Ontopic Political Poo Flinging

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Amstel said:
Canada on canada:

https://www.ctvnews.ca/health/is-canadian-health-care-as-great-as-we-like-to-think-1.3641544

healthcare systems compared:
https://www.nytimes.com/interactive/2017/09/18/upshot/best-health-care-system-country-bracket.html
among Canada, Britain, Singapore, Germany, Switzerland, France, Australia and the U.S.,

Canada was eliminated in the first round.
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it looks like they're only comparing the cost aspect of healthcare, probably like RVUs and shit. there's a metric fuckload of metrics that go into determining the quality of healthcare, and cost is only one piece of that. it isn't looking into the actual care they have access to or are actually being given, and again even with cost alone it's not a comparable sample when you have giant swaths of the population that aren't even being factored in.

I literally work in healthcare quality. I spend all day looking at medical records and data and staying up to date with the most recent quality specs. cost is a factor in healthcare, sure, but the actual CARE, which is right there in the word, is the important piece. providing cheap but shitty care doesn't make anyone better at healthcare, it just makes you better at making or keeping money.
 
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It went far beyond 'costs.'

I'm comfortable with the people who provided the info for and compared in those two articles.

Maureen O’Neil is the president of the Canadian Foundation for Health Improvement, a not-for-profit organization funded by Health Canada to evaluate ways to improve our country’s health system.​
  • Aaron Carroll, a health services researcher and professor of pediatrics at Indiana University School of Medicine
  • Austin Frakt, director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; associate professor with Boston University’s School of Public Health; and adjunct associate professor with the Harvard T.H. Chan School of Public Health
  • Craig Garthwaite, a health economist with Northwestern University’s Kellogg School of Management
  • Uwe Reinhardt, a health economist with Princeton University’s Woodrow Wilson School of Public and International Affairs
  • Ashish Jha, a physician with the Harvard T.H. Chan School of Public Health and the director of the Harvard Global Health Institute
 
like hey, it is costly to cover a person with diabetes. they have a lot of chronic care needs. and overall, it's actually cheaper to keep up with those chronic care needs, like A1c testing and urine microalbumin testing and dilated eye exams for retinopathy and comprehensive foot exams to monitor for neuropathy and all of their testing supplies and their insulin, than it is to pay for their hospitalizations for shit like DKA and CKD and ESRD and amputations of gangrenous toes and feet and limbs if they don't stay on top of it. but also, if that system instead runs the numbers and realizes that the cheapest of all is just making it so hard to access care that they just die early about it, and cost is the key determinant, than yeah, that system that lets folks die is actually doing GREAT on costs.
 
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Amstel said:
It went far beyond 'costs.'

I'm comfortable with the people who provided the info for and compared in those two articles.

Maureen O’Neil is the president of the Canadian Foundation for Health Improvement, a not-for-profit organization funded by Health Canada to evaluate ways to improve our country’s health system.​
  • Aaron Carroll, a health services researcher and professor of pediatrics at Indiana University School of Medicine
  • Austin Frakt, director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; associate professor with Boston University’s School of Public Health; and adjunct associate professor with the Harvard T.H. Chan School of Public Health
  • Craig Garthwaite, a health economist with Northwestern University’s Kellogg School of Management
  • Uwe Reinhardt, a health economist with Princeton University’s Woodrow Wilson School of Public and International Affairs
  • Ashish Jha, a physician with the Harvard T.H. Chan School of Public Health and the director of the Harvard Global Health Institute
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I'm not questioning their credentials, I'm questioning the metrics against which they compared everything. focusing on that second article, since that's the one that is attempting to compare health systems, cost is themain refrain repeated over and over in the comparisons. some occasionally mention other justifications, but because we all track (or don't track) data differently, they can't as easily compare the care aspect, and so they don't much attempt to, but good care exists entirely separate from money. money affects it, and in most ways absolutely shouldn't, but if you're comparing actual care, if what you're asking iswho provides the best care, you can't focus on cost/efficiency to the country, you have to look at what is the standard of care and who, of all who needed it, received it. and especially in places like the US where, again, people who desperately need care do not seek it, you're never going to have accurate numbers.

NCQA has a number of metrics regarding access to care and timeliness of care (e.g. prenatal care w/in first trimester and postpartum care within 21-56 days after delivery), but they're only collecting that HEDIS data on folks with insurance, be it commercial, Medicare, or Medicaid. the orgs that track regardless of insurance can get a slightly better picture, but like one of the big ones we report to still uses N# of PCP visits in the last X# years to select for the denominator, which still leaves out the folks that don't have a PCP or don't see one (or see one less often than once in the last year and twice in the last two years, which is the standard for most of the annual metrics).
 
gee said:
amstel don't care, soshulist health care bad
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No, not 'bad.' Just more limited than what we've got.

I'll take this from Maureen O’Neil, President of the Canadian Foundation for Health Improvement

"U.S. health system is “a bit of a mess,” expensive and non-universal, that country excels in medical technology innovation, has few delays, and good outcomes for patients. "​

Hey, how do you like the lower cost of the same meds we create & pay more for?

spoiler alert: We're underwriting your healthcare.

Trump is working on lowering drug costs & using you guys as the example of "we should pay what they pay." Since the cost is the cost, & at the moment we're paying more, are you OK with pricing increases?
 
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"few delays, good outcomes"
again, only addresses folks that either can afford it in the first place or are forced into it thanks to an emergent situation and unresponsiveness.

and specialists here can keep delays down by refusing care entirely to those who can't afford it. its disingenuous at best and intentionally malicious at worst to compare the denominators here.
 
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