American healthcare system

[[li...]]

Well, I'm somewhere else ...

 

I know there are problems, drawbacks. The very poor may have a hard time, and 'money talks' (or not?).

 

Is my perception accurate that usually people can get what they want, in the sense of timely appointments with specialists, a customer oriented healthcare system (not always, everywhere, but you can always go elsewhere?), doctors offering/pushing drugs (which you usually can ignore, or accept but just not take), excellent diagnostics, treatment that is good most of the time ? With (of course) restrictions on controlled drugs ?

[[Fl...]]

We don't (yet) have fully socialized healthcare and hopefully that got pushed back many years with a new president coming into office, so appointments aren't a problem. Our healthcare system is expensive but I'm sure it is as good as anywhere in the world. The standard of care is of course centered on drugs but it should be something that any drug aware patient can account for and work around.

[[Ph...]]

Your perceptions are basically correct.  And if I may ask, why do you ask?

[[li...]]

Well, because I'm basically dealing the the polar opposite of that ... I'd rather not say where I live, except somewhere in Europe ... and going abroad means no insurance ...

 

Timely appointments with specialists, picking your own doctor, no referrals required (most of the time), not having to deal with a GP who prides himself on not prescribing drugs/refusing to refer people, but who prefers to give lifestyle advice and to 'wait till it's over'.

Getting proper diagnostics, not depending on a GP 'who knows nothing about everything'.

 

Imagine suffering from a benzo and being at the mercy of a GP if serious other somatic issues are

playing a role ... Lifestyle advice, waiting till it's over, seriously ?? And in this country, they just don't know Klonopin.

 

And of course they don't know about benzo withdrawal (like most docs in the USA), but at least they are not an obstacle to care ...

 

PhotoBug, that was indeed my impression. I was just asking if it was correct.

 

Try tapering a very problematic and physical drug when you have relevant health problems, and at this point, a really poor health. And of course, being at the mercy of the GP since it's so hard to find a new GP ... They are even very reluctant to prescibe drugs like Seroquel for sleep, gabapentin for withdrawal etc.

 

So my perception is correct. Not that it's going to do me a lot of good, since I don't have 500,000 USD to move to the USA ...

 

I guess crowdfunding isn't gonna work ...

[[Ph...]]

Well, because I'm basically dealing the the polar opposite of that ... I'd rather not say where I live, except somewhere in Europe ... and going abroad means no insurance ...

 

Timely appointments with specialists, picking your own doctor, no referrals required (most of the time), not having to deal with a GP who prides himself on not prescribing drugs/refusing to refer people, but who prefers to give lifestyle advice and to 'wait till it's over'.

Getting proper diagnostics, not depending on a GP 'who knows nothing about everything'.

 

Imagine suffering from a benzo and being at the mercy of a GP if serious other somatic issues are

playing a role ... Lifestyle advice, waiting till it's over, seriously ?? And in this country, they just don't know Klonopin.

 

And of course they don't know about benzo withdrawal (like most docs in the USA), but at least they are not an obstacle to care ...

 

PhotoBug, that was indeed my impression. I was just asking if it was correct.

 

And of course, being at the mercy of the GP since it's so hard to find a new GP ... They are even very reluctant to prescibe drugs like Seroquel for sleep, gabapentin for withdrawal etc.Try tapering a very problematic and physical drug when you have relevant health problems, and at this point, a really poor health.

 

So my perception is correct. Not that it's going to do me a lot of good, since I don't have 500,000 USD to move to the USA ...

 

I guess crowdfunding isn't gonna work ...

 

<<Try tapering a very problematic and physical drug when you have relevant health problems, and at this point, a really poor health. >>

 

I can relate 100%.  It's very difficult.  But not impossible if you go slow.  VERY slow.  Just use your quack as a supplier and then fall back on the experts here on how to taper it.  The quack doesn't need to know what you're doing.  He's not even qualified to know.

[[bu...]]

Well, I'm somewhere else ...

 

I know there are problems, drawbacks. The very poor may have a hard time, and 'money talks' (or not?).

 

Is my perception accurate that usually people can get what they want, in the sense of timely appointments with specialists, a customer oriented healthcare system (not always, everywhere, but you can always go elsewhere?), doctors offering/pushing drugs (which you usually can ignore, or accept but just not take), excellent diagnostics, treatment that is good most of the time ? With (of course) restrictions on controlled drugs ?

 

Yes, that is essentially a correct description of the American health care system.

[[wh...]]

America spends more money on health than any other country in the world, but we rank 37th in the world for overall health.

 

The fourth leading cause of death here is medical error/medication complications. I'm afraid you might be mistaken that things are better here. You may have some obstacles, but we have a whole set of problems you don't have.

 

 

[[Te...]]

I agree with who-am-I.

 

 

 

[[bu...]]

America spends more money on health than any other country in the world, but we rank 37th in the world for overall health.

 

The fourth leading cause of death here is medical error/medication complications. I'm afraid you might be mistaken that things are better here. You may have some obstacles, but we have a whole set of problems you don't have.

 

That statement might be true, but a link or other attribution would certainly increase its credibility.

[[wh...]]

The ranking is a World Health Organization stat:

 

http://www.who.int/whr/2000/media_centre/press_release/en/

 

The leading causes of death in the US has many sources but here is just one:

 

https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/researchers-medical-errors-now-third-leading-cause-of-death-in-united-states/

 

[[Bl...]]

America spends more money on health than any other country in the world, but we rank 37th in the world for overall health.

 

The fourth leading cause of death here is medical error/medication complications. I'm afraid you might be mistaken that things are better here. You may have some obstacles, but we have a whole set of problems you don't have.

 

That statement might be true, but a link or other attribution would certainly increase its credibility.

 

 

The following quote is a bit dated….year 2000. I’m not sure if things have improved. Seriously, I’m afraid to find out if things have improved or not.

 

Better to stay in the dark(not know every single detail) but still, to proceed with due caution when using the system that is set in place.

 

Quote:

Toxic Medicine?

Medical mistakes kill anywhere from 44,000 to 98,000 hospitalized Americans a year, reports the Institute of Medicine. The problem is said to be the result of flaws in the way hospitals, clinics, and pharmacies operate. For example, pharmacists filling prescriptions are often hampered by doctors’ poor handwriting. Did the doctor prescribe ten milligrams or ten micrograms? Compounding the problem are the many drugs having similar-sounding names, which can cause confusion among doctors, nurses, pharmacists, and patients alike. The Institute of Medicine has called for a 50-percent reduction in medical errors within five years.

 

Source link:  Watching the World; g00 7/22 p. 29

[[Ph...]]

America spends more money on health than any other country in the world, but we rank 37th in the world for overall health.

 

The fourth leading cause of death here is medical error/medication complications. I'm afraid you might be mistaken that things are better here. You may have some obstacles, but we have a whole set of problems you don't have.

 

That statement might be true, but a link or other attribution would certainly increase its credibility.

 

 

The following quote is a bit dated….year 2000. I’m not sure if things have improved. Seriously, I’m afraid to find out if things have improved or not.

 

Better to stay in the dark(not know every single detail) but still, to proceed with due caution when using the system that is set in place.

 

Quote:

Toxic Medicine?

Medical mistakes kill anywhere from 44,000 to 98,000 hospitalized Americans a year, reports the Institute of Medicine. The problem is said to be the result of flaws in the way hospitals, clinics, and pharmacies operate. For example, pharmacists filling prescriptions are often hampered by doctors’ poor handwriting. Did the doctor prescribe ten milligrams or ten micrograms? Compounding the problem are the many drugs having similar-sounding names, which can cause confusion among doctors, nurses, pharmacists, and patients alike. The Institute of Medicine has called for a 50-percent reduction in medical errors within five years.

 

Source link:  Watching the World; g00 7/22 p. 29

Although not unique to the U.S. system, add to this the practice of poly-drugging, where doctors are unaware of contra-indications and drug interactions.  Jesus, what a mess!

[[lo...]]

the problem is not the american healthcare system (which delivers little value to the dollar). the problem is mainstream medicine in general which is profit driven. profit trumps real health.

I did experience the health care system of 4 wester countries. they all the same in the essence. they more accessible outside of the usa, but modern medicine does not aim to heal anybody. it aims at symptom managment at best. some parts are really destructive (like cancer 'treatment), others can be helpful (surgery when you break a bone).

[[...]]

Some interesting reading (and watching):

 

2016 - Medical errors are the 3rd leading cause of deaths in the US

Dr. Marty Makary

 

Video Interview: 

Study:  http://www.bmj.com/content/353/bmj.i2139

 

"Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care" by Dr. Marty Makary

 

Book Trailer -

Book - https://www.amazon.com/Unaccountable-Hospitals-Transparency-Revolutionize-Health/dp/1608198383

 

According to Dr. Makary, some hospitals have monthly quotas, surgeons are told they need to perform x number of operations in a month.  Very scary stuff. 

 

Is your hospital hurting you? - By Marty Makary

http://www.cnn.com/2013/01/02/opinion/makary-hospital-doctors/

 

Last year, Dr. Kiran Sagar, a cardiologist in Wisconsin, was fired two months after presenting strong data showing that cardiologists in the hospital she worked at misread a substantial number of heart tests.

 

Similarly, a nurse from Columbia Hospital Corp. of America (HCA) was let go after complaining that a doctor was performing unnecessary cardiac procedures, even after an internal investigation found the nurse's claim to be substantiated.

 

And a few weeks ago, the CBS News program "60 Minutes" reported on ER doctors fired for not meeting quotas on the percentage of patients they admitted to the hospital.

 

$$$$

[[Fl...]]

the problem is not the american healthcare system (which delivers little value to the dollar). the problem is mainstream medicine in general which is profit driven. profit trumps real health.

 

Profit may be the reason why many people are damaged by medicine but it is also the reason why there are a ton of innovations that legitimately treat serious illnesses and save lives.

[[wa...]]

US is complex mixed bag of services depending on where you live and your income.  An acquaintance of mine wrote the comment in this and also refers to her own research on hospitals  -  https://www.healthcare-now.org/blog/ny-hospitals-saddle-uninsured-patients-with-massive-debt-despite-100s-of-millions-in-govt-aid/

 

Something to chew on.  I have loads of relatives in Canada - and that waiting-to-see-the-doc or get-the-surgery-delay stuff is exaggerated according to them but it sure scares the bejeezus out of US voters and is an oft used canard to bury single payer discussions. WBB

[[li...]]

Oh, at some places it's worse ...

 

Imagine having a GP block a mandatory referral ... or have the GP the referral doen the wrong way, so that everything has to start all over, including the waiting ...

Simply not getting needed prescription drugs, instead you get lifestyle advice ... while on/withdrawing from a benzo ... GPs know so little.

[[co...]]

US system is about MONEY ONLY.  If they can't make money off you, then you are ignored (at best) or medicated to the gills.

 

Former RN here; I hated that my job was primarily about getting payment codes correct, and making sure all possible supplies/labs were billed for.

 

Patient care is waaaay down at the bottom of concerns.

 

At this point, I believe in *emergency medicine* only.  The origins of physical problems are rarely diagnosed…and pill pushing to mask symptoms dominant.

[Guest [mu...]]

Amen. A for-profit health care industry will always create more sickness than it cures by its very design.

 

Yet another year has gone by where my husband and I are forced to pay ever higher monthly premiums for the lowest quality insurance available, which we're too poor to use anyway.

 

Not only do Americans pay more for our medical care than anywhere else on the planet, we also pay the world's highest taxes for it. The idea that taxpayers can't "afford" a single-payer system is a joke. We already pay more health care taxes than most citizens in countries with universal health care programs, we just don't get anything for it.

 

Even so, giving people more affordable doctor visits doesn't mean much when those visits are cursory and the treatments mostly supression-based, and likely to cause iatrogenic harm or death (according to the AMA, the third leading cause of death in the U.S. is iatrogenic, and over half of those deaths are due to adverse reactions to medications). As important and revolutionary and life-saving as some of our modern medical treatments are, many are worse than doing nothing.

 

In short: it's a mess.

[[li...]]

Even though I don't live there, my 2 cents:

 

'US system is about MONEY ONLY.  If they can't make money off you, then you are ignored (at best) or medicated to the gills.'

 

'Amen. A for-profit health care industry will always create more sickness than it cures by its very design.'

 

If not for profit, then what ? Government bureaucracy ?

 

Let's not forget that the healthcare in the USA is heavily regulated.

 

It's a bit of a read, but if you like a truly free market (vs. crony capitalism) analysis:

 

https://mises.org/library/myth-free-market-healthcare

 

I don't think that the US system is about money only. I'm sure there are caring doctors. People without insurance and money are treated in emergency rooms, right ? It's more limited where I live if you don't have insurance ...

 

'At this point, I believe in *emergency medicine* only.  The origins of physical problems are rarely diagnosed…and pill pushing to mask symptoms dominant.'

Honestly ... where I live, it's not much better. With the exception that GPs are reluctant to prescribe drugs, for referrals it's even worse.

Here, the origins of medical problems are often not investigated, and treatment of symptoms (if that occurs at all!) takes precedence. It's cheaper, I guess.

 

 

 

[[co...]]

"I'm sure there are caring doctors. People without insurance and money are treated in emergency rooms, right ?"

 

riiiiight…

 

Single payer *NOW*.

 

Like I learned in nursing school (tho not from my instructors): Health care is a *right*, not a *privilege*. 

 

ps I'm sure there are individuals who go into medicine to 'help' people--I did, but to stay in a system that is obviously so broken at this point--it corrupts your soul.  You stay for your retirement, you stay to get your kids thru college…you go to work at a Native American 'indian' reservation…but it gets grueling and seeing so much suffering for the simple lack of MONEY is more than most humans can bear.

[[Be...]]

You can be seen in an ER here in the US without insurance or money, etc. but you will get the bill!  I went to the ER a few years ago after I got off these pills because I was shaking all day.  I waited about five hours and then all the ER doc did was run a few lab tests and give me a benzo and send me home.  Took him about 10 minutes at most to see me.  He didn't even look at me when he came in the examining room.  He kept his head in his laptop.  Got a bill for about $1200 bucks.  That's how good our healthcare system is.  Some hospitals have bill forgiveness programs, but those are few and far between anymore in my area and it's harder to qualify for those programs.  The US healthcare system is about money.  I agree.  Not affordable for the middle-class even with self-pay insurance or Obamacare.  Only if your employer pays your insurance do you have a chance. 

[[Te...]]

I had to take an ambulance down the street one time to get another test, from the hospital where I was at. No one told me the ambulance was not in my network. I wasn't in any shape to ask questions as I had just had a scope put down my throat to look for clots; none were found. Yet I could see on the monitor that my blood pressure was 214 systolic. Of course I was scared.

 

Bottom line: I got a bill for $1900 and some change for the ambulance ride. I doubt if I would have been able to take a cab, but it probably would have cost me about $6 max.

 

However, I did get the bill adjusted or taken off by doing a lot of talking to the insurance people. I remember sweating it out very badly all the while going through panic and anxiety attacks.

 

This was before the Affordable Care Act, and I would have gone bankrupt with all the appointments, tests, ER, and hospital visits. And most of it was because of that crappy Ativan! Which I didn't realize until years later.

 

I agree with cookienose: single payer now!

[[wa...]]

After watching commercials on TV for my private health insurance (which had refused to cover my treatment for a specific non benzo condition) - I thought about all those millions of $$ of subscriber's money going into advertising and not into patient care.  ALso the insane charges for treatment, etc will be driven down by a single payer system. 

 

Does your local private hospital really need those marble and glass lobbies BTW?  That money should go into staff salaries and patient care, right?

 

This organization helped me get to YES for single payer. http://www.pnhp.org/  I've worked on both sides.  As a provider, the amount of time I spent on paperwork and resubmitting, etc.  There was no point in being an in-network provider -- the headache.  So the patients had to pay fee for service and deal with the paperwork - a burden.  WBB

[[Co...]]

I'm in europe as well. And although are system is pretty crappy. I Would never pay these amounts. Seeing a knowledgable pdoc (yes they exist on the mainland but they don't advertise because of fear of repurcutions, but if you want to find them you can) would cost me about 80 dollars. So for things like this i'm glad i'm not in the USA.

Maybe for more specialized surgeries you would like a good one, and here doctors aren't nearly as qualified. But when it comes to prescribing your pills or tapering you from pills it's not so much about the skill as it is about the will to listen to someone.