Modern Healthcare in the US

[physica]

We do have a stack. This is anecdotal as I can't find studies on this but two of our consultants dropped out of physics because it was too hard, one of our senior regs couldn't get into grad school in maths because his grades were too low and one of our shos got a 2.2 in maths not cutting the mustard for grad school. This is why I said it describes about 30% of my department. Again the intelligence is debatable. Yes you get smart doctors but there are a lot that can survive blindly following guidelines and googling every 2 minutes. As for the flooding, train more and open medical trade with Cuba. They have highly disciplined doctors who will work a lot harder for a lot less money. Cuba trains their doctors to high standards and treats them like we treat our military (they don't even have much of a say in what country they get stationed in) because it uses them as a commodity, it will send a load of doctors in exchange for money or goods. Philippines also trains more nurses than it needs.

[John Cuthber]

The population of Cuba is a little bigger than that of London.

Ignoring the question of whether it's fair to poach their doctors, do you really think that have very many?

 

So, where are you going to find this flood?

 

Anyway, if we are already short of people in medicine to the extent that the medical schools are taking other depts' rejects, how many more can we find without compromising (further) on quality?

[physica]

Cuba has 42,000 workers in international collaborations in 103 different countries, of whom more than 30,000 are health personnel, including no fewer than 19,000 physicians. Cuba provides more medical personnel to the developing world than all the G8 countries combined, although this comparison does not take into account G8 development aid spent on developing world healthcare. The Cuban missions have had substantial positive local impact on the populations served. It is widely believed that medical workers are Cuba's most important export commodity.

 

This country knows how to churn out hard working disciplined doctors who will work for a small wage. No one will be able to create a flood in a year and rushing something like that would just spell disaster but opening up trade boarders on this front and setting up training schemes where they advise us on managing training and recruitment. People don't die because doctors don't know what they're doing. Problem solving in medicine is noway near as complex as the hard sciences, patients die or become unnecessarily ill because they are no assessed on time, it costs too much or they wait in a bed for 24 hours with a perforated bowel or a certain specialty just is't there. In 5 to 10 years time you will generate a flood of doctors and nurse who will compete, actually work hard to stay in the profession.

Edited June 1, 2014 by physica

[imatfaal]

physica - please ensure you quote material that isn't yours and provide a link to the source

 

http://en.wikipedia.org/wiki/Cuban_medical_internationalism

 

Citation aside - good info, Thanks.

[iNow]

So... just a friendly reminder... The thread topic is the US healthcare system, and more specifically some of the ridiculous complexities that are part of the system given its current setup. Perhaps if the above posters would like to continue debating how to improve the NHS in England they could open another thread to do so?

[Ten oz]

So... just a friendly reminder... The thread topic is the US healthcare system, and more specifically some of the ridiculous complexities that are part of the system given its current setup. Perhaps if the above posters would like to continue debating how to improve the NHS in England they could open another thread to do so?

Not to be a nuisance but you ignored my last response to you. I listed attempts made by FDR, Eisenhower, LBJ, Nixon, Clinton, etc to nationalize healthcare in the European model you seem advocating. My question to you is why do you think all those attempts have failed?

 

I personal like the european model and desperately wish we would adopt it. My question isn't challange whether or not the system could work. I know that it could. It has already been proven in other countries.

[iNow]

Not to be a nuisance but you ignored my last response to you.

My apologies. It wasn't my intent to ignore you, I just interpreted your question to be a rhetorical one and so did not directly address it.

 

 

I listed attempts made by FDR, Eisenhower, LBJ, Nixon, Clinton, etc to nationalize healthcare in the European model you seem advocating. My question to you is why do you think all those attempts have failed?

IMO, it's a complex combination of factors, but the top ones that come to mind are:

• Differing ideologies about the proper role of the state and acceptable level of government involvement among our elected representatives and also the populace itself
• A distracted and largely uninformed populace where minority opinion tends to receive the loudest and most passionate voices while majority opinion is largely quiet (see also: gun control and how minority opinion continues to hold sway, preventing background check bills from passing despite 90% support among the populace). I'm reminded of a quote by Yeats: "The best lack all conviction, while the worst are full of passionate intensity."
• Massive amounts of lobbying and campaign funding from private interests (private insurance companies, hospitals, drug manufacturers, etc.) that has the effect of influencing how votes are ultimately cast for bills (see also similar problems in the FCC with net neutrality votes and Comcast influence winning over public outcries, as laid out humorously in this clip)
• Parliamentary tactics being used in record-breaking obstructionist ways so minority opinion can prevent votes from happening at all, despite our constitutional republic seemingly not being intended for that type of gamesmanship

There are others, but those capture most of my opinion on that. We could have a much longer conversation about the problems with representation in our current system and where the power for change truly resides or how money is drowning out the voice of citizens, but again that would be better in another thread. Edited June 2, 2014 by iNow

[CharonY]

One thing that one should note is that there is no European systems. Each country has a different model ranging with the NHS sytem in the UK being the most centralized (I believe) to mixed models (e.g. Germany). They are compulsory, however, and all receive at least some degree of public funding, ranging from almost 100% in the UK to about 50% as in Italy, I believe.

Edited June 2, 2014 by CharonY

[iNow]

Indeed. Additionally, not all countries doing this well are in Europe... Taiwan, Australia, Canada, etc. all come immediately to mind.

[CharonY]

It could be helpful to break out some specific mechanisms and discuss their implementation in the US. Oftentimes terms like universal health care, European/socialist system etc. are thrown around without specifically defining what is meant. This is especially troublesome if quite different models are discussed under the same term.

[Phi for All]

The thread topic is the US healthcare system, and more specifically some of the ridiculous complexities that are part of the system given its current setup.

 

Making things ridiculously complex always signals to me that there's some major agenda I'm not privy to. Like the tax structure; you hear everyone complain about it but it never changes, so some group wants it to stay that way. Unnecessary complexity doesn't serve the People, it's serves the Per$on$.

 

I think we're at a tipping point in the argument between the uber-wealthy and the rest of us in the US. If we can avoid the "class-war" red-herring and focus on reform that takes more People into account, I think we can show how stripping the parasites off our health system will make us physically and economically healthier.

 

It's (not) funny, but in a lot of ways, the US has regressed in medicine, and have taken the practice of leeching to new heights.

[Ten oz]

My apologies. It wasn't my intent to ignore you, I just interpreted your question to be a rhetorical one and so did not directly address it. IMO, it's a complex combination of factors, but the top ones that come to mind are:

• Differing ideologies about the proper role of the state and acceptable level of government involvement among our elected representatives and also the populace itself
• A distracted and largely uninformed populace where minority opinion tends to receive the loudest and most passionate voices while majority opinion is largely quiet (see also: gun control and how minority opinion continues to hold sway, preventing background check bills from passing despite 90% support among the populace). I'm reminded of a quote by Yeats: "The best lack all conviction, while the worst are full of passionate intensity."
• Massive amounts of lobbying and campaign funding from private interests (private insurance companies, hospitals, drug manufacturers, etc.) that has the effect of influencing how votes are ultimately cast for bills (see also similar problems in the FCC with net neutrality votes and Comcast influence winning over public outcries, as
• Parliamentary tactics being used in record-breaking obstructionist ways so minority opinion can prevent votes from happening at all, despite our constitutional republic seemingly not being intended for that type of gamesmanship

There are others, but those capture most of my opinion on that. We could have a much longer conversation about the problems with representation in our current system and where the power for change truly resides or how money is drowning out the voice of citizens, but again that would be better in another thread.

I agree. However I think you left out important ideological/emotional things like racial bias. It is impossible to talk about entitlements in this country without people blowing racial dog whistles.

Unfortunately a lot of great ideas have already been presented by both major parties. Understanding that is to understand that the development of a better healthcare plan will not succeed. The other issues must be addressed before any action can be taken on healthcare. Gerrymandering of congress, corperate personhood, immigration reform, and a laundry list of other issues have to be resolved first.

[Arete]

"We have received and analysed the results for GAMSAT 2014 entry and can confirm that the overall minimum cut-off score to be selected for interview is 60,"

 

 

Just an FYI - GAMSAT is the national entry exam for graduate student to get INTO medical school in Australia. Passing GAMSAT doesn't guarantee you will get to practice medicine by a long shot. Even if you get through the exam and the interview, all it does is get you a spot in 1st year med school - which is a long way from being a practicing clinician.

[iNow]

I've shared this link before, but will share it again. I watched the larger special being discussed in the summary clip and it was quite well put together, well referenced, and well reasoned.

 

http://globalpublicsquare.blogs.cnn.com/2012/03/17/zakaria-how-to-fix-u-s-health-care/

I also suspect this post I wrote in another thread toward the end of last year might apply: http://www.scienceforums.net/topic/79573-obama-care-economic-analysis/?p=774818

[Marshalscienceguy]

Through its use of satire and the presentation of a concept in another context helps to illuminate some of the key problems facing healthcare in the US. Some of this has been improved slightly since the implementation of the ACA, but most of it still rings true.

 

This video presents what the experience would be for an air traveler if booking your trip worked the same way as our "modern" healthcare in the US. The crazy part is that you don't have to strain to imagine how awful this would be.

 

 

 

 

Is there any chance we get this fixed or improved in the current political climate? Other systems in other countries seem to do this all much better, but are there important problems and limitations with those that we should be aware of in the US? What do you think?

 

 

http://www.vox.com/2014/5/22/5739702/the-insanity-of-the-american-health-care-system-in-one-hilarious-video

This reminds me of how my bank works.