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A Medical Dashboard for the Star Trek Fans
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Re: What I want to know
  • 7/25/2017 12:49:19 PM
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Part of the issue is that there is no incentive for preventative care and many insurance companies are offering costs for preventative care. The benefits can be great, but poor medicine is regularly prescribed. I have a family member that will get antibiotics for anything from their physician even with no sign of a bacterial infection. The physician never warns them about side effects and damage that can be caused by it!

Re: What I want to know
  • 7/10/2017 5:06:36 PM
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@Lyndon_Henry I believe that the Israeli system is not currently a single-payer one. I believe it used to be dominated by Kupat Cholim but now has various other options. Students who go there to study have to purchase some form of medical insurance, and they do have several options with different price points.  When I looked up medical coverages on nbn.org.il/aliyahpedia/government-services/health-care-national-insurance/private-insurance-options-in-israel/, it offered several levels of coverage, including some plans that do cover pregnancy but not hospitalization. I'm not sure if that is intended only for pregnant women who expect to give birth elsewhere or if there would be some provision for a midwife type of birth.

From what I understand, in the UK women typically use a midwife rather than a doctor for delivery, which saves the NHS money, too. In the US, it is much less common to use a midwife, and there are some states that disallow home births.

As for life expectancy, I'd think there are other factors, too. The American diet is probably one of the worst, for one thing. American also seem to walk very little.

BTW when I looked up the country rankings, I found a lot of slide shows and other things that force many clicks on those who want the data. I then found this data.oecd.org/healthstat/life-expectancy-at-birth.htm which does try to pack a lot more into a single graph.

But I think that it could use some Rober Allison improvements. 

 

 

Re: What I want to know
  • 7/10/2017 4:57:47 PM
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..

Airella quotes

"A risky, delicate procedure done for the first time in Israel this week repaired a severe heart defect in a 28-week-old fetus."

This made me curious about the Israeli healthcare system. It's described as a universal healthcare system, and while it seems to have some problems, they don't seem anywhere near as severe as those of the British NHS. I found a particularly interesting article:

An Overview of Israel's Universal Health Care System

I found the comparison with the USA especially interesting:

According to the latest Organization for Economic Co-operation and Development (OECD) figures, Israel's health care costs constitute 7.5% of its GDP; in the U.S. they account for 17.9% of GDP.

According to the World Bank's latest tally, Israel ranks 8th in the world for life expectancy; the U.S. ranks 26th.

 

 

 

 

 

Re: What I want to know
  • 7/9/2017 11:25:44 AM
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@Lyndon_Henry agreed, they do run out of money, and that leads to not having the equipment and staff resources necessary to treat everyone. That's why the heart surgeon who wrote Open Heart recounts having to raise funds outside the systems for his experimental surgeries. In one case, a whole team of people also had to be flown in for the procedure. That takes a great deal of money, and the NHS would never pay for something like that. They would cite the poor odds of survival, but the money is really what it boils down to.

I saw this today, and it's exactly the kind of thing that would never happen under the NHS. It's never been done before, no doubt expensive, and cannot guarantee a positive outcome: "Rare heart surgery performed in utero to save sick baby" It's described as "A risky, delicate procedure done for the first time in Israel this week repaired a severe heart defect in a 28-week-old fetus." Much cheaper, cleaner, simpler to abort the fetus. BTW I found it fascinating that they make a point of giving the fetus anaesthesia because they know it does feel pain. When my 3 week old was given a spinal tap, the doctors didn't give her anything to diminish the pain, and she certainly felt it.

 

Re: What I want to know
  • 7/8/2017 9:51:46 PM
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..

Ariella writes

Well, you can look at the UK. The good news is that they do have extensive electronic records. The bad news is that OECD 2015 report ranked the system as one of the worst in the developed world, as  the Telegraph reported, "Hospitals are now so short-staffed and underequipped that people are also dying needlessly because of a chronic lack of investment."

In evaluating universal healthcare systems like Britain's National Health Service, and their current problems, I think it's important to consider whether problems arise from an intrinsic dysfunction of the system or official policy decisions. In the case of the NHS, I'm convinced that the evidence is overwhelming that policy decisions by the UK government have been the key factor in underfunding and undermining the system, which had otherwise been working effectively since its inception after World War 2.

See, for example:

Outrageous Decline in British Healthcare a Result of Cuts and Privatization

NHS at breaking point, according to British Medical Association

..

Re: What I want to know
  • 6/30/2017 8:32:12 AM
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I think the defensive medicine attitude is what bothers me the most.  If I could walk in once a year at no cost to get a physical, get all the typical diagnostics done and have a 10 minute discussion about how to adjust lifestyle I'd see them more often.  I find that a lot of people don't do any kind of preventative health care and only start paying attention when something is so bad it's debilitating.  I had a talk with an acquaintance earlier this year about the fact that the edema in his legs is probably a result of his diabetes, to which he snapped back that he doesn't have diabetes.  We talked some more and it turned out that he's never had his blood sugar checked and avoids going to doctors. We end up paying more to fix severely broken people because it's a hassle to do business with our health care system.  There are so many conditions, diseases, etc. that are simple to fix or manage if you catch them early but there's no external incentive for anyone to do so.

Re: What I want to know
  • 6/30/2017 8:22:40 AM
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@Areilla, What I find most funny about them charging $1 per page is their printer sounds like it's dying.  I suspect they are pooling that money to replace the printer but they won't get the money from me, I have an account with the lab that I go to and I get all my lab results before their office does. 

Re: What I want to know
  • 6/29/2017 10:50:35 PM
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T Sweeney, the problem is how doctors have long been compensated by payors --- by quantitiy of procedure or patient. So they are incentivized to crowd their waiting rooms and try to fly through as many people as possible. Likewise for diagnostics and the problem of over-prescription. Doctors always blamed "defensive medicine," but it's more like, let me get paid for that! Obamacare was moving physicians and hospitals to a pay for results model ... but who knows what will happen now.

Re: Trends in medical practice size
  • 6/29/2017 1:18:40 PM
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Very true and the logistics and costs of operating an independent office are crippling many physicians. Implementing technology is often another cost not just for the initial turnover but for all the ongoing maintenance. Many physicians offices feel overwhelmed by the demands of running their office and practicing medicine.

Re: What I want to know
  • 6/29/2017 10:58:14 AM
NO RATINGS

I don't think your post is off-topic at all. To me, it speaks to the impact of the business model being used to deliver healthcare for most people in this country. When every minute is measured and costed out, common sense goes out the window in favor of efficiency and the rules of the system, as you found in your blood text incident.

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