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Medicine United States Science

US Life Expectancy May Have Peaked 1053

Posted by timothy
from the so-lose-some-weight-and-eat-some-spinach dept.
Hugh Pickens writes "Live Science reports that although life expectancy in the United States has risen to an all-time high of 77.9 years in 2007 up from 77.7 in 2006, gains in life expectancy may be pretty much over, as some groups — particularly people in rural locations are already stagnating or slipping in contrast to all other industrialized nations. Hardest hit are regions in the Deep South, along the Mississippi River, in Appalachia and also the southern part of the Midwest reaching into Texas. The culprits — largely preventable with better diet and access to medical services — are diabetes, cancers and heart disease caused by smoking, high blood pressure and obesity. What the new analysis reveals is the reality of two Americas, one on par with most of Europe and parts of Asia, and another no different than a third-world nation with the United States placing 41st on the 2008 CIA World Factbook list, behind Bosnia but still edging out Albania. 'Beginning in the early 1980s and continuing through 1999 those who were already disadvantaged did not benefit from the gains in life expectancy experienced by the advantaged, and some became even worse off,' says a report published in PLoS Medicine by a team led by Harvard's Majid Ezzati, adding that 'study results are troubling because an oft-stated aim of the US health system is the improvement of the health of "all people, and especially those at greater risk of health disparities.'"
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US Life Expectancy May Have Peaked

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  • Re:Eh, who cares (Score:3, Informative)

    by dogmatixpsych (786818) on Thursday August 20, 2009 @01:59PM (#29136777) Homepage Journal
    I know the AC was trolling but Republicans on average have higher SES (socioeconomic status) than Democrats do (Subramanian, S. V., & Perkins, J. M. (2009). Are republicans healthier than democrats? International Journal of Epidemiology, doi:10.1093/ije/dyp152). Sure, people who live in rural areas tend to be Republican, but people who live in inner-cities tend to be Democrats. As the article I referenced shows, Republicans actually tend to be a little healthier than Democrats (related more to SES than anything else).
  • Re:what? (Score:5, Informative)

    by macemoneta (154740) on Thursday August 20, 2009 @02:12PM (#29137035) Homepage
    I know I shouldn't reply to trolls, but... If your medical expenses for a year exceed $35,000 (not hard to do at all), your chance of having your health insurance canceled retroactively is 50% [tauntermedia.com]. That link helps explain some of the math, but the testimony it is based is in the public record from the recent House hearings on rescission (the retroactive cancellation of individual health insurance policies).
  • Re:Slashkos (Score:4, Informative)

    by pnuema (523776) on Thursday August 20, 2009 @02:13PM (#29137049)
    And we are fat because the least expensive foods are all terrible for you, thanks to subsidizes to big agriculture.
  • Re:Wait, really? (Score:3, Informative)

    by jridley (9305) on Thursday August 20, 2009 @02:16PM (#29137119)

    No. I have family members who are unable to get their conditions treated. One has a tumor and can't afford to even get it biopsied, and can't find any agency to help. Nor could he do anything about it even if it was found to be malignant (other than die).

  • Re:what? (Score:2, Informative)

    by Anarchduke (1551707) on Thursday August 20, 2009 @02:20PM (#29137175)
    In reply, let me quote to you the posting itself. not even the fucking article.

    report published in PLoS Medicine by a team led by Harvard's Majid Ezzati, adding that 'study results are troubling because an oft-stated aim of the US health system is the improvement of the health of "all people, and especially those at greater risk of health disparities.'"

    If that wasn't clear enough, you could click on the link, and find the citation used in the article. To make it easy for you, I will post the cited link myself for your benefit.
    It is the Center for Disease Control's Strategic Imperatives [cdc.gov]
    To save you time, it states

    "All people, and especially those at greater risk of health disparities, will achieve their optimal lifespan with the best possible quality of health in every stage of life."

  • Re:Wait, really? (Score:4, Informative)

    by jamstar7 (694492) on Thursday August 20, 2009 @02:23PM (#29137225)

    There were no charitable organizations or free clinics that he could have gone to? (doubtful) I also doubt that not having health care was the primary concern for this death.

    Depends on your income. If you make enough to disqualify you for the free stuff, that doesn't mean you automatically make enough to afford health insurance on your own. Rule of thumb is, if you make minimum wage, you can't get the freebies. And I'd love to see somebody pay 2200/yr for the cheapest medical insurance advertised on tv when they make about 16.5K before taxes.

  • Re:Wait, really? (Score:5, Informative)

    by cml4524 (1520403) on Thursday August 20, 2009 @02:28PM (#29137319)

    It's not improbable at all, especially if he lived in a rural area. You can't be denied care for an emergency condition in an ER, but if you're in the ER, it's an emergency. If it's an emergency brought on by a chronic, untreated ailment, odds are you're in pretty bad shape and at a much greater risk of death than if you'd been treated for the underlying cause earlier on. As an example, if you show up in the ER with an undiagnosed malignant tumor in its last stages, you can still be saved, but your odds of being saved are extremely decreased by that point.

    Furthermore, many rural areas in the U.S. do not have ready access to the most modern treatment options available. If I go fifteen miles north, as the crow flies, over the mountains I can see out my front window, those people have horrible treatment options. They are, basically, limited to less than half a dozen family doctors and a small free clinic that is not capable even of treating a broken bone. The quickest access they have to modern medicine in an emergency is a 40 minute helicopter flight to the nearest university medical center.

    Our doctors, hospitals, specialists, and medicines are, by and large, incredible in the U.S. Our access to them, however, is pretty sorely lacking for a great number of people.

    I don't know that he's telling the truth, and I don't know that his brother/friend (sorry, I forgot the relationship) did everything he could have, but, based on the rural area I grew up and still visit sometimes, I could absolutely see how it happens.

  • by mcgrew (92797) * on Thursday August 20, 2009 @02:30PM (#29137349) Homepage Journal

    I'll get a "woosh" for this, but you might want to read this AP article [google.com]. Or not, if you're a Rushie.

    THE POLL: 45 percent said it's likely the government will decide when to stop care for the elderly; 50 percent said it's not likely.

    THE FACTS: Nothing being debated in Washington would give the government such authority. Critics have twisted a provision in a House bill that would direct Medicare to pay for counseling sessions about end-of-life care, living wills, hospices and the like if a patient wants such consultations with a doctor. They have said, incorrectly, that the elderly would be required to have these sessions.

    House Republican Leader John Boehner of Ohio said such counseling "may start us down a treacherous path toward government-encouraged euthanasia."

    The bill would prohibit coverage of counseling that presents suicide or assisted suicide as an option.

    Republican Sen. Johnny Isakson of Georgia, who has been a proponent of coverage for end-of-life counseling under Medicare, said such sessions are a voluntary benefit, strictly between doctor and patient, and it was "nuts" to think death panels are looming or euthanasia is part of the equation.

    But as fellow conservatives stepped up criticism of the provision, he backed away from his defense of it.

  • by Anonymous Coward on Thursday August 20, 2009 @02:32PM (#29137405)

    The reason is simple. The US health care system has one key flaw that is the problem. All of the medical options available are for illness and injury treatment, NOT Prevention. People are allowed to grow to humongous sizes that they could stunt double for Fat Bastard and there is complaining but no real options given or pushed. The moment these people have a heart attack the medical system jumps in with drugs, transplants, continual followups, etc all costing hundreds of thousands of dollars. But only a tiny fraction is ever spent on trying to prevent them from become obese in the first place. result is bad habits, and health care costs ballooning almost as fast as waistlines and soon a dropping life expectancy. Its only because of the ability to do extensive medical treatment do many of these people even live that long.

  • Re:Wait, really? (Score:5, Informative)

    by GameMaster (148118) on Thursday August 20, 2009 @02:44PM (#29137643)

    "And I'd love to see somebody pay 2200/yr for the cheapest medical insurance advertised on tv when they make about 16.5K before taxes."

    Also, if you're in the situation the OP's friend was in you couldn't get health insurance for 10x that much money. American health insurance companies can refuse, outright, to cover you if you have a pre-existing condition. So, someone making minimum wage, and having a hard time even putting food on the table, has to choose between paying that $2200/yr in the off chance they develop a serious illness later in life, or they can go without it and be unable to receive adequate medical care should they end up getting seriously ill.

  • Re:Slashkos (Score:3, Informative)

    by Alinabi (464689) on Thursday August 20, 2009 @02:54PM (#29137839)
    $50 doctor visit? Was that a witch doctor? My last doctor visit, a 10 minute cursory visual examination by a sports medicine doctor, cost $687. And I pay $450/month for my insurance. So I have to call bull on your story.
  • by Urkki (668283) on Thursday August 20, 2009 @03:02PM (#29137985)

    In industrialized countries, obesity is more a problem for the poor. Fatty, sugary (corn syrup!) foods are cheap. They contain lots of calories, but not much other nutrients. The healthy food (fresh veggies and fruits, full grain rice, bread and pasta, quality meat etc) is more expensive.

  • by Black Parrot (19622) on Thursday August 20, 2009 @03:02PM (#29137987)

    the portion they're talking about is between Beaumont and Texarkana, right on the border

    Which makes me wonder if this was a study of US Citizens or merely US Residents?

    It might be hard to eliminate the illegal population from those areas, without finishing the job that the treaty of Guadalupe Hidalgo stopped and annex all of Mexico.

    Wrong border. Beaumont-Texarkana lies along the Texas-Louisiana border.

    All of Texas has a high Hispanic population, but that area wouldn't be outstanding in that regard. Maybe even lower than most of the state. It's just a backwards "piney woods" region, sort of a cross between the Ozarks and the Bayou Country. Voodoo-practicin' hillbillies, or something.

    Not to belittle the people who live there. (I can get away with hillbilly jokes as an in-group member.) It's just a very economically backward part of the state. Oddly, because Dallas banking and Houston oil lie just to the west of its two termini.

  • Re:USA vs Europe (Score:5, Informative)

    by dduck (10970) on Thursday August 20, 2009 @03:10PM (#29138111) Homepage
    I think it would be extremely instructive if it was expressed as a ratio of - say - life expectancy pr. $ expended pr. year. Or the marginal cost per year of increase, or something. The debate is not really about how long the average person lives . it's about how many people are not treated for even simple ailments (morals), and the effectiveness of the system (cost/benefit).

    I am from Denmark, but married to a US citizen. We have a lot of opportunity to compare notes. While Danish doctors are often somewhat rude and will cheerfully refuse to give you a prescription for stuff you are sure you need, we would never see a case like my wife's uncle. He lost his leg because he didn't see a doctor about the pain, and his reason for not seeing the doctor was that he was worried the visit would not be covered by his insurance. When he finally went, it was too late, and they had to amputate. So it goes. Meanwhile, in Denmark the government is often imploring the citizens to see their doctor more often, to keep health costs down by spotting problems before they become expensive to treat.

    Personally, I have received many, many treatments ranging from setting of broken limbs to specialist examinations for this and than, and every night I use a C-PAP machine, paid for and maintained by the socialized health system, but supplied by a private specialist. I can, in fact, choose any doctor I want as my GP, or just make an appointment or show up as a walk-in. The only practical limit is that in order to see a specialist, I need a referral from a GP. This has never been a problem for me.

    Our system? Socialized with a private option, with an overflow to the private system if the public system is too tardy - again at no extra expense for the user. You can add a private insurance if you wish, and many people choose to do so for things such as dental, plastic surgery etc, but it's really not required to stay hale and taxable :)
  • Re:Slashkos (Score:2, Informative)

    by svtdragon (917476) on Thursday August 20, 2009 @03:11PM (#29138145)

    Only Greece rivals the US in plumpness.

    I call bullshit. For one, your BC study is out of date by a decade, and in that decade, healthcare costs in the US have risen 87% [nytimes.com].

    And even granting the fact that Greece is as fat as us, or fatter, Greece has national healthcare and ranks fourteenth [photius.com] on the same scale that rates the US as #37 (2005). And the Greeks spend the least per-capita on healthcare in the EU [undp.org] at $2,179/person, per the 2007 UN Human Development Report. (not, however, the least as a percentage of GDP, according to the first link). The US, per the same report, spends $6096/person.

    So what accounts for the other $4000? We aren't 3x as fat. Just 3x as stupid because we accept this state of affairs.

  • by Rising Ape (1620461) on Thursday August 20, 2009 @03:23PM (#29138411)

    Works fine from where I'm sitting (UK). Always been able to access it, never had treatment refused. The same is true for everyone else in my family.

  • Re:Slashkos (Score:2, Informative)

    by svtdragon (917476) on Thursday August 20, 2009 @03:34PM (#29138575)
    FYI, Massachusetts mandates insurance, and there's no true public system, which would drive down costs. And I don't care about guns either way.

    Our death rates, as per my post above, are not even close to being due solely to obesity. Greece is fatter than us and has national healthcare twice as good for a third the cost. (Sources cited in my original post.)

    We do not have universal healthcare. We have universal disease care, wherein we treat only those critical illnesses that have gotten to the point where patients will die without care (and sometimes not even then) when they could have much more easily been prevented by better care earlier--but the ER doesn't do that. And your so-called "health-care" system is one that bankrupts those who are unfortunate enough to get sick, or get hit by a car driven by someone uninsured (true story; I knew an engineer that had that happen when I volunteered at a drop-in center because after he got hit, he couldn't work, and he had so much to spend on physical therapy for 9+ months that he spent all his savings on copays so he couldn't afford his rent). And over half of bankruptcies in the US, before the housing bubble popped, were due to medical bills, and mostly people who actually had insurance.

    And as for ability to choose your insurance, the idea is that there is no insurance--it's transparent. Whatever your doctor says you need, you get. None of this bullshit care denial based on pre-existing conditions or bureaucracy. Everyone gets the same basic standard and nobody's left to die on the street. If you want to purchase additional insurance on top of it, feel free; we will just stop rationing basic, necessary, and preventative care based on ability to pay.

    And as to the proposed new system in the US, it's starting to resemble the Belgian system, much more than the Canadian or British systems, which are quite different [fivethirtyeight.com]. Look it up. It's better than ours.

    The main reason our system is broken is the profit motive. Normally it drives the free market to great things, but in our case, the less care the individual gets, the more money the insurance company gets, and there's little room to choose another option. Then, one would suggest, we should take down the barriers between states and dismantle the employer-based system--I used to agree with that point, until it came to my attention that this is how credit card companies operate: they move to the state in which the regulations and consumer protections are most lax. Hence it has to be regulated in a federal manner, and at that point, the conservative ideal of a free market has been violated anyway, so we might as well eliminate the 30% administrative costs associated with insurance companies, which, by the way, Medicare outperforms them on.
  • Re:Wait, really? (Score:5, Informative)

    by Achromatic1978 (916097) <robert@@@chromablue...net> on Thursday August 20, 2009 @03:34PM (#29138583)
    No, healthcare in America is the furthest bastard stepchild from insurance you can find. And I write claims adjudication software for the insurance industry. Have a heart attack, but the insurer finds that you forgot to mention that when you were 12 you had an appendectomy? Denial of coverage. Insurer decides that the treatment, available in every Trauma I in the country, is 'experimental'? Denial of coverage.

    Change insurer for non-medical reasons (premium, employer change, so on)? Welcome to waitlist hell, and scrutinization for pre-existing conditions, even though the populace's preponderance for a given condition didn't change as a result of your enrollment.

    It's a bastardized, one sided situation, and where health insurance is your ONLY realistic option, because collusion and collaboration between insurance providers has ensured that most healthcare rates are jacked up way out of the realm of ordinary affordability, it's very delineating, you either have, or you have not.

    Pop Quiz: Do you really think your overnight stay in emergency had an actual cost of $12,000? Do you wonder why the same chiro treatment costs $50 without insurance, but they bill the insurance provider $165 for it? Do you think that the insurance carrier is covering that $115 out of the grace of their heart, or because they employ such amazingly stellar investment gurus that they can do so on the return from the dividend from your premiums?

    Where's that bridge and that "for sale" sign?

  • Re:USA vs Europe (Score:5, Informative)

    by Pascal Sartoretti (454385) on Thursday August 20, 2009 @03:42PM (#29138733)

    Here [blogspot.com] is a comparison of life expectancies between the US and Europe.

    I guess it is based on bullshit data. For instance, Switzerland has a much higher life expentancy, see here [admin.ch]. 80 years for men, 84 for women.

    adjusted for the effects of premature death resulting from non-health-related fatal injuries

    Why this adjustment ? Oh, to make data fit to your conclusion ? You live in a violent country [washingtonpost.com], deal with it.

  • by svtdragon (917476) on Thursday August 20, 2009 @03:43PM (#29138741)
    Canada = single-payer. Canada != UK. UK != single-payer. UK = national health care. Big difference. [fivethirtyeight.com]

    And to answer your question, it works right here in the good ol' U-S-of-A [medicare.gov]. Just ask someone on medicare if they want it taken away. But wait! Claire McCaskill beat you to it [freedomslighthouse.com]. "Get your government hands off my Medicare," indeed.
  • by careysub (976506) on Thursday August 20, 2009 @03:43PM (#29138745)

    Do check out the blogspot post, but then check this out:

    According to "OECD Economic Surveys: United States 2008", p. 137 (http://tinyurl.com/mt3g76):
    "It has been claimed (Ohsfeld and Schneider, 2006) that adjusting for the higher death rate from accident or injury in the United States over 1980-99 than the OECD average would increase US life expectancy at birth from 18th of of 29 OECD countries to the highest. In fact, what the panel regression estimated by these authors shows is that predicted life expectancy at birth based on US GDP per capita and OECD average death rates from these causes is the highest in the OECD. The adjustment for the gap in injury death rates between the United States and OECD average alone only increases life expectancy at birth marginally, from 19th on average among 29 countries over 1980-99 to 17th. Hence, the high ranking of adjusted life expectancy mainly reflects high US GDP per capita, not the effects of unusually high death rates from accident and injury."

    In other words, the figures in Table 1-5 are not U.S. life expectancies adjusted for fatal injuries, but rather a model that assumes that both the relationship of life expectancy to per capita GDP and injuries in the U.S. follow OECD trends.

    That is - they are falsely giving the U.S. credit for having the same basic life expectancy as other other high GDP OECD countries, when in fact it is markedly lower.

    Check it out for yourself, the Ohsfeld and Schneider report is at:
    http://www.aei.org/docLib/9780844742403.pdf [aei.org]
    See p. 20-21.

  • Re:what? (Score:3, Informative)

    by hoggoth (414195) on Thursday August 20, 2009 @03:49PM (#29138831) Journal

    > give a discount or rebate for people who join a gym,

    I am in favor of this in general, however, I personally use high intensity interval training [wikipedia.org] outside with very limited equipment. I'd like MY gym rebate in cash, thank you.

  • Re:Slashkos (Score:3, Informative)

    by jwhitener (198343) on Thursday August 20, 2009 @03:50PM (#29138853)

    "I don't mind subsidizing someone who is missing a leg or arm or is paralyzed. What I don't like is subsidizing people which have a problem with the area between their ears."

    You don't seem to understand that despite not having free public health care, you are in fact subsidising people without health insurance.

    You see, without health care, the poor, lazy, mentally ill, illegal aliens, etc.. all wait until they are extremely sick, and use an emergency room, often with long stays and huge bills. By law, hospitals must provide emergency care. They attempt to make up for this massive loss, by increasing the costs for those that can pay.

    So all of us working folks pay way more for health care than a true free market system would otherwise dictate. We pay more per person for health care than any nation on earth, yet the WHO rated us 37th for effectiveness of that care and overall health.

    So here's the two general choices for bringing the cost of health care down:
    1. Remove the laws requiring free emergency care.
    2. Give people that don't have health care, free insurance plans, so we are treating by prevention and general care, rather than paying for emergency care.

    Now obviously health care is incredibly complex. But that is one of the primary factors driving up the cost.

    Insurance companies in the "free market" now, have one job: maximize profit. They are for profit companies. That means denying as many claims as they can, while making insurance premiums/plans as costly as the market will allow.

    Without a public option, there really is no competition to bring the costs down. And when you add morality into the equation, and have laws guaranteeing emergency care for anyone, you further push the cost up.

  • Re:Slashkos (Score:3, Informative)

    by jwhitener (198343) on Thursday August 20, 2009 @03:56PM (#29138967)

    Massive profit does lead to a lot of cutting edge research and top notch facilities.

    From what I've read though, a lot of our cutting edge stuff only helps people with very rare diseases, like rare cancers, etc..

    So we are probably better at treating 1% of medical problems, while the cost of the other 99% of medical problems costs more per person to treat than anywhere on earth.

  • Re:Not entirely (Score:5, Informative)

    by dkleinsc (563838) on Thursday August 20, 2009 @04:11PM (#29139257) Homepage

    Maybe if someone does their shopping only at some corner convenience store instead of going a few extra miles to a real grocery store, but that's true of anywhere.

    If you're poor enough that the difference between $1.50 Cambell's soup and $1 frozen pizza is critical, then you're not going to have the time or the $3 for bus fare to get to the real grocery store a few miles away. There really are areas where you can't easily get to a grocery store: they are called "food deserts" by those who work on issues surrounding food supplies in poor urban areas.

  • Re:USA vs Europe (Score:2, Informative)

    by teallach (729563) on Thursday August 20, 2009 @04:48PM (#29139809) Homepage
    mod parent "comforting perhaps but entirely untrue"

    Read the supposed source [aei.org]... which is a true Dilbert-esk powerpoint.

    I love the bit where the US is an "outlier on spending", but only until you turn the stats into "semi-log[arithmic]". LOL.

    The lies told about the US healthcare system are absurd. Particularly the recent comparison of the US and UK systems. I would rather be wheeled into a UK hospital after a car crash than walk into a US hospital with a ripped fingernail.
  • by SPickett (911670) on Thursday August 20, 2009 @04:52PM (#29139875)
    There's an elephant in the room that is being ignored. The AMA artificially limits the number of doctors and nurses available, which drives up prices. As the baby boomers age, it is going to get worse.

    If you increase the supply of doctors and nurses, the shortage will decrease and prices will drop. Unfortunately, the AMA would switch from being a strong supporter of health-care reform to a strong opponent and it would be more difficult to pass.
  • Re:Wait, really? (Score:3, Informative)

    by geekoid (135745) <dadinportland AT yahoo DOT com> on Thursday August 20, 2009 @05:04PM (#29140031) Homepage Journal

    false. You might want to rad the bill.
    No wher ein the bill are the elderly denied health care. no. where . at. all.

    Oops, Someone with facts on /., what is the world coming to.

    The panel you mention is only there in case soeone wants to discuss the end of life plan.
    Do you want to be on a respirator? then fine. You don't? then fine. and everything in between.

    I've seen pretzel less twisted then that lie.

    You go ahead and read you 'articles' but keep quite while the grown-ups are dealing with actual information. Let us know when your grown up enough to be a contributor to the debate.

    Idiot.

  • by hey! (33014) on Thursday August 20, 2009 @05:16PM (#29140175) Homepage Journal

    Unfortunately, these things bear repeating. The problem is that the Big Lie still works even if you say it with a smirk on your face. I'm not talking about aquatone282 here, who's just making a wisecrack, but propagandists like to fall back on the "joke" excuse too often after they've been caught lying.

  • by tsotha (720379) on Thursday August 20, 2009 @05:19PM (#29140217)

    The reality is there's an unlimited demand for free (or almost free) goods, so somehow the government will have to decide when to stop spending money on grandma. Whether you actually have a "panel" (whatever you call it) that meets to decide, or some QALY [wikipedia.org]-style formula to make that determination, it will have to be made.

    Under the current US system, it's possible your insurance company will deny you coverage for some technical reason, but they risk being sued for millions if they deny anything considered "customary".

  • by ArcherB (796902) on Thursday August 20, 2009 @05:20PM (#29140229) Journal

    I don't know if I would be called a "Rushie", but I am a Libertarian leaning Conservative.

    It's not just the end-of-life counseling that makes us think of "death panels". It's the fact that countries that already have a "public option" or single (government) payer system are having to ration medical care. Of course, there will always be rationing of some sort. Right now the limiting factor is price and availability. Insurance companies can decide not to cover a medication or procedure due to price or necessity. For example, you wouldn't give a new hip of gastric bypass surgery to a patient that will die from pancreatic cancer in six months. If the patient doesn't like it, they can take the company to court and let a judge decide. The problem with a government run system is that you can not sue the government. If a government-based -insurance panel decides that you don't need a new hip or breast cancer medication, then you're simply SOL. You only option is to pay your taxes and die.

    Here is a good quote from THIS [telegraph.co.uk] article:

    However hysterical some of the US attacks may be, the central core of the argument is indisputable: the NHS relies on the principle of rationing. Whatever resources there are should be distributed absolutely evenly (which may mean thinly) regardless of circumstances, and no one should receive what can not be made avaliable to everyone. If a given drug or procedure cannot be offered to the entire population (or to all those who might benefit from it), then it should not be offered to anyone at all because that would be "unfair". This doctrine is carried to its logical conclusion by the prohibition on top-up payments in which patients can be refused NHS treatment (even when they have paid for it through years of taxation) if they choose to buy medication out of their own funds. This is something that most Americans would find shocking and even positively immoral. And there are a good many British patients (and doctors) who would agree with them.

    Is this how an American system would operate? Who would decides who gets what drugs? Who decides who DOESN'T get what drugs? What happens if a private insurance company is willing to pay for a procedure that a government panel has deemed unnecessary? That panel that decides to deny a potentially life saving drug or treatment is the panel that is referred to as death panels.

    Personally, I think the government has to much power as it is. I certainly don't want to literally give them power over life or death.

  • Re:Wait, really? (Score:5, Informative)

    by Jaysyn (203771) <jaysyn+slashdot@NoSPAm.gmail.com> on Thursday August 20, 2009 @05:24PM (#29140269) Homepage Journal
    Funny you mention this, my step-dad is dying (6 months to a year) of a cancer (bladder) with a pretty high remission rate that has metastitized because he decided to go the "natural medicine" route instead of chemo & radiation. One of the things the *quacks* he went to had him try was exactly what you mentioned. It's bullshit. The "alkaline-body" treatment is bullshit as well. The quacks that spread this nonsense are making money off killing people as far as I am concerned. He's now taking radiation, but basically, he's not going to make it.
  • Re:Slashkos (Score:5, Informative)

    by jabuzz (182671) on Thursday August 20, 2009 @05:24PM (#29140275) Homepage

    What the fuck, even in the United Kingdom with the NHS for over 60 years now, there is a thriving private insurance industry, with private hospitals. Some employers even over private health insurance, and some people take it out privately.

    This is clearly uninformed nonsense, along the lines of claiming that Stephen Hawkings would be dead under the NHS, when he is in fact British and gets excellent treatment without which he would be dead under the NHS.

    The thing is that life expectancy is closely tied to your socioeconomic group. The top group in the USA has worse life expectancy and health outcomes than the lowest group in the UK, despite expenditure on health care in the USA being twice the percentage of GDP that it is in the UK.

    I don't for one minute claim our health care system is perfect, but it is *FAR* less broken than the one in the USA.

  • by Rising Ape (1620461) on Thursday August 20, 2009 @05:55PM (#29140627)

    Well, obviously. No system in the world can offer every possible treatment to anyone who might want it - to do so would take unlimited resources, which nobody has. And that includes the USA - it's just your insurance company that makes the choice (or if you're rich you can pay for yourself, but you can do that here too).

    The major difference is that it's essentialy impossible for UK citizens to be uninsured - so no refusal of cover for "pre existing conditions", no trying to wriggle out of payment for treatment and no bankruptcy due to medical bills.

    However, I think the most telling information about the NHS is that private insurance *is* available in the UK, but few people bother with it (under 10%, and mostly through employers).

  • Re:Not entirely (Score:5, Informative)

    by dkleinsc (563838) on Thursday August 20, 2009 @06:02PM (#29140727) Homepage

    All over the place, according to the USDA:
    http://www.ers.usda.gov/Publications/AP/AP036/ [usda.gov]

  • Re:Wait, really? (Score:3, Informative)

    by Runaway1956 (1322357) on Thursday August 20, 2009 @06:17PM (#29140895) Homepage Journal

    "allocation of medical care based on "how valuable you are to the government"

    I've got news for you - we already have that. The insurance company won't cover you, or you simply can't afford the rates they set, or the insurance company simply denies claims. In short, you only survive if you are valuable to some corporate headquarters, ie, they can see how to make a profit off your lame ass.

  • Re:Slashkos (Score:5, Informative)

    by Lemmy Caution (8378) on Thursday August 20, 2009 @06:29PM (#29141011) Homepage

    Your understanding is wrong. The US has less economic mobility than most developed nations.

    Read this [americanprogress.org] for more.

    Oddly enough, generous funding for higher education and universal health care are two of the reasons for higher economic mobility elsewhere. At the time of the report, you were techinically right - the UK was about as bad as the US (and both lagged behind other European societies). Since then, the US has actually fallen even lower in mobility.

  • Re:wow only 77 (Score:3, Informative)

    by JustNiz (692889) on Thursday August 20, 2009 @06:40PM (#29141109)

    Interesting feedback.

    >> Mexicans use our Emergency Rooms for free and then go back to their country so they don't have to pay,

    Same thing happens in UK, its just different races. At least your illegals go back home. Ours stay around for all the other free handouts our stupid government gives them, but they don't integrate or contribute anything back to our society. Then they try and force islam on us too.

    >> Incidentally, the rate of organ transplants in the US is much higher than in Europe.
    That doesn't necessarily sound like a good thing. I'm guessing it has a lot to do with the US obesity rate, and also the fact that your hospitals are almost completely profit-based. They can charge a fortune every time they do a transplant so of course they're going to push patients into costly surgery whenever they can.

    A few years ago my UK doctor perscribed some muscle relaxant for a recurring back problem. The prescription cost me about 10 pounds ($16 USD). When I visited the US I got exactly the same prescription. It cost over $500 for 24 pills. If that isn't criminal exploitation by the US drug cartels then I don't know what is.

  • Re:Wait, really? (Score:4, Informative)

    by Just Some Guy (3352) <kirk+slashdot@strauser.com> on Thursday August 20, 2009 @06:41PM (#29141113) Homepage Journal

    Do you wonder why the same chiro treatment costs $50 without insurance, but they bill the insurance provider $165 for it?

    I can't speak for everyone, but I know why we bill that way: because the insurance companies will pay a set percentage of the "reasonable and customary" charge for each procedure performed. If that currently happens to be 30%, then a $50 procedure gets billed at $165 so that it actually gets reimbursed at $50. If notice comes down that the new rate is 25%, then expect that to go to $200 overnight. There's also the need to periodically raise rates above the reasonable and customer charge to pull the average upward. If everyone starts billing $200 for the $165 procedure, then insurance will only "allow" $165 at first and will reject the extra $35. After a few years, they'll adjust the allowance to some multiple of the new rate.

    Yes, it's horribly screwed up. That's still better than travesties like Medicaid that often reimburses for procedures at less than the cost of the supplies needed to perform them. Yes, you read that right. There are certain billing codes that Medicaid pays at about 5 to 10 percent of what insurance would. It's hard to make up profits with volume when you are literally, tangibly losing money on each treatment. That's why almost no doctors will see new Medicaid patients without a referral from a colleague. Every doctor I know does a lot of free/charity work, but you have to save some time for paying patients if you want to keep the doors open.

  • by hey! (33014) on Thursday August 20, 2009 @06:52PM (#29141211) Homepage Journal

    Homicides rates are higher among the poor -- particularly drug related murder, and the murder of a teenager in a drug incident has a disproportionate affect on life expectancy. That said, the rate of death by homicide is *tiny* in relation to other causes of death.

    For some reason economic based breakdowns of things like accidents are hard to find. Race and ethnicity based data is easier. Blacks don't die from accidents a higher rate than whites -- in fact the rates are nearly identical. Race isn't a very good stand-in for income, but since blacks are generally less prosperous, we'd expect the rates to be higher. Rates for accidents *are* higher for Latinos, but that may reflect the large number of Latinos that are employed in agriculture, which is dangerous. Latinos are on average less prosperous than the rest of the US.

    So accidents and violence probably *do* contribute to the discrepancy, but not hugely.

    But if you really want to go where the rubber hits the life-expectancy road, look at infant mortality. A recent study (doi: 10.2105/AJPH.2004.040287) found a very significant correlation between low income and infant mortality in New York (p 0.0005), but *no* correlation in Tokyo or Paris and a barely significant correlation in London (p 0.05).

    It's not really all that mysterious. People who don't have access to health care are more likely to die, and in the US that's more likely to be a poor, uninsured person. You don't need to imagine all kinds of mysterious reasons for the discrepancy. There *are* of course other factors that contribute, but that isn't necessarily a cause for celebration.

  • Re:USA! USA! USA! (Score:5, Informative)

    by lawpoop (604919) on Thursday August 20, 2009 @06:53PM (#29141229) Homepage Journal

    Just remember, the USA is better at everything. Why? Because!

    The technical term for this idea is American Exceptionalism [wikipedia.org].

    "American exceptionalism (def. "exceptionalism") refers to the theory that the United States occupies a special niche among developed nations[1] in terms of its national credo, historical evolution, political and religious institutions and unique origins. The roots of the term are attributed to Alexis de Tocqueville,[2] who claimed that the then-50-year-old United States held a special place among nations, because it was a country of immigrants and the first modern democracy.[citation needed] The term itself did not emerge until after World War II[3] when it was embraced by neoconservative[4] pundits in what was described in the International Herald Tribune as "an ugly twist of late".[5] More recently, President Barack Obama noted that "I believe in American exceptionalism, just as I suspect that the Brits believe in British exceptionalism and the Greeks believe in Greek exceptionalism."[6] He also said that "there have been times where America has shown arrogance and been dismissive, even derisive."[7] Research shows that "there is some indication for American exceptionalism among the [U.S.] public, but very little evidence of unilateral attitudes".[2]

    The theory of American exceptionalism has a number of opponents, especially from the Left.[8][9] The U.S. Democratic Party in particular is said to be "fundamentally opposed to" American exceptionalism.[10] They argue that the belief is "self-serving and jingoistic" (see slavery and civil rights issues, Western betrayal, and the failure to aid Jews fleeing the Nazis),[1] that it is based on a myth,[11] and that "[t]here is a growing refusal to accept" the idea of exceptionalism both nationally and internationally.[12] "

  • Re:Slashkos (Score:3, Informative)

    by hey! (33014) on Thursday August 20, 2009 @07:49PM (#29141719) Homepage Journal

    It's not like we don't have figures for this.

    Some figures put the obesity related excess costs at around 147 billion. That's a lot of money, but we're still only talking 6% of our total health care expenditures. It doesn't explain why we spend multiple times what other countries spend to get worse outcomes.

  • Re:USA vs Europe (Score:4, Informative)

    by sjames (1099) on Thursday August 20, 2009 @08:14PM (#29141887) Homepage

    Apparently Switzerland, Norway, and Canada have a problem with violent resurrections. How else would eliminating the effects of violence from the picture decrease the mean lifespan?

  • by ArcherB (796902) on Thursday August 20, 2009 @11:18PM (#29143073) Journal

    The system under discussion when we talk about the "public option" isn't anywhere near a single-payer system

    You are absolutely correct... for now. Individuals will have a choice as to stay with their current private coverage or to go with the new government option (now called "public option).

    Of course, the government option will have to be as good as any private insurance, right? Otherwise why have it? If health insurance is a right, then everyone, regardless of income should have equal access to it.

    Next, it will have to cheaper than private insurance. The whole point is universal coverage. That means the poor should be able to afford it as well. The only way the poor will be able to afford it is if it's cheap. How do you make it cheap? Well, tax the rich, of course. (Obama has already stated that this is how it will be paid for)

    So now you have a competitor to the private sector that is just as good or better than the private sector, at half the cost. It is financed by the American taxpayer so it can profit is not a concern. For that matter, it doesn't have to break even. It can lose billions of dollars every single year and it does not matter. Oh, and it can make it's own rules because it has the backing of the United States Congress. They are the people who write laws.

    Now tell me. How long do you think it will take before every private health insurance company is out of business? Obama says 10, 15 or 20 years [youtube.com].(watch the whole thing, but it's about 50 seconds in where he says eventually, he plans for there to be a single payer system.)

    Handing anybody power over life and death is worthy of close examination, but the fact is, someone will have to do it. It's far from clear that the government is any less trustworthy than the private sector, and it's at least theoretically more accountable.

    If an insurance company screws over enough of its customers, word gets out and it loses its customers and goes out of business. It has to keep a vast majority of its customers happy or they'll become the competition's customers.

    But you are correct about one thing. If there is going to be a single payer system, I would prefer that the monopoly be the government and not some corporation. But we don't have a monopoly now and we won't if we keep the government out of it.

    With that said, I agree that there needs to be reform. For example, I don't believe an insurance company should allowed to consider your health history when providing coverage or deciding what to charge. They should not be allowed to drop a customer for any reason other than lack of payment, and in the case of unemployment due to the illness, the government should pick up those payments as part of unemployment benefits. But we don't need the government to compete directly with the insurance companies.

  • Re:Slashkos (Score:2, Informative)

    by coaxial (28297) on Friday August 21, 2009 @02:24AM (#29143895) Homepage

    And since I'm burning karma anyway lemme toss another sacred cow onto the grill. Enough with this continual blather about the 'disadvantaged/poor/etc.' if you nitwits aren't going to deal with the actual problem. To a very high degree of correlation, the 'poor' aren't living in poverty because of a lack of money. They lack money because they have make poor lifestyle decisions that RESULT in a lack of money. Things like failure to get an education (or worse reject the value of knowledge entirely), become a single parent, waste money on substance abuse or Xbox... but I repeat myself.

    Wall Street Journal reported [acces.us] that generational class mobility -- how likely it is for someone born poor will die middle class -- is lower in the US than Europe, even though the rags-to-riches story is ingrained, even intrinsic, to the American Dream. Why is that? Are we to believe that Americans are lazier than their "socialist" "nanny state" European brethren? I doubt that. In fact, if one was to take the conservative talking points at face value, the European-style social safety nets would discourage economic mobility. So what gives? Well, European poor are healthier, due to easy and affordable access to health care, thus allowing them to work more. They have better access to daycare, thus enabling them to find a job, instead of being forced to stay home with children.
    You repeat the canard, that the poor are all lazy that fritter away their money, ironically on luxuries (alcohol, drugs, video games, etc.), but what does the science actually reveal? [bts.gov] says that 27% of income of the working poor is left after housing, food, and commuting expenses. The working poor income is defined as less than $8000 a year, so that's $2160 a year, so $180 a month. So where does that $180 go? Well perhaps University of Akron chart [uakron.edu] will help. $50 for child care, and the rest for "housekeeping supplies, apparel and services, and personal care products and services" And the end ? $-81.

    You clearly have no interest in actually reading a study of what's going on, because "reality has a well known liberal bias."

  • Re:Wait, really? (Score:3, Informative)

    by hairyfeet (841228) <bassbeast1968 AT gmail DOT com> on Friday August 21, 2009 @03:19AM (#29144105) Journal

    You DO realize that poor folks die because of their diet, which is often all they can afford, yes? And folks 'fall through the cracks' pretty much every damned day. Next week I'll be burying my sisters ashes. You know what the cause was? lack of copper. Yep, she got butchered by a lousy surgeon and couldn't absorb copper naturally anymore. because my state has a 250K malpractice cap, nobody would take her case. And because Medicaid says copper isn't necessary they wouldn't pay for it, and at more than $1600 a month for the copper and vitamin infusions even with me helping we simply couldn't afford it. She was 36 BTW, with two teenage boys in case you were wondering.

    So i doubt very seriously you have been poor or seen what it was like to be caught under the wheels of the American medical situation. I have buried 2 friends so far for things that would have been preventable if they could afford a doctor or decent food, and like I said I bury my sister next week. Here in the rural south folks are often only able to afford the cheapest (read fattiest)cuts of meat and bulk like potatoes. Also after working 12 hours in a shitty dead end job they are too tired to fix more than just the most basic of meals.

    And frankly with the flood of illegals taking the "strong back" jobs that the uneducated poor used to take like construction, and more and more of our educated jobs being sent overseas or given to H1-Bs, I honestly don't see how you expect the average Joe to pay for health care short of a government run plan. Or do you honestly think they can afford quality health care while working at Wendy's?

  • by locofungus (179280) on Friday August 21, 2009 @04:54AM (#29144437)

    I don't know why you would think that Europe won't intervene.

    http://www.telegraph.co.uk/health/healthnews/4420446/Premature-births-cost-the-NHS-almost-1-billion-a-year.html [telegraph.co.uk]

    80000 premature births in the UK

    http://www.nlm.nih.gov/medlineplus/prematurebabies.html [nih.gov]

    480000 premature births in the US.

    Adjusted for population they look very similar to me.

    The fact is that the NHS will treat every and all premature birth. It will also treat every and all pregnant mothers (unless you elect to pay to go privately) If there is skewing of the statistics due to infant mortality I'd think it was the other way with babies not being taken to hospital in the US until it is too late.

    Tim.

  • Re:Wait, really? (Score:3, Informative)

    by Ihlosi (895663) on Friday August 21, 2009 @08:52AM (#29145713)

    Actually you should read up on glucose metabolism. Your body does not make glucose EVER except from the carbohydrates you eat. There is no other magical way you get glucose.

    It's not magic, just chemistry.

    http://en.wikipedia.org/wiki/Gluconeogenesis [wikipedia.org]

    Your body will break down your own fat or use fat from your diet and use that to fuel your brain. It's not the preferred energy source for your brain but it will work.

    Your body _will_ make glucose from other substrates, because it's the energy source that the brain needs. Also, your red blood cells _cannot_ use anything but glucose for their energy needs. Blood glucose levels need to be kept in the right range, or you'll die - regardless of the availability of other energy sources.

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