a pain in the ass).
I don't know of anyone, politician or otherwise, who thinks the health care system is perfect.
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Old 05-15-07, 09:05 PM
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Originally Posted by hahn
First you need to prove this is actually true. Then prove that it is actually true to such a degree that it would skew the statistics. Otherwise, you're not really explaining the difference - you're just theorizing.
Kinda like how this ethicist you quoted is theorizing?
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Old 05-15-07, 09:08 PM
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Have a look at infant mortality rates by race. Minorities (i.e. the poor) in the US have significantly higher infant mortality rates than whites. So it's not only that "we just try to save more babies", there are other factors such as (lack of) access to pre-natal care, mothers having pre-existing health conditions, etc...
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Old 05-15-07, 10:10 PM
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Originally Posted by eXcentris
Have a look at infant mortality rates by race. Minorities (i.e. the poor) in the US have significantly higher infant mortality rates than whites. So it's not only that "we just try to save more babies", there are other factors such as (lack of) access to pre-natal care, mothers having pre-existing health conditions, etc...
Since the 1997 figures show that Asians/Pacific Islanders have the lowest infant mortality rate, I hereby welcome our Samoan overlords.

p.s. The only thing that drove hispanic infant mortality higher than whites was that they had a higher rate of congenital infant mortality. Their incidence of SIDS and other non=congenital infant mortality was lower than whites.

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