ABC Nightline -- Healthcare ... Is the US really #1?

[Bozita]

 
Nightline Daily E-Mail
October 23, 2003


TONIGHT'S SUBJECT: We continue our week-long look at the national health care crisis that leaves millions without insurance coverage and puts millions more in financial jeopardy. Tonight we take stock of the U.S. health care system in general. Many praise the system as the best in the world. If you are sick and in need of cutting edge treatment, there is no country in the world where you'd rather be. But does it surprise you to learn that a World Health Organization study ranked health care systems and concluded that the U.S. is not #1. Not even close.

------------------------------------------------------------------------

The U.S. health care system is the best in the world. Right? That's what so many of us believe — what so many politicians say. And as we hear about wealthy or famous people from other countries flying here for cutting-edge treatments often discovered and developed here, and simply not available anywhere else in the world, that statement seems fundamentally sound.

But if you look at the health care system overall, is the U.S. system still the best? It is a system that leaves more than 40 million Americans without health insurance. Millions more struggle financially with the meager coverage they have. The best health care is available — but often only to those who can afford to get it.

When people lack insurance coverage, they often avoid getting health care until their conditions worsen — perhaps until it's too late. It is that situation that allows the U.S. system to come up short in international comparisons. For instance, infant mortality can be compared country to country. So can life expectancy. And the U.S. does not rank #1 in either.

Yet would it surprise you to find that a study by the World Health Organization ranked the overall performance of the U.S. health care system 37th in the world? It surprised us. And so we asked Nightline correspondent Dave Marash to take a look.

When comparing the U.S. system to others in the world, one important factor is that virtually every "first world" country, save the U.S., guarantees all citizens health care. Take our neighbors to the North for example. Every Canadian is guaranteed health care coverage, no matter their income or ability to pay. Dave Marash compares the experience of patients in both the U.S. and Canada and finds the experiences are drastically different — with advantages and disadvantages in both places.

Finally, Ted Koppel will talk to ABC News Medical Editor Dr. Timothy Johnson. Can some of the Canadian advantages be brought to the U.S.? Or does the Canadian system demand compromises that Americans are unwilling or unable to make?

We hope you'll join us.

Sara Just and the Nightline Staff
Nightline Offices
Washington, D.C.

[Hieronymus]

1. Yes, WHO.....

World Health Organization ranks the US number 37. France, that will frost the righ wingers, and Italy is number two.:crazy:

[Hieronymus]

3. oooops

France is number one and Italy number two. We are number 37.

[Thinman12]

8. France is number one?

Remember the heat wave that hit France this last summer? Somewhere between 11,000 and 13,00 deaths. Sure we have issues with the uninsured, but I wouldn't trade our healthcare system for France's system anyday of the week.

http://www.cnn.com/2003/WORLD/europe/08/29/france.heatdeaths/

[mhr]

10. I Would, Been Unemployed For 39 Months, No Healthcare

Currently have terrible cold turning to Pneumonia, no money, no doctor, possibly death.

[LunaC]

36. I'm concerned about you!

I'm not a doc so I can't technically "prescribe" for you but if it were Me in your shoes, I'd start eating garlic (antibiotic) - fresh bulbs are best and with a stuffy nose you won't smell yourself anyway ;-) - I'd pound down echinacea capsules (boosts the immune system and should be available at your local supermarket in the supplement section - two tabs every two hours), drink Red Clover tea (removes the toxins from your body) and include 1000 - 2000 mg of Vitamin C to further assist the immune system. I have an aversion to idiot doctors and have been successfully treating myself for years. This formula is a real winner so you might give it a try. It certainly beats being dead! Please be well again.

[Lars39]

12. That had more to do with a heat wave and no air conditioning.

They were basically caught unprepared by an unprecedented heat wave, and the elderly used the same methods for cooling off that worked in cooler temp summers.

[Thinman12]

14. Read the CNN article

because many of these deaths were not just at homes, but at the hospitals:

"The government was criticized for failing to react fast enough to the crisis, during which hospitals were swamped with people, especially the elderly, suffering from dehydration and hyperthermia."

So the number one healthcare system can't deal with dehydration? All that access to hoptial did those poor folks so much good.

[Lars39]

17. You CAN be too dehydrated that even being in the hospital won't help.

I read the article. You are aware that 41 million US citizens have no insurance, right?

[Thinman12]

31. Not arguing that issue

I knowthat there is an issue with insurance, but that is not my point. France is rated as having the number one healthcare system in the world, and a heat wave kills 13,000 people. This does not sound like a best in class healthcare system to me.

[Name removed]

16. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Thinman12]

33. So if I disagree with you

I must be a Republican? There's that grand liberal/progressive tradition of tolerance. I consider myself a left of center independent. I am not a partisan, and I have little patienace for hard-core partisans. Some folks try and classify me as a liberal Republican, others as a conservative Democrat, but being registered in no major party I do consider myself an independent.

In '92 I voted for Clinton, in '96 I did not (his personal failings disappointed me). So if I do not take on the "approved" DU positions is this a place I am not welcome? Is this a place that I cannot express my opinions? Is there someplace I can get a DU cheat sheet with all the approved positions for every issue?

[T Bone]

22. nah, take the French health care, just keep your Central Air too

Why won't Europe get on board with air-conditioning? :shrug:

[RainDog]

28. Our ally, the UK, says France is best and they are studying it

to learn how they can apply it to their own country.

Go to The Guardian online and search for an article about the French health care system...noted by our Brit allies as the best in the world.

Americans are in deep denial about how abused they are by the health care system, the pharmceutical system, and every politician who continues to deny universal health care to Americans.

The heat wave deaths had nothing to do with the health care system. France doesn't have such hot days usually, and people do not generally even have air conditioning because they rarely need it...sort of like Chicago.

And like Chicago has deaths from the heat from the elderly whenever there's a heat wave, the same thing happened in France. It also happened in August, when the French get their one month of vacation time, and who knows if family members were away and no one was maybe checking on their elderly family members (at least that's what I heard one person mention as a way to insult France...those selfish French with a month of vacation...)

America has the MOST EXPENSIVE health care system, but not the best.

And we're the only western democracy which has such draconian policies which deny basic health care to citizens.

The repukes have been really good at propaganda, and too many Americans believe their b.s. about the "problem" with universal health care.

[Bandit]

41. Remember 9-11 three thousand people died boy does our system suck

:crazy: You obviously don't have a legitimate argument. How does people dying from heat mean lack of health coverage? It is just like my comparison with 9-11. It is completely illogical.

[Zero Gravitas]

43. Different issue

In any US city there are deaths due to heatwaves every year. A couple of hundr4ed died in Chicago a few years back during a hot summer. It has nothing to do with the quality of healthcare, but is dues to old/sick people without air-conditioning. The US has hotter summer than France so air-conditioning is more common. Those with out AC in the US are at rick of dieing fromt he heat. The French had an unusualy hot summer and AC is rare hence so many people dies from the heat. It has nothying to do with the qulity of thier healthcare.

[Thinman12]

46. Sorry, it does have to do with the quality of the system

There are many stories in the press at the time about the heatwave, and thousands showed up at hospitals. Many of the patients may of gotten some fluids and a sponge bath, and I repeat myself, 13,000 died! A cup of water and a sponge bath. Yep, the best health care in the world.

My point was not to compare the US system to the French system, I am very suspect of the WHO claims the France is number one. I sense a little politics at work here.

[TrogL]

9. Where was Canada?

TV's tied up.

[hedda_foil]

2. Nearly on.

ABC has been pulling no punches on this series. Every one of their news shows all week has been featuring the disgraceful state of our health care system. Nightly News tonight had a feature about how health care in this country is already being rationed by insurance companies by denying coverage of essential treatments.

It's really been amazing.

[Bozita]

4. You're right. ... And I'm not even wearing my hat now.

This work by ABC is excellent.

[spinbaby]

39. ABC has been doing a great job

I've been watching all week. This is an issue that by now affects most Americans--even the middle class have trouble getting insurance and are sick of getting perpetual bureaucratic runarounds whenever they get sick and actually need the insurance to pay for something. I'm beginning to think that what brings down * may not be Iraq or the economy, it will be healthcare.

[coda]

5. Man, ol' Dave Marash gets around doesn't he?

I though he was still in Pakistan.

[loyalsister]

6. As far as technology

we are number one. Apart from that we are trailing far behind the rest of the world.

[pandatimothy]

7. I agree that the best and newest treatments are in the US but

most people are denied access to them.

[Thinman12]

13. Denied access?

I'm sorry, but I work in the healthcare system. Where are your sources that "most people" (more than 50%!) are denied access to new treatments.

Working for one of the top terriary care facilites, 15% of our patient base is international. Yep, their coming here because our heathcare system is so bad. We have many Canadians that come here, not because treatments are not avaialble at home, but the wait for treatment is years off. Many of these patients will be long dead before they can receive treatment at home.

[jab105]

21. Most people are not denied treatment...PERSONAL STORY!!

but many are, because either they dont have good enough health insurance or they have none at all...we do have the best patient system in the world, BUT, the "best" is only available to those that can afford it...we spend more per person on health care than any other nation, but we are ranked 37th, because the number of people who get that incredible health care is directly correlated to money...

Personal story:
I was a grad student, they dont offer health insurance, and I'm too old to be on my parents insurance, so basically, I'm dirt poor...
I was iceskating last year (at a rink in Florida, since they are fairly novel, it was packed)...anyways, some guy cut in front of me, I fell and broke my kneecap...screaming in pain, but I wouldn't let anyone call an ambulance because I knew that I had no health insurance, so I freaking walked to my car (lucky my friend was there to drive me)...and the whole time, I was crying about how much it would cost!! At the hospital, they had my into the x-rays, and a doctor came in and said I had a broken kneecap, couldn't have taken more than 15 minutes...but, the bills I got: $600 for the hospital visit to the emergancy room, $250 for the doctor (she was in there for a minute), and I forgot how much the x-ray bill was (wasn't as expensive as the other two...anyways, I got crutches and a brace, and thats it...

They told me to go see a orthapaeadic surgeon, cause they didn't know if I needed surgery or not...the place I called took my information, asked about insurance, I said I had none, and they said "I'm sorry ma'am we dont except people who cant pay"...I had said nothing about not paying, my parents would have done anything at that point to help me...but I was denied THE BEST POSSIBLE CARE (and that is the key!!) because I didn't have insurnace!! ANyways, I ended up at a clinic, they said that if the pieces of my kneecap were 1/4mm more apart, I would have needed surgery...which would have cost another who knows what (around $15,000) and anyways, I couldn't have gotten the best since they wouldnt accept me...

All total, it cost about $3000...but I was lucky...

I discovered www.mybrokenleg.com among others while I was splinted for 8 weeks, and let me tell you, ALL (and I mean EVERY SINGLE ONE!!) of the Canadians or Australians, or Brits who are on that board are very very happy that they dont live in America, some people on that board are more than $60K in debt...all because of bad luck and a broken leg...what other option does a person have, and what does that kind of debt do to a person and to a society??

[mhr]

27. In Texas Thinman, No Money, No Insurance, No Service - You sick, You Die!

eom

[Thinman12]

32. Link to prove this statement?

As I said elsewhere, I work in the healthcare system and if a medical facility accepts Federal dollars (Medicare / Medicaid) they cannot deny lifesaving emergency care.

[caledesi]

18. Well said ! n/t

[loyalsister]

45. "many" but probably not "most"

I have experience with this. If a person is rich enough or poor enough, they will get access. People can also make payment arrangments. There are some people who are denied access entireley, but if a person is denied initially, they can usually find ways around it if they know how to "work the system." Unfortunately, this can result in hospitals eating a lot of the costs for treatments.
So, I'm not sure your argument for "most" being denied access is reasonable. However, I am very sure that many are denied access entirely, and it is a ridiculous state of affairs. It is also ridiculous for anyone to have to make long term payment arrangments when their fate is unknown.
We absolutely need to move towards universal health care.
BTW: For those who claim that waiting to see a Dr. or get treatment in the US isn't an issue, try making an appointment with a specialist of some variety.

[laura888]

11. I heard of a story of a woman who knew she couldn't afford...

...a doctor (I believe a miscarriage), and while worrying about the money, bled to death in the parking lot.

[Thinman12]

15. Hospitals cannot turn away emergency care

by law. Someone walks into a ETU with life threatening wounds will treat first, ask questions later.

[Resistance Is Futile]

19. Except in Texas

There was a thread here some days (?) back about changes to Texas law which will allow emergency rooms to turn away people in life-threatening condition if they cannot pay for care.

[Lars39]

20. Not necessarily. Texas is starting to turn away folks without insurance,

life-threatening or not.

[mhr]

25. Affirmative, No Money, No Insurance, You DIE In Texas

Charity is a thing of the past as all hospitals are FOR PROFIT!

[Thinman12]

34. That's patently untrue

I work for a large not for profit academic health care facility. Most academic (all? not sure) are not for profit.

Go talk to a hospital administrator of small primary care facilities. They ain't making any money at all.

[SoCalDem]

37. Maybe you should be giving directions to YOUR facility

sounds like a lot of people could use it..

I had to loan a friend $500. They had no insurance and their 3 yr old broke his leg ..(jumped off the top of the van..thought he was Superman)..

They gave Allan a pain shot and sent him to the waiting room while Dad visited the "business office"... He was panicked when they said they could not admit Allan without a $500 deposit.. I called my husband and told him to go to the bank and bring us $500..

They treated him them..

It was August 1996..Riverside Community Hospital emergency room..

Allan was 3 years old, and in a lot of pain..

[jab105]

23. true...

but not necessarily the best care...and usually much debt insues...see my post above...

[Bozita]

24. You speak of "wounds" ... Most stuff ain't wounds.

Enjoy your stay here at DU

[mhr]

26. Not True Thinman, In Texas! No Money, No Insurance, No Service!

All should be able to understand that!

[jab105]

29. I hadn't heard that before...

not something to be proud of in a first world nation, huh?

[Bozita]

30. Dumbya wants to make America more like Texas. ... So does...

...Ah-nuld in Colliefornya.

[Avalon Sparks]

35. In response to the Texas threads....

Yes there was a thread here where a claim was made that Texas emergency rooms can turn patients without insurance away...

But after extensive goggling, I wasn't able to find anything about any new laws directing that in Texas.

That thread was based on a claim made by someone that posted to Buzzflash. I'm curious to see if anyone can provide a link to information about that new Texas law...

It is a fact though that the Bush administration is pushing to change the rules for hospital emergency care for all states.

Emergency-room rules relaxed
BY ROBERT PEAR
New York Times

WASHINGTON — The Bush administration is easing rules that say hospitals must examine and treat people who require emergency care, regardless of their ability to pay.

Under the rule, which takes effect Nov. 10, patients might find it harder to obtain certain types of emergency care at some hospitals or clinics owned and operated by hospitals.

The new rule makes clear that hospitals need not have specialists "on call" around the clock. Some patients might have more difficulty winning damages in court for injuries caused by violations of the federal standards.

"The overall effect of this final rule will be to reduce the compliance burden for hospitals and physicians," the administration says in a preamble to the new regulation, to be published in the Federal Register next Tuesday.

The administration drafted the new rule after hearing complaints from scores of hospitals and doctors who said the old standards were onerous and confusing, exposed them to lawsuits and fines, and encouraged people to seek free care in emergency rooms. Courts have often ruled for patients, against hospitals.


More

http://www.twincities.com/mld/twincities/living/health/6677984.htm



Here's a link to the DU discussion on Texas emergency room laws...

http://www.democraticunderground.com/discuss/duboard.php?az=show_topic&forum=104&topic_id=552324

[mhr]

40. Fancy Words, No Money, No Insurance, No Care, You Die

Go read about this in the Wall Street Journal. Article appeared about middle September. It was mentioned here at DU. The article was clear, No money, No Insurance, etc, etc.....

[eauclaireliberal]

38. Careful...

you may be accused of socialistic ideals.

[Zero Gravitas]

42. No Surprise here

I'm mystified how anyone other than the knuckle dragging uber-nationalists could possibly think that the USA has the best healthcare in the world.

[Art_from_Ark]

44. Healthcare in Japan

Participation in the national health insurance program is mandatory and premiums are based on income. Young families and retired people get nice breaks, and people 70 and over get completely free care.

My current family premiums run about $500 every two months. The insurance pays for 70% of all medical costs, including basic dental and prescriptions. Prescription medications are MUCH cheaper in Japan, while over-the-counter remedies are usually more expensive (and not covered by the health insurance).

My friend recently spent five days in a Japanese hospital. His total bill came to about $520, including emergency room treatment the first night. A week's worth of prescriptions is costing him about $20.

By the way, Japan has the highest life expectancy of any major country.