Comparative Health

[ewx]

Americans reportedly less healthy than British, but not because of their broken health care system or greater tendency towards obesity. I wonder why?

Comments

[aldabra]

Oh great. British government target to reduce differences in life expectancy and infant mortality by 10%. I bet one way to achieve that is easier than the other...

[rmc28]

Greater awareness of conditions like diabetes, and thus greater tendency to report? A few years ago Diabetes UK were campaigning saying that a million people in Britain were undiagnosed diabetics, though of course their campaign may have reduced the numbers somewhat.

[ex-lark-asc.livejournal.com]

I'm with rmc28: greater tendency to be a nation of bitching, litigious whiners.

[hairyears.livejournal.com]

Partly it's the NHS: we hear so many bad things about hospitals, but they are almost irrelevant in terms of patient-hours: Britain's health system runs on primary care - the family GP - whereas the American system is almost entirely based on intervention by hospital-based specialists.

This hits the poor particularly hard, because the low-level illness that is part of poor housing and diet goes untreated and there's no real preventative medicine, no early diagnosis of more serious diseases, and no-one working for their health rather than treating their illnesses.

But, poor or not, fat or not, you don't get a healthy population by having superb hospitals and patchy primary care.

[bopeepsheep.livejournal.com]

There's a climate of fear in the underinsured in the US - skipping treatments, appointments, medications to save on the co-pays and OOP expenses - which of course often leads to the need for expensive treatment anyway because they didn't go and get the early signs of whateveritis treated. I see it manifested most in pregnant and its sister communities (particularly the formula-feeding ones), people ignoring dangerous symptoms in order to save doctors' fees. :( Here at least no one should be afraid of a doctor's visit eventually leading to bankruptcy.

At the other extreme, the adequately insured seem to have heavily over-medicalised treatment, and 'doctor as God' syndrome.

[naath.livejournal.com]

America has *the best* health care in the world. IF you can afford it. Most Americans can't. And insurance doesn't cover preventative care to any where near the extent that the NHS does. In America they have sick-care, in the UK we manage somme measure of *health* care.

[aldabra]

Even with real insurance, the insurer dictates which hospital you get to use, which isn't necessarily the one you'd have chosen. I don't think there's mauch more in the way of patient choice there than there is here; it's just the insurers rather than the NHS choosing on your behalf.

[naath.livejournal.com]

Unless you are a rich bugger. In which case you pick the hospital, the consultant and when you would like it done. And then pay through the nose.

[aldabra]

Of course you can do that here too.

[mtbc100.livejournal.com]

TBH I've never managed to want to use a doctor or a hospital who wasn't nicely covered by our insurer, and for years we've had the PPO policies that have directories of preferred providers, it's just that everyone we try seems to be in the directory, even the really great doctors. There are restrictions, but I think you get much more choice than you do on the NHS.

[mtbc100.livejournal.com]

We've had to actively manage our case in a way we've never had to in Britain: facilitating communication between doctors, making sure that prescriptions were written correctly, etc. I really don't know if it's typical, but I've been surprised at the degree to which we have been having to fill people in on our case and correct misapprehensions. Perhaps they just get less time per patient so they can't take a few minutes to review the file or something.

[mtbc100.livejournal.com]

Five hypothetical problems:

• Doctors are biased toward old, conventional ways of doing things because you can't get sued for doing what there's a strong precedent for.
  
• Insurance companies are biased toward old, conventional ways of doing things because it's harder for them to argue against paying for what there's a strong precedent for.
  
• The FDA-approval trials that get funded tend to be those where that funding provides good return on investment, so it'll be for the expensive drugs instead of cheaper treatments that may be available to more people.
  
• The pharmaceutical companies heavily market their more profitable products to doctors, who will then end up more likely to have their awareness biased toward the expensive drugs instead of cheaper treatments that may be available to more people.
  
• Preventative care is less worth an insurance company investing in because it'll plausibly be a different insurance company that benefits.
  

IMLE more worthwhile treatments are available in Europe before they are available here.

[mst3kgirl.livejournal.com]

Amen to that!

I can't tell you how many times we've been in a medical situation where clearly a simple visit to a GP would have been all that was needed, but instead our only option was to go the Emergency Room. Half the people you see waiting in the ER are walk-ins who really *don't* need ER care.

And on top of that, the price between seeing a GP in an office or clinic and the price to be seen in the ER is prohibitive. (In time as well as money - you can expect an ER visit to take you 5x+ as long as an office visit!)

Grrr... clearly I shouldn't get started on this topic! :-)

[aldabra]

I don't think that's been the case with Dad's insurers, but doubtless it varies.

[kaet.livejournal.com]

What about the endless "why not ask your doctor about taking our drug" type adverts on the telly in the US?

[mtbc100.livejournal.com]

Yes, that's true, they're marketing to both doctors and patients. As if your doctor or insurer wants their time wasted by you asking them all this rubbish.