<p>of 18 industrialized nations.</p>
<p>[Measuring</a> The Health Of Nations: Updating An Earlier Analysis – Nolte and McKee 27 (1): 58 – Health Affairs](<a href=“http://content.healthaffairs.org/cgi/content/abstract/27/1/58]Measuring”>http://content.healthaffairs.org/cgi/content/abstract/27/1/58)</p>
<p>Best heath care system in the world…</p>
<p>So what?!</p>
<p>I think we lost a thread that I was going to post one of my infamous comments.</p>
<p>Based on the abstract, the only fact in evidence is that “The decline in amenable mortality” over a 5-year period was slower in the US than in 18 other industrialized countries. The full text of the report costs money, and the abstract does not include enough information to draw other conclusions. For example, if the absolute death rate in the US was much lower to start with, the fact that the rate of decline was less is unremarkable. Likewise, mini uses “mortality” as a stand-in for “health care system.” This linkage is not even discussed in abstract linked to.</p>
<p>I know you tend to hyperbole, mini, but you learned this stuff in freshman statistics. I know you know better.</p>
<p>(Your linkage and conclusions might be right, but it is not in evidence in the abstract.)</p>
<p>Other random comment: I find the “101,000 fewer deaths” factoid to pretty damned amusing. Over a five-year period we could save about that same number of lives by putting computerized breathalyzer lockouts in cars and motorcycles. It’s not necessarily worth doing. Also, you can tell the authors backed into the facile “101,000 deaths” number by only comparing to “the three top-performing countries” rather than some aggregate performance number. The sound of ax-grinding is drowning out the academic value (if any) of this report.</p>
<p>I’m over it now.</p>
<p>We in USA have a lot of freedoms that perhaps the other countries do not have. Because of these freedoms we do things that are more risky- Biking without helmets, access to drugs legal and illegal, seat belts, access to cars, driving long distances without rest, overall bigger autos, bigger mountains, high emphasis on SAT and HYPS. All are preventable but do we want them regulated?</p>
<p>"Best heath care system in the world… "</p>
<p>is simply not going to beat the fast food nation mini…sorry buddy. </p>
<p>the health care system isn’t the cause mini, it’s the band aid. Have you had your whooper, big mac, quadruplestack bacon cheese today? :)</p>
<p>Easy on the guy. He had a severe heart attack. Saw purgatory, and found that it wasn’t open for business. </p>
<p>I find it ironic that those who need medical/life insurance don’t pay for it but let the middle class supply it and pay for it in their taxes. </p>
<p>I went to the local health insurance, local hq across the street today, to pay for DS’s new, individual health insurance, since he is now an independent contractor, and in India. The rate table shows that he should pay $X. but the billing that he got last week was 25% less than published. Now I realize that we/he should pay our/his fair share and I questioned the help at the desk. She called up her proper people and confirmed in my presence the lesser rate. I got home and looked up the rate table supplied by this Big Health Co. and it showed the higher rate. A 25% difference is a lot. </p>
<p>Question: Does Big Health actually publicize the higher rate to discourage marginal clients who are in poorer health and wealth. Those who can afford health insurance will pay the Rate because they cannot afford not to pay. Because those who can afford to pay, are rewarded for this willingness by getting the Real Rate.</p>
<p>Thisoldman - If I understood your post, the small local insurer gave you a significantly better rate than one of the “Big Boys”. Not too surprising. Even though in theory the “Big Boys” should be able to offer lower rates because of more market leverage in negotiating contracts with hospitals and other providers, the “Big Boys” often have bloated rates because they: 1) know they control the market of providers, 2) are for profit corporations that are answering to stockholders or 3) are non-profits that act like for profits and want to generate revenue to pay insanely high compensation to a large cadre of executives, support palatial offices and build up indefensible reserves. The smaller local insurers are leaner in their operation and are seeking to capture market share by offering better pricing. As to the “tables” you were referencing, I’m not sure what they were but you should keep in mind that health insurance rates are not developed off a simplistic table. For a given plan design, premiums will vary depending on whether the specific plan in which you are going to enroll is an individual plan, group plan, community rated, demographically rated or experience rated. The underwriting process by which premiums are generated is intentionally complex, convoluted and shrouded in mysticism. It could very well be that the premium rate you initially saw at the local company was more illustrative than actual and when the actual underwriting process occurred, there were factors that resulted in a lower premium. Also, were you really comparing “apples to apples” on plan design?</p>
<p>^ The Ins Co is the BIG Health Ins, which has the color. DS/we chose a HSA program which has a high deductible but high coverage.</p>
<p>I am not against private cos or against making money. We as a nation should make up our mind, to say that we will provide health care for all or provide no health care. Ironic that we spend such enormous amount of money on essentially a nonproductive endeavor that benefits only a relatively small number of people.</p>
<p>“I’ve been shocked by the antagonistic posts to Mini since his illness by those on this board, and the moderators allowing them. Knowing Mini, he may be enjoying them, but it is not what is needed by someone recovering from a serious accident.”</p>
<p>And who might you be that you “know mini” so well? Care to introduce yourself (and what your previous identity may have been)?</p>
<p>“Based on the abstract, the only fact in evidence is that “The decline in amenable mortality” over a 5-year period was slower in the US than in 18 other industrialized countries. The full text of the report costs money, and the abstract does not include enough information to draw other conclusions. For example, if the absolute death rate in the US was much lower to start with, the fact that the rate of decline was less is unremarkable. Likewise, mini uses “mortality” as a stand-in for “health care system.” This linkage is not even discussed in abstract linked to”</p>
<p>Sorry, I am trying to link the full article. It is “as advertised”. The U.S. ranks last in preventable deaths, and has fallen further behind over time. Some portion the deaths are associated with lack of insurance, the rest with overall quality of care. I have the paper copy of the journal in hand. (There is also an ABC News video link for those who like such things.)</p>
<p>I can take care of myself, thank you. Getting my blood pressure up is a good thing! ;)</p>
<p>We have more stupid people than most other industrialized countries.</p>
<p>You must mean “more stupid health care professionals and insurers” - the study measured only those conditions amenable to prevention through timely and effective health care. Factors such as 'population" and “lifestyle” were stripped out.</p>
<p>– here’s one abstract:</p>
<p>ScienceDaily (Jan. 8, 2008) — The United States places last among 19 countries when it comes to deaths that could have been prevented by access to timely and effective health care, according to new research. While other nations dramatically improved these rates between 1997–98 and 2002–03, the U.S. improved only slightly.</p>
<p>If the U.S. had performed as well as the top three countries out of the19 industrialized countries in the study there would have been 101,000 fewer deaths in the U.S. per year by the end of the study period. The top performers were France, Japan, and Australia.</p>
<p>In “Measuring the Health of Nations: Updating an Earlier Analysis,” Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine compare trends in deaths that could have been prevented by access to timely and effective health care. Specifically, they looked at deaths “amenable to health care before age 75 between 1997–98 and 2002–03.”</p>
<p>Nolte and McKee found that while other countries made strides and saw these types of deaths decline by an average of 16%, the U.S. experienced only a 4% decline. “It is notable that all countries have improved substantially except the U.S.,” said Nolte, lead author of the study. The authors also note that “it is difficult to disregard the observation that the slow decline in U.S. amenable mortality has coincided with an increase in the uninsured population, an issue that is now receiving renewed attention in several states and among presidential candidates from both parties.”</p>
<p>“It is startling to see the U.S. falling even farther behind on this crucial indicator of health system performance,” said Commonwealth Fund Senior Vice President Cathy Schoen. “By focusing on deaths amenable to health care, Nolte and McKee strip out factors such as population and lifestyle differences that are often cited in response to international comparisons showing the U.S. lagging in health outcomes. The fact that other countries are reducing these preventable deaths more rapidly, yet spending far less, indicates that policy, goals, and efforts to improve health systems make a difference.”</p>
<p>In 1997–98 the U.S. ranked 15th out of 19 countries on the “mortality amenable to health care” measure. However, by 2002–03 the U.S. fell to last place, with 109 deaths amenable to health care for every 100,000 people. In contrast, mortality rates per 100,000 people in the leading countries were: France (64), Japan (71), and Australia (71). The other countries included in the study were Austria, Canada, Denmark, Finland, Germany, Greece, Ireland, Italy, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden and the United Kingdom.</p>
<p>Study authors state that the measure of deaths amenable to health care is a valuable indicator of health system performance because it is sensitive to improved care, including public health initiatives. It considers a range of conditions from which it is reasonable to expect death to be averted even after the condition develops. This includes causes such as appendicitis and hypertension, where the medical nature of the intervention is apparent; it also includes illnesses that can be detected early with effective screenings such as cervical or colon cancer, and tuberculosis which, while acquisition is largely driven by socio-economic conditions, is not fatal when treated in a timely manner.</p>
<p>“Cross-national studies conducted by The Commonwealth Fund indicate that our failure to cover all Americans results in financial barriers that are much more likely to prevent many U.S. adults from getting the care they need, compared with adults in other countries,” said Commonwealth Fund President Karen Davis. “While no one country provides a perfect model of care, there are many lessons to be learned from the strategies at work abroad.”</p>
<p>This research was supported by The Commonwealth Fund and published in the January/February issue of Health Affairs. The Commonwealth Fund is an independent foundation working toward health policy reform and a high performance health system.</p>
<p>Adapted from materials provided by London School of Hygiene & Tropical Medicine.</p>
<p>–</p>
<p>What the study failed to report were levels of spending per person. Add that into the mix, and the U.S. would likely fall below the top 50. </p>
<p>Best health care system in the world…</p>
<p>this oldman, there may be several reasons for the price difference above and beyond just profit margin… Are the plan designs the same? Co insurance the same? out of pocket expenses? Is there a gatekeeper? is one a nonprofit (blues?)? the devil is in the details sometimes.</p>
<p>As far as the big entities go, I hate them as well. They are an offshoot of the first go round at national healthcare in the 80’s. The regional player concept. If you check you’ll find a few companies acquiring smaller carriers over the last 20 years. I think the reason is they see what’s coming and they are positioning themselves to simply take over a region when competition is completely erased by government programing. Think for a second, does anybody really think you can stop our healthcare system on Monday and start a “new” program on Tuesday? What we’ll have is the big giants inplace with their infrastructure in place becoming overnight government contractors. They will simply be the only game in town. Will we still hate the guys that make 24 million a year as ceo’s on the private side when they join the “public” side and make 30 million?</p>
<p>OTOH</p>
<p>America’s Pursuit Of Happiness </p>
<p>Public Opinion: Each time you open a newspaper or turn on a TV, you’ll hear how unhappy, glum and dissatisfied Americans are. Don’t believe it. The U.S. is, to borrow a phrase, the happiest place on Earth. </p>
<p>A long-forgotten 1960s movie title pretty much sums up how Americans feel about their lives: “What’s So Bad About Feeling Good?” According to a new Gallup Poll, for most people that’s not just a rhetorical question. </p>
<p>“Most Americans say they are generally happy, with a slim majority saying they are ‘very happy,’” according to the Gallup Poll released on the final day of 2007. “More than 8 in 10 Americans say they are satisfied with their personal lives at this time, including a solid majority who say they are ‘very satisfied.’” </p>
<p>Another extensive survey conducted in 2007 by the Pew Research Center found that 65% of Americans termed themselves “satisfied” with their lives. That compares with the four economic powerhouses of Britain, France, Germany and Italy, which averaged about 53%. </p>
<p>This difference isn’t something new. It’s been around for a long time. It’s a part of what foreign-affairs mavens call “American exceptionalism.” The question is, why are Americans so darned happy? </p>
<p>For one thing, Americans are far richer than those in other countries. And yes, this matters. Contrary to popular belief, neither the Europeans nor the Japanese lead better lives than Americans. </p>
<p>A study a few years back by Sweden’s Timbro think tank came to these startling conclusions: Virtually every nation in Europe lagged the U.S. in income. Indeed, if it were a state, the EU would rank 47th in per capita GDP – on par with Mississippi and West Virginia. </p>
<p>Americans’ homes have roughly twice the square footage per occupant as those in the EU, Americans own more appliances, and, on average, they spend about 77% more each year than Europeans.</p>
<p>We are using the Big Blue Ins co. Their published rate is 33% higher than the written rate. (The final rate is 25% LESS THAN their published rate) </p>
<p>My concern is that the careful selection of plan is now in question. If the publish rate for the top plan is wrong, Then what is the rate for the lower plans?</p>
<p>As for mini’s topic: Someone must be 18th and someone must be 1st. How much does it cost to be 1st and what are the barriers or nonbarriers. Just ass in anything else there is a first place college and a lesser college-How much does it take to be the 1st place college or How much does it take to attend the first school? </p>
<p>“Oh, for the humanity of it” which I never truly understood why it applied to big balloons and not much else.</p>
<p>We also know what the cost of being the greatest military power. But is second or even last place in the military scheme of things make a difference in waging war of killing people, material destruction, and collapse of economies> such things are not measured in dollars … but I am not sure how these things are quantified, maybe Paster Huck will know, or perhaps Dr Paul, or Col McCain, or Mrs H Clinton or Mr Edwards,JD, or</p>
<p>Thank you for posting the longer excerpt, mini. It’s a lot better (obviously) than the tiny abstract in the free section.</p>
<p>“We are using the Big Blue Ins co.”</p>
<p>And that would be? </p>
<p>I don’t know what state your in but rates have to be approved by the OIC in your state. Please call you office of the insurance commissioner, they should be able to answer your question. All rates are OIC approved and filed for records. Insurance carriers can’t make em up as they go… </p>
<p>If you want to pm me with some detail I could probably help you, but so can the OIC.</p>
<p>Mystery solved! Birth year 1985. A slip in placing 7 in the application rather than a 5 caused the age bracket to be lower thus the rate being lower.</p>