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The U.S. Has the Most Expensive, Least Effective Health Care System

A survey released today by the Commonwealth Fund ranks the United States dead last in the quality of its healthcare system compared to ten other developed nations. At the same time, it's also the most expensive in the world.

Frustratingly, the new report (pdf) shows that the U.S. is not improving; it ranks last, just like it did in the 2010, 2007, 2006, and 2004 editions of the survey. Call it a ten-year losing streak.

Other nations evaluated in the survey included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom. The U.K., which spends just $3,405 per person on health care, ranked first overall among the 11 nations. Compare that to the United States' $8,508 per person.

This of course is not new information to the people who have been listening. It would be stunning news for the people who put their fingers in their ears and insist that the US has the greatest health care system in the world. It MUST be because it cost the most.

As the ACA is implemented there is a sizable number of people who now have better access to what we've got but that legislation only funnels more money into the same inefficient and disorganized system. Given all of the political blood that has been shed in getting that up and running, any prospects for more fundamental reform are dismal to say the least.

I find it interesting that the UK consistently ranks first in most of the categories. It is by far the most socialized and the least privatized system of those evaluated. Even with the neoliberal austerity fetish of the present British government, they don't dare lay hands on the National Health Service. They would have an easier job of selling off the crown jewels.

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Comment Preferences

  •  Isn't David Cameron experimenting with all (21+ / 0-)

    sorts of "free market" solutions for the NHS?

    “In the beginning there was nothing, which exploded.” Terry Pratchett

    by 420 forever on Mon Jun 16, 2014 at 01:24:14 PM PDT

  •  "We're Number 37!!" (31+ / 0-)

    Recorded during the 2009 health care debate, when the most our President would say to promote health reform was that America gets "no better outcomes."

    Last year we were actually down to #38.

    We are called to speak for the weak, for the voiceless, for victims of our nation and for those it calls enemy.... --ML King "Beyond Vietnam"

    by Gooserock on Mon Jun 16, 2014 at 01:26:22 PM PDT

    •  But...I read on DKos that ACA was a game-changer! (15+ / 0-)

      The writer didn't mention it changed the game from "Go Into Debt To Get Shitty Health Care!" to "Get Forced to Pay Inflated Premiums To Get Shitty Health Care!"

      Just another brilliant victory for the greatest President ever.

      •  It was game changing (45+ / 0-)

        It took all the energy that had been building from the90s for either federal or state government option and turned universal health care into private insurance

        I've been following this issue since 2004

        A few thing the "progressives" never understood

        1. Poll after poll from the late 90s on
        Supported a government option

        (It took different forms from a federal solutions to a system run by individual states but centered on govt not private insurance )

        There used to be this site that tracked these issues

        It was always strong support

        It's why the public option despite DC efforts remained popular

        2. Private insurance knew its numbers were going to decline

        3 as early as 2005 or even earlier they knew universal coverage was coming

        4. The battle was always about them
        Obtaining gains from that idea by killing govt competition.

        5. ACA effectively halted public opinion while guaranteeing them a market

        The best if both worlds

        The game did change

        It changed to favoring the insurance  companies as they were about to face decline and denying the public govt insurance

        Neoliberals are smart

        •  I concur on every single point. (8+ / 0-)

          But try telling any of it to the "Obama walks on water" contingent. Best of luck.

        •  Ahh, here we have all the folk who opposed the ACA (3+ / 0-)
          Recommended by:
          MVOregon, portlandzoo, samddobermann

          gathering together to indirectly declare the ACA a failure.

          Granted, none of these folks, the policy makers they support (whoever they maybe) or critics on the Right have created a healthcare reform system in a hundred years of political rhetoric, but here they are through the auspices of some poll here to declare the ACA a failure! The same ACA which has already given over 20 million people access to healthcare and perhaps a 100 million people the security of not being able to be kicked of their existing plan due to catastrophic illnesses.

          I love these complaining group hug diaries....

          •  I never opposed the ACA. Ever. (0+ / 0-)

            I was disappointed that Obama pre-negotiated a poor policy solution written by and for insurance companies. The chance was there for more (he surrendered single payer down to public option without much of a murmur).

            Health care systems that are better have been installed in every single other wealthy democracy on the planet.

            Every. Single. One.

            Ours was and is the worst. Obama could've done much better.

            The ACA was better than nothing, but marginally so. I never, ever said that the prior system was better than the ACA. No one responsible would.

            I do oppose declaring as "victory" forcing low-income people to pay for premiums they cannot really afford -- and cementing a "system" that is an anarchic joke and a feeding trough for the predatory insurance companies and their pals in Big Pharma.  

            Spiking the ball over the ACA is the same as cheering Obama's "carbon targets" as death knells for global warming.

            •  Your statement reveals a lot more than what you (1+ / 0-)
              Recommended by:

              profess. I noticed you appear to be resentful that the President is taking credit for the ACA.... This is quite clear:

              I do oppose declaring as "victory" forcing low-income people to pay for premiums they cannot really afford -- and cementing a "system" that is an anarchic joke and a feeding trough for the predatory insurance companies and their pals in Big Pharma.


              Spiking the ball over the ACA is the same as cheering Obama's "carbon targets" as death knells for global warming.
              If there is one thing I have noticed about the President's opponents, it is their all consuming resentment of the President taking credit for anything. They will say, "Obama is spiking the football over capturing Osama bin Laden" or Obama is taking credit for winding down the war in Afghanistan" or for saving the car industry. This really irks them....

              Now...getting back to the issue at Let me address your statement below:

              I was disappointed that Obama pre-negotiated a poor policy solution written by and for insurance companies.
              Well, if the ACA was written by the insurance companies they certainly gave up a lot, for the ACA requires private insurance companies to give in to a number of stipulations before they could participate in the program. Do you want to know what those are? It doesn't matter, I'll spell them out nevertheless:

              The ACA forces private insurance companies to cover a wide range of preventive services, including well-woman visits (Pap tests, cancer screenings, etc), diabetes screening, and prenatal care without co-pays. (Big Big Concessions!)

              It also forces:

              Insurance companies to spend at least 80-85 cents of every premium dollar on medical costs as opposed to profits, marketing and overhead (can you imagine such a thing? This certainly indicates the insurance companies wrote this bill)

              The ACA also forces:

              insurance companies to justify a rate increase before it shows up on your bill (Yup, they had to give in to this)

              The ACA also established major new provisions to combat health care fraud and abuse in Medicare, Medicaid, and private insurance (Yup, you and I just know that the insurance companies "who wrote this bill" were anxious to give in to this)

              The ACA forces:

              insurance companies to stop disqualifying individuals based on pre-existing conditions (this was HUGGEEEE and affects tens of millions of people)

              The ACA forces:

              insurance companies to stop placing caps on care (another huggeee issue, also affecting millions of people.)

              Let's recap here, the insurance companies would not have independently offered these provisions…they did not author this bill…. The bill was constructed on the premise of allowing them customers in return for major concessions.

              And this:

              I do oppose declaring as "victory" forcing low-income people to pay for premiums they cannot really afford
              In case you haven't heard, the poor benefits from the ACA even more than any other group, for if they are unable to afford care they will receive subsidies....

              Yes, the President deserves to take credit! The ACA isn't perfect but it is a greatly needed start as Paul Krugman commented:

              This thing is going to work. And, yes, it's also a big political victory for Democrats. They can point to a system that is already providing vital aid to millions of Americans, and Republicans - who were planning to run against a debacle - have nothing to offer in response. So my advice to reform supporters is, go ahead and celebrate.
              You don't like Obama taking credit? Well...tough....
              •  Your propaganda essay reveals your aim. (1+ / 0-)
                Recommended by:

                You misrepresent my position and attempt to drown me out with a virtual PowerPoint slideshow of gauzy pro-administration exaggeration.

                It was you who declared ACA a victory and spiked the ball.

                And it was you I challenged for having done so. I would do the same to any analyst who made such absurd claims. It's not always about Obama alone.

                It's very weak to discount dissent based on a false fantasy theory about its origins.

                Then we get the obligatory laundry list. None of it denies:

                (1). Insurance companies literally co-wrote the ACA.

                (2). The ACA maintains insurance companies' massive profits.

                (3). The ACA maintains Big Pharma's massive profits.

                (4). Even with ACA, the US system is worst among rich nations.

                (5). US system is also least efficient and most expensive in same group.

                (6). Heritage Foundation originally proposed individual mandate.

                (7). Romney Massachusetts plan first used individual mandate.

                (8). ACA incorporates both Heritage and Romney plans.

                There is no denying any of these 8 points.

                They are historical and actual reality. Period.

                The President is welcome to take all the credit in the world for every one of those 8 points. That's not going to work out so well.

                What would happen if you tried to market the ACA to any other developed nation, anywhere on earth?

                Once they stopped laughing, they'd tell you to take a hike.

                Why would I care what Paul Krugman has to say about it? Mr. Krugman is an economist, not a health care expert. Yes, he has been tacking to the center lately and praising Obama for this and for that. Perhaps he wants a job in the pending Hillary administration, who knows? It's irrelevant.

                Any time a propagandist like you attempts to distort the facts of the ACA, you will face resistance from those who remain in the reality-based community.

                •  It is your contention that your reference to (1+ / 0-)
                  Recommended by:

                  "spiking of the football" and "victory" had nothing to do with the President whose signature legislation the ACA is but an individual on a website you had never met before. I don't think I need to explain how that is the height of is self evident.

                  Why would I care what Paul Krugman has to say about it? Mr. Krugman is an economist, not a health care expert.
                  Which begs the question, are you a healthcare expert? If you say yes I hope you are prepared to establish your expertise. So, in the interest of economy, you don't have to answer that question, you have already established your penchant for disingenuous statements.

                  It is amazing how you Obama opponents admired Krugman when he criticized the President now you resent him because he is celebrating the Affordable Care Act. This next statement by you reveal a nasty piece of pettiness that is only found on some of the extreme hate Obama blog sites:

                  Yes, he has been tacking to the center lately and praising Obama for this and for that. Perhaps he wants a job in the pending Hillary administration, who knows?
                  Yes he is praising Obama because he wants a job from Hillary. You would think he would praise Hillary if he wanted a job from Hillary; it is confusing logic, but it stems from extreme resentment and condemnation for someone who disagrees with you or, even more so, someone who agrees with Barack Obama. I understand you more than you could ever imagine.

                  Most of what you just regurgitated I already addressed, so I think I have said just about all I need to say to you, except:

                  This thing is going to work. And, yes, it's also a big political victory for Democrats. They can point to a system that is already providing vital aid to millions of Americans, and Republicans - who were planning to run against a debacle - have nothing to offer in response. So my advice to reform supporters is, go ahead and celebrate.
                  Paul Krugman says it all... I have no doubt you have more "healthcare expertise" to challenge him...and challenge Elizabeth Warren and tons of other individuuals who are happy the healthcare law is finally helping individuals receive healthcare.

                  I wonder how many people you or, better yet, the policy leaders you support have provided healthcare for.... Absolutely zero.... But, nevertheless, in terms of Mr. Krugman, I am sure you also have a Nobel Prize in economics as well to challenge his theories now that he is supposedly "looking for a job from Hillary."

                  Save the additional diatribe....

                  •  The propaganda is strong in this one. (1+ / 0-)
                    Recommended by:

                    If you aren't a paid shill for the administration, you really ought to be.

                    You spiked the ball and declared ACA an astounding victory. You. I responded to you. I didn't write a letter to Obama, I responded directly to you. Sorry.

                    You ignore the entirety of my comment. You refuse to respond to any of my list of 8 main failures of the ACA.

                    Ignoring its failures does not diminish them. It is not an argument.

                    Instead you blather on about Paul Krugman. Funny stuff.

                    You accuse me of not being a health care expert. Ironic, for your language marks you as the farthest thing from a health care expert, but simply an Obama militant. Regardless, discussions like this one should be evaluated on one's logic and evidence, not on appeals to authority as you attempted.

                    I never uncritically championed Krugman's views on anything.

                    It is you who are doing so -- now that he has decided he likes second-term Obama as much as he hated first-term Obama. If Krugman is now some perfect Oracle on all policy matters, do you agree with his oft-stated view on ACA:

                    I believe that universal single-payer is the only sensible way to go.
                    Do you agree with Krugman that ACA is rife with flaws?

                    Do you agree with Krugman's view on Obama from the same article you quoted:

                    There were huge missed opportunities early in his administration — inadequate stimulus, the failure to offer significant relief to distressed homeowners. Also, he wasted years in pursuit of a Grand Bargain on the budget that, aside from turning out to be impossible, would have moved America in the wrong direction.
                    Do you? I'm guessing no.

                    No, you just like sporting Krugman quotes when they agree with you and ignoring them when they don't.

                    That's uncritical. That's being a typical party hack.

                    The truth is, I don't know why Krugman has tacked more to the center during Obama's second term and neither do you. As an economist, Krugman is a lefty who opposes neo-liberals like Hillary and Obama. Since he's softening his column's rhetoric, perhaps he's negotiating with a neo-liberal power to come in Hillary. Or perhaps he's after something else -- a big grant or a more pro-establishment post of some kind. He's not writing in a void.

                    You understand nothing. You're so trapped in the Party militant's simple-minded reflexive dismissal of any critique that you just won't engage in reasoned discourse.

                    The ACA is better than what preceded it, but only marginally. It could have been much better, and the ACA system is terrible. Those are my views, which, ironically, Paul Krugman shares (see quotes and links above).

                    And then you close with some more wild-eyed, frothing insults.

                    I'm going to ignore your bile. Policy alternatives to ACA were and are available. Every other single developed country has instituted them.

                    Hundreds of millions, perhaps billions, of people have policy leaders and care providers in systems that put ACA to shame. Your "arguments" in favor of the genius of ACA are puerile and absurd.

        •  You are misled about the public option (0+ / 0-)

          as proposed. It would have only affected a few. Moreover  Medicare IS a single payer system and has the SAME problems of over treatment, overpriced, unsafe care as all the rest.

          The ACA provides for coops that are run by the citizens who are insured. There are several that are doing well and even expanding. They can reflect local needs and keep POLITICS out of health care decisions. Or are you OK with no coverage for abortion or most contraceptives?

          President Obama did not kill the public option; in fact he and his staff worked hard and planned to get it passed through the Conference Committee. The ACA as passed by the House contained the Public option. It died when Reid tried to force it into the Senate bill. That wasted time AND locked in Senators opposition to the provision. The plan had been to tuck it into the final bill in conference.

          Reid was bowing to pressure from "progressives" who didn't have a clue about strategy — and against the advice of those who knew how to count votes. It was a predictably bad call.

          You don't know markets. 75- 80% of people under 65 are insured through their work. Another 10% have Medicaid. The number of new policies to be generated is a fairly small number and a significant portion of them are those with "preexisting conditions" some with real expensive problems.

          This was not a huge plus for insurers. In fact, if there was a "public plan" they would be shunting all of the sickest people to it. They can do that by selective advertising and by adjusting panels. Thus it would have Higher premiums than private insurance. The public plan would be a win for insurance companies.

          A Question:  Exactly how would a single payer plan impact the actual problems of the crappy healthcare in the US?

          I'm asking you to believe. Not in my ability to bring about real change in Washington ... *I'm asking you to believe in yours.* Barack Obama

          by samddobermann on Tue Jun 17, 2014 at 06:48:32 PM PDT

          [ Parent ]

          •  Well, it worked before it was privatized (1+ / 0-)
            Recommended by:
            Team Leftie

            There were 3 bills that came out of the House and 2 that came out of the Senate. Obama picked the one WITHOUT the public option: Max "Blue Dog" Baucus' Finance committee.

            Then it was held Behind Closed doors like most important policies of this administration are handled.
            I don't knwo where you get the abortion coverage, that was negotiated away early on by using the Hyde Amendment.

            The Medicaid expansion was privatized and handed to the HMOs.
            If this thing is so good, why are we dead last in healthcare outcomes in the developed world?
            It didn't do a thing except spread the risk among policy holders for things they don't even need.
            AND nobody "got to keep their policy if they liked it" if it didn't conform to the new rules.

            Teddy Kennedy would have never stood for this thing as it had already been offered by NIXON in the 70's.

            It would also help if going to med school wasn't so damn expensive that doctors have to work for nothing for years to pay off their school loans.
            You either don't have to go to doctors/dentists or you like getting soaked...again.

            Libera Nos A Malo

            by Medusa on Wed Jun 18, 2014 at 08:02:30 AM PDT

            [ Parent ]

      •  It's saving my life at the moment (28+ / 0-)

        I went without for 12 years while I was an unpaid family caregiver for my Dad. Wasn't eligible for MediCal because I don't have dependent children. I signed onto Covered California less than 48 hours after it started (I have some income now) and eventually picked Kaiser.

        They put me though a all the normal tests plus a bunch more and diagnosed very early stage breast cancer.

        Am involved in treatment now. I'll diary the experience when it's all over, probably in a couple of months.

        I also got three ladies signed up for MediCal. None of them had ever had health insurance in their lives.

        So there's that.

        Enjoy the San Diego Zoo's panda cam! And support Bat World Sanctuary

        by Fonsia on Mon Jun 16, 2014 at 08:39:37 PM PDT

        [ Parent ]

      •  You mean (4+ / 0-)

        "Get Forced to Pay Inflated Premiums To Get Shitty Health Care! and Still Go Into Debt Paying for what Insurance Doesn't"

        "It's not surveillance, it's data collection to keep you safe"

        by blackhand on Tue Jun 17, 2014 at 07:43:46 AM PDT

        [ Parent ]

      •  Just think: (1+ / 0-)
        Recommended by:

        Hundreds of billions of tax dollars are subsidizing private health insurance companies whose only value added is to provide the death panels that Sarah Palin warned us about.

        The 99% are watching.

        by unclejohn on Tue Jun 17, 2014 at 11:22:16 AM PDT

        [ Parent ]

      •  I never read that ACA was the final solution - (0+ / 0-)

        just the first step in improving US health care.  Would you prefer that Obama had tried for the English fully socialized medical system - and lost?

      •  Consider This (1+ / 0-)
        Recommended by:

        Point taken Rithmck. But lets look a little further into it. It's early in the Presidency of the first black President of the United States. He's charged and ready to take on the world. First stop, healthcare. He's seen all the data on how quickly doing nothing will take us even further over the abyss. Single payer was tossed around and we dems LIKED IT. Pelosi comes back and says they're(Repugs) not going to let this happen. Tons of people out of work and you want me to try to sell them on putting the Insurance Companies out of healthcare ? Why don't you reach your black hand across the aisle and sell them on Romneys plan, thereby cooling their jets long enough to get it passed ? He says O.K., reaching across the aisle is a good thing, right ? Then they set forth and write this awful legislation and because it's so long, nobody reads it and somehow, Pelosi gets the thing passed and you know the rest. I should point out it's at this point where the President should have realized this was going to be a long, very frustrating eight years but that's another story for another time.

    •  Yeah, that tends to come with (1+ / 0-)
      Recommended by:

      not getting stuck with a huge bill or fighting with insurance companies.

      I'd bet that malpractice suits are relatively rare too - when you don't have to worry about being taken care of if something goes wrong, you tend not to sue unless it's a real negligence issue.

      •  Actually its a myth that Americans are more sui... (3+ / 0-)

        Actually its a myth that Americans are more suit happy

        As I remember most law suits are between commercial parties not individuals

        But that's just memory and I maybe wrong

        What's not wrong is that in the states where law suits were limited the result was not a reduction in cost

        So the real issue is likely deeper

      •  mmac - the entire concept of malpractice (3+ / 0-)

        lawsuits, with punitive damages, is a US-only practice.

        "let's talk about that" uid 92953

        by VClib on Mon Jun 16, 2014 at 09:35:05 PM PDT

        [ Parent ]

        •  Yes, because that is the system we have (2+ / 0-)
          Recommended by:
          Tonedevil, corvo

          chosen to regulate bad doctors.  As an example, what do you think would happen to a doctor in Europe if they were to leave their patient cut open on the operating table to go deposit their paycheck at the bank.  Well here in the US what happens is they get sued and that's it because instead of regulation we rely on the civil "justice" system.  The McDonalds case would have never happened either as they would have been forced to lower the damn temperature by government regulators but here we rely on punitive damages instead.

          You have watched Faux News, now lose 2d10 SAN.

          by Throw The Bums Out on Tue Jun 17, 2014 at 02:58:42 AM PDT

          [ Parent ]

          •  Well, it isn't strictly to regulate bad doctors. (1+ / 0-)
            Recommended by:

            Bad hospitals are part of the problem, too. And bad hospitals and bad doctors both reflect our bad system. (I think that's not really a counterpoint to your point so much as another dimension of it.)

  •  Nothing is perfect but single payer gets a lot... (9+ / 0-)

    correct....And yet, there's this discouraging post from Gallup: Most Americans Remain Satisfied With Healthcare System

  •  And here's all you need to know... (30+ / 0-)

    As to why I didn't like the aca. We have the worst system and now we have everyone buying into the worst system.  

    I sing praises in the church of nonsense, but in my heart I'm still an atheist, demanding sense of all things.

    by jbou on Mon Jun 16, 2014 at 02:34:20 PM PDT

  •  The for-profit health care system works (17+ / 0-)

    About as well as our for-profit federal and state governments. If you have a lot of money to spend, its a decent health care sydtem.

    The only upside is that the for profit health care model is guaranteed to fail. I suppose we'll mjust have to wait until it crashes before we see any improvement.

    Money is property, not speech. Overturn Citizens United.

    by Betty Pinson on Mon Jun 16, 2014 at 02:37:20 PM PDT

  •  No such thing as "UK NHS" (5+ / 0-)

    The National Health Service is a devolved function which means there are separate services for Scotland, Wales, Northern Ireland and England. Only the last is still run by the Westminster government, because there is no English Parliament, and there are differences which distort some of the statistics.

    For example, prescription drugs are free in Scotland and Wales but each item is £8.05 (@US$ 13.60) in England with exceptions for people under 18 and over 60 years, pregnant women, those on state income support and with certain long term diseases like cancer.  Scotland has much worse outcomes in terms of life expectancy because of historical diet differences although I should add that the lowest paid quartile in Scotland have better health than any American according to a survey a few years ago.

    "Come to Sochi, visit the gay clubs and play with the bears" - NOT a Russian advertising slogan.

    by Lib Dem FoP on Mon Jun 16, 2014 at 02:37:25 PM PDT

  •  it has to be inefficient (30+ / 0-)

    Otherwise, the insurers, pharmaceutical companies, device manufacturers, hospital consortiums etc. wouldn't get their cut. I mean, if you spent the pot of health care dollars on actual health care, and tried to use the simplest and most effective treatments, and put more emphasis on preventive care, what would be left over for the health-industrial complex?

    Now that we've passed a law that requires Americans to buy into this predatory system that funnels their money into everything but health care, one can only expect it to get worse.

    It is incredible that Americans don't think health care should be a basic right. Even when the public option--which was only an infinitesimally piddly baby step towards the realization of that right--was eliminated, people just sort of yawned and said, "Well, we might as well pass this law anyway."

    "In America, the law is king." --Thomas Paine

    by limpidglass on Mon Jun 16, 2014 at 02:50:13 PM PDT

  •  How long until Republicans blame ObamaCare? (2+ / 0-)
    Recommended by:
    Rogneid, thanatokephaloides

    Not because it's true, mind you, but because it is politically expedient and too many low information voters will believe them.

    •  the ACA is a giant exercise in cost-shifting (20+ / 0-)

      Obama bought the support of large and powerful factions of the health care industry (insurance, drug companies, hospitals) for very weak, very tiny, short-term cost controls by promising them far larger deferred profits down the road.

      For instance, this was why drug reimportation was killed, so the drug companies could make a killing charging us for meds--killing us in the process.

      The heart of the ACA is the individual mandate, which, thanks to the Roberts Court, established the constitutionality of laws mandating American citizens to give their money to private companies. This precedent will be expanded greatly in coming years. Imagine laws that require you to pay 5% of your income to Goldman Sachs! Such laws are now constitutional, according to the Roberts Court.

      The genius of the ACA, politically speaking, is that it's so complicated, and takes so long to kick in, that Obama will be long gone before people realize what he did. Huge chunks of the law aren't even in effect yet, and won't come online until after 2016.

      Once they're in charge again, the Republicans will strip away the shiny, appealing veneer of the ACA to reveal the cold steel trap beneath. They will build on the foundation Obama laid for them to complete the privatization of American health care.

      "In America, the law is king." --Thomas Paine

      by limpidglass on Mon Jun 16, 2014 at 03:18:42 PM PDT

      [ Parent ]

      •  ObamaCare has problems. (6+ / 0-)

        My intention was not to say that ObamaCare is good, but to point out that the problems with our health care system were in place prior to the passage of ObamaCare. I fully expect Republicans to use this report to blame ObamaCare as the sole fault of the health system's failures despite the systemic problems being in place prior to the ACA's passage.

      •  So I'll just keep repeating this comment: (4+ / 0-)

        It's saving my life at the moment.

        I went without for 12 years while I was an unpaid family caregiver for my Dad. Wasn't eligible for MediCal because I don't have dependent children. I signed onto Covered California less than 48 hours after it started (I have some income now) and eventually picked Kaiser.

        They put me though a all the normal tests plus a bunch more and diagnosed very early stage breast cancer.

        Am involved in treatment now. I'll diary the experience when it's all over, probably in a couple of months.

        I also got three ladies signed up for MediCal. None of them had ever had health insurance in their lives.

        So there's that.

        Enjoy the San Diego Zoo's panda cam! And support Bat World Sanctuary

        by Fonsia on Mon Jun 16, 2014 at 08:45:02 PM PDT

        [ Parent ]

        •  And you'll keep asserting that anecdotes trump (9+ / 0-)

          actual measurements of outcomes across the board.

          The ACA didn't save my life - I've got 2-3 months to go. Part of the reason is mandated private insurance and no public option that contributed to delays in treatment of what turned out to be a very aggressive cancer. 2 months of delays between discovery and treatment. Not entirely due to ACA (and I could afford the diagnosis and treatment because of ACA), but it was a contributing factor.

          Not everyone is a lucky as you are, for example the people in 25 states who aren't eligible for ACA or Medicaid, and are still both poor and uninsured, as well as people like me. And those people who don't qualify are getting costs shifted to them as insurance companies negotiate big discounts from providers. They're still in the same boat you were in before ACA.

          Health care shouldn't be based on luck or income.

          No matter how cynical you become, it's never enough to keep up - Lily Tomlin

          by badger on Mon Jun 16, 2014 at 09:34:08 PM PDT

          [ Parent ]

          •  I'm acutely aware of how lucky I am (3+ / 0-)
            Recommended by:
            sethtriggs, samanthab, Hillbilly Dem

            As you say, not everyone is.

            And, sadly, I'm highly aware that not everyone has been so lucky. (I went with Kaiser. They've been extremely aggressive in their diagnoses and treatment.)

            But I don't blame it on the ACA. I blame it on the Republicans and John Roberts. I wish there really were a Hell for monsters like them.

            I'm trained in science. I'm well aware of the value of real statistics over anecdotes. I do intend to tell my story, however. It's already got three people signed up for MediCal.


            Enjoy the San Diego Zoo's panda cam! And support Bat World Sanctuary

            by Fonsia on Mon Jun 16, 2014 at 10:01:13 PM PDT

            [ Parent ]

        •  There's no doubt that the ACA was, for some people (0+ / 0-)

          better than the nothing which they had, and I do know several people who now have coverage only because of the law. But it's still a band-aid on a severed limb. Especially if you live in a state that turned down the Medicaid expansion.

  •  Communist! Marxist! Nazi! (16+ / 0-)

    Why do hate America?
    Why do you want to make baby Jesus cry?
    Pony wanter!
    What, you think Obama's got a magic wand?
    Tell this to all the millions who come here for surgeries!
    But I heard a story once where someone had to wait for 6 whole weeks to get a brain transplant--in Canada!
    If we didn't have this system, all of our doctors would quit!
    No other country has our existing system, so they can instantly have something better, and we can't!
    There was a woman who lost her free insurance with no deductible and no premiums!

    "Lone catch of the moon, the roots of the sigh of an idea there will be the outcome may be why?"--from a spam diary entitled "The Vast World."

    by bryduck on Mon Jun 16, 2014 at 03:08:09 PM PDT

  •  I looked in the link (2+ / 0-)
    Recommended by:
    Rogneid, thanatokephaloides

    but couldn't find what "Effective Care" means for that subcategory, could someone explain?

    Der Weg ist das Ziel

    by duhban on Mon Jun 16, 2014 at 03:14:51 PM PDT

    •  If you can't download the PDF (11+ / 0-)

      Effective Care
      An important indicator of quality is the degree to which patients receive “services that are effective and appropriate for preventing or treating a given condition and controlling chronic illness.”11 In this report, the indicators used to define effective care are grouped into two categories: prevention and chronic care

      Prevention. Preventive care is crucial to an effective health care delivery system. When utilized appropriately, lists of patients who are due or overdue for tests or preventive care, reminders for preventive care visits, and discussions of lifestyle issues can increase the effectiveness of care through the early diagnosis or prevention of illness. Consistent with previous editions of Mirror, Mirror, the U.S. does well in providing preventive care for its population. Respondents in the U.S. were more likely than those in most other countries to receive preventive care reminders and advice from their doctors on diet and exercise.

      Chronic care. Carefully managing the care of patients with chronic illnesses is another sign of an effective health care system. Overall, the U.K. outperforms all countries on each of the seven chronic care management indicators. Different countries, however, were successful on different aspects of chronic care. Australia performs well in delivering recommended services to patients with diabetes, as well as providing written instructions to chronically ill patients. A relatively large percentage of primary care physicians in the Netherlands report that it is easy to print out lists of patients by diagnosis and lists of all medications taken by individual patients. Meanwhile, a very low percentage of chronically ill patients in Sweden did not follow recommended care or treatment plan because of cost.

      The U.S. is third on effective care overall, performing relatively well on prevention but average in comparison to other industrialized nations on quality of chronic care management. The U.K and New Zealand scored first and second, respectively, in terms of effective care. The widespread and effective use of health information technology (HIT) in the U.K. plays a large role in the country’s high score on the chronic care management indicators, as well as its performance on system aspects of preventive care delivery. All countries, however, have room for improvement to ensure patients uniformly receive effective care.

  •  Those per capita costs (4+ / 0-)
    Recommended by:
    bruh1, Rogneid, bkamr, thanatokephaloides

    will go up to 12,500 next year.  

    Since we now have more people participating in the health care system the previous system of overcharging/rationing is being revealed.  The per capita costs are artificially low due to non-participants.

    Be the change that you want to see in the world

    by New Minas on Mon Jun 16, 2014 at 03:56:31 PM PDT

  •  Because we like spending money on killing (15+ / 0-)

    People abroad. Corporate welfare at its best.

    I voted Tuesday, May 6, 2014 because it is my right, my responsibility and because my parents moved from Alabama to Ohio to vote. Unfortunately, the republicons want to turn Ohio into Alabama.

    by a2nite on Mon Jun 16, 2014 at 03:56:34 PM PDT

  •  Here's my little analogy (30+ / 0-)

    Most of the actors in our health care system are not there for their health - or yours!  They are there to make a profit.
    It's silly to blame profit making corporations for putting profit ahead of patients - that's like blaming a lion for killing.  And leaving profit-making corporations in charge of our health is like hiring a lion to babysit your kids.

    "Wouldn't you rather vote for what you want and not get it than vote for what you don't want - and get it?" Eugene Debs. "Le courage, c'est de chercher la verité et de la dire" Jean Jaures

    by Chico David RN on Mon Jun 16, 2014 at 04:13:44 PM PDT

    •  Chico David where you been? (6+ / 0-)

      We've been missing your health care diaries. Glad to see you!

      Money is property, not speech. Overturn Citizens United.

      by Betty Pinson on Mon Jun 16, 2014 at 04:58:25 PM PDT

      [ Parent ]

      •  Why thank you! (0+ / 0-)

        In all honesty, it's been hard to get excited about the issue right now - the ACA is SUCH a mixed bag - it has a lot of good features and a whole bunch of bad - many of the worst of which have not yet become apparent to the average person.  I don't want to be part of the chorus either defending the ACA or beating up on it.  In the not too distant future, the push for single payer in California will ramp up again and I'll be more active then.

        "Wouldn't you rather vote for what you want and not get it than vote for what you don't want - and get it?" Eugene Debs. "Le courage, c'est de chercher la verité et de la dire" Jean Jaures

        by Chico David RN on Sun Jun 22, 2014 at 03:05:57 PM PDT

        [ Parent ]

    •  I still don't understand (0+ / 0-)

      how it is that anyone would think health care can be left up to the market. It's completely different from, say, making and selling cars or TVs or corn chips. If I tried to charge someone 500 bucks for a bag of corn chips they'd tell me to go fry ice, pound sand, whatever. I would be out of business in very short order- luckily the corn chips only cost me 50 cents a bag, so I could charge a buck, which is reasonable, and still profit. The corn chips are worth what people are willing to pay. But if I make a drug that will keep you from dying, or keep your child from DYING, what are you willing to pay then? The answer is probably "everything you have." The other point is that free market principles only work when consumers have the opportunity to shop around. There is one level one trauma center in my area. One. One ambulance service. And if I'm hit by a truck I'm probably not gonna be pulling up Consumer Reports ap on my phone looking for a bargain. Not to mention the ethical issues of putting a price on human life......

  •  How dare you criticize the ACA (23+ / 0-)

    The greatest achievment of the Democratic Party in the last 70 years.

    You must be a Teabagger or something.

    I now have insurance for the first time in more than 25 years. My deductible is $6000 so, I can't actually afford to go and see a doctor. But, thanks to the ACA,  more than $500 per month is paid out on my behalf for me to have the exact same healthcare plan that I had before:

    I wonder how many others that we don't hear about got the same sort of plan that I have under ACA? Sure the ACA is better than nothing, but not by much.

    It was meant to pacify us so that we would all shut the fuck up about single payer.

    Lucky for me I haven't needed the services of a doctor for more than 11 years, which services I payed cash for the last time I needed them.

    Hopefully my good health will last for at least one more year when I turn 65.

    God spare me the Heart to fight them... I'll fight the Pirates forever. -Mother Jones

    by JayRaye on Mon Jun 16, 2014 at 04:24:37 PM PDT

    •  Yes (12+ / 0-)
      It was meant to pacify us so that we would all shut the fuck up about single payer.
    •  Crappy health insurance.... (15+ / 0-)

      ...A mandate to buy it and the inability to negotiate drug prices, guaranteeing we'll still pay 10 times the cost for our prescriptions than do Canadians into the foreseeable future. Yeah! We Liberals really showed 'em....Any more victories like that and we'll be third world.

      "Given the choice between a Republican and someone who acts like a Republican, people will vote for a real Republican every time." Harry Truman

      by MargaretPOA on Mon Jun 16, 2014 at 05:15:24 PM PDT

      [ Parent ]

    •  I think you can go see a doctor (5+ / 0-)

      and preventive care, almost all of it, is FREE. As in it doesn't count toward your deductible and you won't get charged for it.

      •  I haven't seen a doctor in eleven years (3+ / 0-)

        and I'm in better health, and have more energy than many people I know 20 years younger.

        so, just perhaps, I've been doing a few things right for lo these many years.

        God spare me the Heart to fight them... I'll fight the Pirates forever. -Mother Jones

        by JayRaye on Mon Jun 16, 2014 at 07:17:03 PM PDT

        [ Parent ]

      •  Which still means "Don't get sick" (6+ / 0-)

        because, for example, getting my cancer diagnosed and treated still cost me $10,500 out of pocket. But without the cancer forcing me to max out on the out of pocket expense, I couldn't afford to get my knee problem looked at, so I bought an ACE bandage and worked out instead of getting diagnosis, imaging and physical therapy, or maybe even surgery

        And if your free colonoscopy finds something (and a lot of them do) you still may have to pay $500 to $1000 for a pathology report.. And then decide whether you can afford to pay for treating something negative the colonoscopy found.

        No matter how cynical you become, it's never enough to keep up - Lily Tomlin

        by badger on Mon Jun 16, 2014 at 09:41:56 PM PDT

        [ Parent ]

    •  And the greatest achievement of the Democratic ... (3+ / 0-)

      And the greatest achievement of the Democratic Party in the last 70 years ... started out as a Republican proposal.

      Tells you all you need to know.

    •  I've always had "Don't Get Sick" insurance, too... (1+ / 0-)
      Recommended by:

      I've always had "Don't Get Sick" insurance, too.

      I was pushed out of insurance several years ago when they wanted 53% of my income plus a $5000 deductible. The math didn't work well. The silver plan on the Exchange from Anthem looked great- low deductible that I could afford, my share of the premium (total as high as ever) was affordable. But it was still "Don't Get Sick" insurance because the more than 250,000 people in seven counties served by our regional hospital were stuck in "out of network" hell. The hospital and doctors were really available only in case of emergency (when hopefully the insurance would pay as for in network, but I didn't want to be the guinea pig to test that theory after seeing how Celtic cherry picked its way through bills on my old "100% coverage past the deductible" policy that was absolutely not). Anthem has other policies that are comparable that have everybody in my region in-network. They do not need to save money on the Exchange customers- they get guaranteed payment of the bulk of their obscene premiums, and lower deductibles and co-pays are all subsidized by the Feds (as confirmed by Anthem when I asked why they were so much different). They narrowed the network for those of us on the exchange because they could. We didn't have other options, they were the only choice and we obviously needed the subsidies. They are thieves, stealing from the US government on a grand scale.

      Fortunately I made it to Medicare, but now have to pay twice the premium as for the Anthem thieves and it is expected to increase 250% in a few years while my income won't. I certainly can't afford private insurance for the 20% Medicare won't pay, so hopefully Medicare will continue to regulate costs enough so that 20% won't destroy me. So even with Medicare, we still don't have what our counterparts elsewhere have. We are still at the mercy of uncertain medical costs and predatory/unreliable insurance companies. And I personally still have "Don't Get Sick" insurance.

  •  I am an American by birth. (30+ / 0-)

    And a Canadian by choice.

    I have written a lot about my experience with the Canadian Healthcare system... Here is another.

    Over the weekend I had a bit of a scare. I have a place on my left leg that is hard, and sore like a deep bruise, but I do NOT remember bumping my leg hard enough to cause this thing. It began bothering me Thursday night.

    By Saturday I was concerned enough about a possible blood clot that I went to the Urgent Care Clinic down the street from my home. It is for non-life threatening emergencies, open 24/7 and is affiliated with McMaster University Medical Center Hospital.

    I had blood tests and an ultrasound to check things out...and it was a relief that it was NOT a blood clot. The doctor said it was just a bruise but he was glad that I came in as it could have been more serious. I still cannot figure out how I got this thing...

    But, to the crux of the matter. I presented my health card, answered a few questions, and within an hour I was seen.

    AT NO OUT OF POCKET COST. Yes, my taxes pay for it...but that IS the point of paying taxes IMO.

    "Growth for the sake of growth is the ideology of the cancer cell." ~ Edward Abbey

    by SaraBeth on Mon Jun 16, 2014 at 04:27:28 PM PDT

    •  Taxes as societal insurance? (1+ / 0-)
      Recommended by:
      AT NO OUT OF POCKET COST. Yes, my taxes pay for it...but that IS the point of paying taxes IMO.
      I wonder, would it be useful to adopt an argument like that? There's the great phrase about taxes being the price tag for civilization, but maybe this is a model that even people who have an aversion to government might understand.

      Taxes are the insurance premiums to ensure the safety net is there when you need it -- but you still hope not to.

      (Sorry for the quasi-derail.)

  •  That's a feature, not a bug. (5+ / 0-)

    Do you think they want most of the money in our healthcare system helping patients or lining the pockets of CEO's and share holders? I mean come on, this is America, we're not like all of those other commie countries.

    We're ranked last compared to commie countries, but nobody does a better America than 'merika! Fuck yeah!!!/what I wish was mostly snark.

    You know why I quit watching the news in this country? Because there usually isn't any on our news programs that is actually consequential to the lives of most Americans. We're number one again at being at the back of the pack. We're the first last losers!!! Woohooo!!!

    Regulated capital serves the people, unregulated capital serves itself.

    by Alumbrados on Mon Jun 16, 2014 at 04:53:45 PM PDT

  •  No matter how often this is pointed out the (8+ / 0-)

    toothless and the brainless in this country led by the MSM will keep shouting from the rooftops

    We are the greatest

    when in fact we are the wrost

    •  Worst at what? (2+ / 0-)

      I have been in healthcare for for 28 of my 46 years on this Earth.  I have consulted in Hospitals in the UK, Italy, France, and the USA.

      If my kid was born as a hypotroph, there is only only place I would want them to be...the US, and that is regardless of socioeconomic status.  Same if anyone in my family had cancer.

      On the flip side, if anyone in my family needed a knee replacement or spinal surgery, I would pick Europe.  Why?  Because Europe has a much lower bar to receive CE status vs FDA clearance.  

      In the end it isn't as clear cut as any survey or ranking.  

      •  What's the point in the best care? (15+ / 0-)

        What's the point in having the best care when so very few can actually afford it? "Regardless of socioeconomic status" tells me that you've never had to do without access or ever let a problem become acute because if you went to the doctor, you'd have to put off paying the electric bill or rent or pay for car repairs. Forgive me, I may be mistaken about your experiences because I don't know what they were but that sounds to me like you've never faced a health issue without the resources to pay for your care. I respectfully have to say that most people I know would roll their eyes at that comment. Sure! U.S. healthcare is wonderful if you can pay for it. The trouble is, (and the point of this study), is that so very few can afford to pay inflated prices for a good result. The people who can pay for it get those results while the rest of us get the result we can afford, which is usually crappy. "Socioeconomic status" indeed! Try it from my socioeconomic stratum a couple of times before posting how great our care is without regard to how expensive it is.

        "Given the choice between a Republican and someone who acts like a Republican, people will vote for a real Republican every time." Harry Truman

        by MargaretPOA on Mon Jun 16, 2014 at 06:00:35 PM PDT

        [ Parent ]

      •  I wish I could have had my 3-level (1+ / 0-)
        Recommended by:

        spine fusion in Germany. I would have had at least two levels done with a rotating ADR disc. Here, they only approve one level. Fuck the FDA...SSK

        "Hey Clinton, I'm bushed" - Keith Richards UID 194838

        by Santa Susanna Kid on Tue Jun 17, 2014 at 04:13:00 AM PDT

        [ Parent ]

  •  Wasted political blood, more like (12+ / 0-)

    Think of all of the expended political blood, capital or whatever that was wasted getting a Republican health care law passed, (for which only 3 Republicans voted in the end, despite all of the pre-retreating that went on and epic capitulations. And please don't lecture me on "the art of the possible". It was never tried or even discussed. The Democrats made a a lot of unnecessary sacrifices and all we got was a Heritage Foundation scheme to make insurance companies and pharmaceuticals wealthier, with a few consumer protections as a candy coating for Liberals.

    "Given the choice between a Republican and someone who acts like a Republican, people will vote for a real Republican every time." Harry Truman

    by MargaretPOA on Mon Jun 16, 2014 at 05:06:53 PM PDT

  •  Been listening and talking about this since (4+ / 0-)

    the 1960s.  Where has everyone been?

    An idea is not responsible for who happens to be carrying it at the moment. It stands or falls on its own merits.

    by don mikulecky on Mon Jun 16, 2014 at 05:21:32 PM PDT

  •  And who, you ask, is the Commonwealth Fund? (1+ / 0-)
    Recommended by:
    A survey released today by the Commonwealth Fund ranks the United States dead last in the quality of its healthcare system compared to ten other developed nations. At the same time, it's also the most expensive in the world.
    And who, you ask, is the Commonwealth Fund?
    The Commonwealth Fund is a private U.S. foundation whose stated purpose is to "promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable" and the elderly. It is active in a number of areas related to health care and health policy. It is currently led by David Blumenthal, M.D.

    The Commonwealth Fund, one of the first foundations to be established by a woman, was founded in 1918 with an endowment of almost $10 million by Anna M. Harkness. The widow of Stephen V. Harkness, a principal investor in Standard Oil, Mrs. Harkness wanted to “do something for the welfare of mankind.”

    "I understand, Mr. Spock. The glory of creation is in its infinite diversity."

    by brainwave on Mon Jun 16, 2014 at 06:01:40 PM PDT

  •  Or more truthfully, 5th. (2+ / 0-)

    That's what it ranked in quality of care.

    The authors of this particular report very clearly put their thumb on the scale with the other measurements.  "Equity" penalizes access based on income, which is a feature of a private system, not a bug.  Many of the Equity data points also date from 2011-2012, so improvement in the interim is inherently impossible.

    "Efficiency" is based on % GDP spending, so that one is also a foregone conclusion.

    It's a political hit piece, basically.

    •  sure, (3+ / 0-)
      Recommended by:
      corvo, cslewis, cybrestrike

      5th for those that get healthcare. Perhaps that's what you are not getting about the report. Just because you don't like the results it does not make it a hit piece. The bottom line is that for what we spend, and if we are as good as many would like to believe we are, we should rank 1st and yet we don't. Look at it as plenty of room to improve not as a hit piece.

      Anyhow, if you have links to any other reports that contradict these findings I would love to see them. Here is a link (warning 213 page PDF) OECD report. We do well on some things and not so well in others but we spend more on health than anyone else.

      "The great enemy of the truth is very often not the lie -- deliberate, contrived and dishonest, but the myth, persistent, persuasive, and unrealistic. Belief in myths allows the comfort of opinion without the discomfort of thought." -John F. Kennedy

      by basquebob on Mon Jun 16, 2014 at 10:39:58 PM PDT

      [ Parent ]

  •  It's conservative legislating (2+ / 0-)
    Recommended by:
    basquebob, thanatokephaloides

    It's not necessarily the legislation itself that is conservative, because it can be done in a progressive way.  If you have non profits and you use a progressive tax structure to pay for the premiums.  

    It's like all legislating that gets done is based on the idea that people are generally cheaters, and we have to do everything we can to deter one cheater, and we have to over punish everyone, because one person wasn't punished enough one time.


    by otto on Mon Jun 16, 2014 at 07:14:08 PM PDT

  •  That's Why We Need a Publicly-Funded System (3+ / 0-)
    Recommended by:
    corvo, basquebob, Orinoco

    What made us think the U.S. system was so great? Well, other than a bunch of Republican candidates plugging it all the time.

    It needs to be replaced with a publicly-funded system that pays for all essential healthcare out of a progressive tax. That's how we get a sensible system that provides quality results at an affordable price for everyone in the country.

  •  For those of you who want single payer (2+ / 0-)
    Recommended by:
    Orinoco, Santa Susanna Kid

    see The VA. That's how well single payer works here in America. Yes, the outcomes for those in the system are much better than those in the general population, but the wait to actually get to see a DR is atrocious! Underfunded, understaffed, not enough facilities to handle the load. And they want to close some of those facilities!

    As a veteran who is forced to use the VA because I'm poor and live in a red state that refused expansion, I will always be vehemently opposed to single payer until the problems with the VA are fixed! Unless they prove they can fix it, then the VA is exactly what everyone will get under single payer. I'm pretty sure no one wants to be treated as badly as our service men and women!

    "Nothing travels faster than the speed of light, with the possible exception of bad news. Which follows its own special rules." ~ Douglas Adams

    by coyote66 on Mon Jun 16, 2014 at 11:43:23 PM PDT

    •  It's not a problem with single payer (6+ / 0-)

      It's a problem with underfunding. I live in a blue state, with adaquate VA facilities, and the health care I get from the  VA is wonderful.

      Granted, the VA's facilities haven't kept up with the shifts in where vets live, but despite everything, the VA has the highest patient satisfaction ratings of any health care available in the United States.

      If everyone in the United States got what veterans get from the Veteran's Administration, we'd be happy campers, because the VA does not provide health insurance, they provide health CARE.

      I'm sorry you have to experience those wait times you're complaining about, but opposing single payer is not going to solve that particular problem. Turning your state from Red to Blue, and getting the VA funded to take care of their entire workload will. Get out there and register people and get them to the polls.

      When we vote, we win.

      "The problems of incompetent, corrupt, corporatist government are incompetence, corruption and corporatism, not government." Jerome a Paris

      by Orinoco on Tue Jun 17, 2014 at 02:45:26 AM PDT

      [ Parent ]

      •  Absolutely! (6+ / 0-)

        "Health insurance" is a huge scamshamalam. We need Health Care; which means cutting the middleman grifter industry out. It's all bullshit; profit motive only...SSK

        "Hey Clinton, I'm bushed" - Keith Richards UID 194838

        by Santa Susanna Kid on Tue Jun 17, 2014 at 04:16:27 AM PDT

        [ Parent ]

      •  The problem isn't (0+ / 0-)

        red state vs blue state as far as the VA system goes. The biggest problem is the fact that they are still using the system first implemented in 1985! Do you even still have anything from 1985? Ok, I do, my HS diploma! But other than that, nada. The second biggest problem is the fact that the VA program can't talk with the DoD program. Can you imagine? Signing up for health care via the national web site and it can't talk with the insurance providers because the system used is so archaic?

        You'll notice that I did say that Vets get some of the best health care in America. You'll also notice that I said that the wait to actually see a Dr. is bad. Do you really think everyone would be happy with having to wait 30+ days to see a Dr, regardless of how well the service was once you actually get to see a Dr? Imagine some natural disaster with a large influx of people needing medical attention. And those people having to wait, in some cases, YEARS for treatment beyond the initial first responder/patch 'em up! This is the current state of the VA! I'm against single payer for a reason. That reason is: until they prove it can be done right, and how they prove it is by doing right by the veterans. Until they can prove that, well what we've gotten is what everyone will get, and believe me, you don't want it; even with the better overall outcomes.

        Support the Troops and Thank you for your Service, now go away!

        "Nothing travels faster than the speed of light, with the possible exception of bad news. Which follows its own special rules." ~ Douglas Adams

        by coyote66 on Tue Jun 17, 2014 at 06:49:19 AM PDT

        [ Parent ]

        •  I know researchers in this area. The main issue... (1+ / 0-)
          Recommended by:

          I know researchers in this area.

          The main issue really is letting people who don't believe in government underfund programs to sabotage their ability ti succeed and then later claiming see the programs don't work

          Its one of the flaws of incrementalism

        •  This is not the current state of the VA I go to. (0+ / 0-)

          Granted, I didn't see my MD for several weeks after I signed up with the VA, but while I was "waiting to see the doctor" I had about a dozen blood samples drawn for various tests; immunizations for flu, pertussis, diptheria, typhoid; got enrolled in a weight management program; had a growth removed from my ear which was biopsied; had x-rays and was seen by a podiatrist for a bump on my toe (a bunion, as it turns out); took an eye exam and got a new pair of glasses; and was screened for homelessness, depression, alcoholism and a few other things I don't recall because the nurse was so nice about it. I also was put on blood pressure and cholesterol medicatation as soon as the doctor reviewed my blood tests, which was a few weeks before I actually sat down in the same room with the doctor for my first exam.

          So I had one of these 'bad' waits for a doctor. Do you imagine I am unhappy about it? I am not. My doctor wants to see me twice a year for routine examinations. Last time I got a notice that I was due for an exam, the next available appointment was eight weeks away. Eight weeks!!! coyote66, this is for a routine physical. It's not an emergency.

          When I had an emergency, I called my nurse practitioner, who screens patients for my doctor, and came in for tests the following day. Had it been something that needed treatment, I would have been treated immediately.

          Vets here do not wait years after getting patched up in the VA emergency room. They are not 'stabilized' and then sent home to wait for a doctor. If they need further care, they move from the emergency room to the main hospital.

          I don't know what programs they are using to track things behind the scenes. From my observation of the hardware things are running on, the VA has the same kind of equipment as Kaiser Permanente and the private practice dentist who does my teeth.

          I do know BlueCross/Blue Shield, at least a while ago, was using a program that was limited to 80 character input strings, since that was all that fit on an IBM standard punch card back in the 60s.

          What I can't imagine is someone talking about the VA as if it were an insurance provider.

          Can you imagine? Signing up for health care via the national web site and it can't talk with the insurance providers because the system used is so archaic?
          This makes no sense to me. Veterans don't sign up for health insurance at some national web site. They sign up for health care at their local VA facility.

          I'm not saying it's red state vs blue state. I'm saying it's red congressmen and senators (Republicans, in other words) who are chronically underfunding the VA. We need to make it politically toxic for them to continue to do so, which means throwing them out of office, and letting them know the reason why.

          "The problems of incompetent, corrupt, corporatist government are incompetence, corruption and corporatism, not government." Jerome a Paris

          by Orinoco on Tue Jun 17, 2014 at 08:56:37 PM PDT

          [ Parent ]

          •  You missed my point (1+ / 0-)
            Recommended by:

            The DoD program that sets up outgoing soldiers as they transition to civilian life doesn't communicate with the VA system. They are too different from each other and were both set up before the internet was anything but a way for colleges and universities to communicate with each other (this was admitted to by an under Secretary of the VA in a hearing). This would be a rough analogy to signing up for ACA and having to wait for someone to print out and send a paper copy of your application to the insurance provider you chose. This is one of the reasons why there is such a long waiting list for veterans to get into the system.

            Yes I too have had a reasonable experience with the VA. I have issues with my thyroid, and I'm a little high on my cholesterol and blood pressure. I've gotten medicine for my thyroid and neither my cholesterol nor my blood pressure are bad enough that the PA (yes PA not Dr) isn't worried about it, yet. We're going the diet and exercise routine first.

            I've been out for near about 20 yrs now and I'm guessing you've been out for some time as well? The real problem is for those just getting out. The ones with brain injuries, lost limbs, PTSD, etc; those are the ones languishing. Waiting for processing so they can get into the VA system. If you really want to get a better grip on the story than I can provide, search youtube: Stewart VA. He nails not only the VA but congress.

            Yeah, you've got it exactly right. The R's in congress defunded the VA (among other things), and have until very recently refused to increase funding. There is hope with the McCain-Sanders bill in the Senate that funding will be increased, but I'm not really holding my breath that the House will do anything with it. And yes making it toxic for members of the Congress to continue down the "road to privatization" (which is what at least some do want) is the answer.

            "Nothing travels faster than the speed of light, with the possible exception of bad news. Which follows its own special rules." ~ Douglas Adams

            by coyote66 on Wed Jun 18, 2014 at 01:40:53 AM PDT

            [ Parent ]

            •  Jon Stewart the comedian? (1+ / 0-)
              Recommended by:
              Team Leftie

              As far as I can tell, there are two dimensions to the problem, and they seem to be conflated. One is vets getting actual health care for serious problems, getting prosthetic limbs, getting other health delivery related services. The second is vets getting approved for disability claims that provide some kind of monetary allotment.

              You are right, I've been out for a long time, and I had employer provided medical insurance (mainly Kaiser Permanente, which is the closest thing I can find to Navy medical care in the civilian world) for much of that time. And I did not get out with any kind of disability, so I have no experience with that side of the system at all.

              However, it seems to me that it's the disability claims processing system that has the biggest problems. And that system, from what I see on the news, seems to be overloaded with paperwork, partly caused by no electronic communications between DOD and the VA, and partly caused by a system that puts the burden of proof on the veteran.

              That one is systemic, ongoing, and isn't really subject to any kind of rapid solution, unless congress, like Major Major Major Major in Catch 22, simply stands at the head of the chow line and yells: "Let EVERYBODY eat!!"  Somehow, I can't see that happening, since a small difference in "percent disabled" adds up to a large amount of money over a veteran's lifetime.

              The VA's OTHER problem, and the one that ties into the debate on single payer, the ACA, 'Socialized Medicine' and so on, is wait times to see actual doctors, nurses or specialists to get actual health care.

              That particular problem varies with the available facilities and the distribution of veterans seeking services. Some facilities are overloaded, some are not. I happen to be in a location where the facilities are not overloaded.

              I'm pretty sure that if a veteran who needed treatment (not enrollement into the system) but actual-by-god medical treatment walked into the Long Beach Veterans Administration hospital, he'd be getting that treatment before the day was out. And vets like me, signed up for routine semi-annual physicals, might be bumped to a later date to make room for that vet.

              What I don't like to see, especially here on Daily Kos, is for the Veterans Administration's problems be all balled up in to one big sticky mess, which Republicans are sure to turn into a 'privatize the whole thing' talking point.

              "The problems of incompetent, corrupt, corporatist government are incompetence, corruption and corporatism, not government." Jerome a Paris

              by Orinoco on Wed Jun 18, 2014 at 08:45:18 PM PDT

              [ Parent ]

    •  My brother is a veteran also and often VA was a... (1+ / 0-)
      Recommended by:

      My brother is a veteran also and often VA was all he had when no insurance was provided by his employer.

      But the only problem with the VA is that it's funding continually gets cut to pay for endless stupid and pointless wars. One local vet who needs a lot of medications found out the hard way about the impact of the first Gulf War- he was told directly that his meds were no longer covered because the funds were diverted to keeping that war going. Programs helping veterans from Iraq/Afghanistan, who are surviving better than my brother's generation in Vietnam but their brains are still vulnerable physically and psychologically, have seen support programs for them and their families chronically underfunded. The military has a long history of treating soldiers like disposable kleenexes. Give them nice uniforms and medals while they are useful, give them minimal support when they are no longer useful. Really, we need to stop going for the new record in continuous warfare (that inevitably today's makes us less safe and just lines the pockets of the military industrialists and their pet politicians). I think the last record in Europe was set by the Hundred Year War. We've been at war since before I was born and I just qualified for Medicare. We're getting close to beating the old record.

  •  Especially for gravid women. (2+ / 0-)
    Recommended by:
    corvo, sillycarrot

    I would go out on a limb and say for anyone female period--especially adult women.

    "It were a thousand times better for the land if all Witches, but especially the blessing Witch, might suffer death." qtd by Ehrenreich & English. For Her Own Good, Two Centuries of Expert's Advice to Women pp 40

    by GreenMother on Tue Jun 17, 2014 at 05:03:51 AM PDT

  •  The Commonwealth Survey seems to (1+ / 0-)
    Recommended by:
    joe from Lowell

    exclude a number of 'developed countries'.

    What about Spain, Portugal, Iceland, Finland, Italy, Greece, Japan, Singapore, U.A.E., Saudi Arabia, Russia, South Korea, et al.

    The selection of countries chosen for this Survey seems to be quite random. Had they surveyed other countries health systems, they might have found a few that rank below the US.

    I don't by any means believe we have the best health care on earth here in the US. We are very good in certain areas and lousy in others. I would prefer a single payer system, but I think the ACA is a major step forward. It was and is the best of all possible health care systems for the US in 2014.

    I fully expect the ACA to transform our medical system over time, as it morphs into different iterations over time. I do think that this survey is irrelevant in evaluating the what ACA has and will do to improve the delivery of health care. Maybe we should look at it again a few years hence and see where the US has improved and where there is more work to be done.

    I do think that there must be better international surveys which actually include all developed countries, not a random group selected for reasons which are not explained.

    Here's my take on it - the revolution will not be blogged, it has to be slogged. - Deoliver47

    by OIL GUY on Tue Jun 17, 2014 at 07:27:18 AM PDT

  •  Chart (0+ / 0-)

    Do  you have a link to the chart on the Commonwealth site?  

    I haven't been able to find any current data. There is a similar comparison chart but it is from 2008.  


  •  I'll have what the UK ordered please. (0+ / 0-)

    Why can't we just copy what works best instead of reinventing the wheel? Badly!

  •  Commonwealth report Far Too Kind (0+ / 0-)

    This report is far too kind. The US Healthecare System is Far Worse. According to WHO, we ranked #36 in 2000. Their 2010 report was not released??
    In 2013 Bloomberg release their own 2012 study showing us to rank #46 out of 48 "civilized" countries. We were just behind Turkey and Iran, and just ahead of Serbia and Brazil.

    However, take heart all you Farout "righties",,, We were #1 in Cost - and this was BEFORE "ObamaCare"

    Bloomberg international healthcare ranking

  •  These results surprise me. (0+ / 0-)

    I'm not surprised that the US ranks lowest.

    However, I am surprised that the UK ranks highest. Not too many years ago, the UK was sending patients to Belgium and France because they didn't have the facilities to treat them. They had the money, but the infrastructure was shot, and hadn't yet recovered from Maggie Thatcher's rampage. Ding Dong the Witch is Dead

    I am further surprised that France ranks so low. During the 28 years that I lived in France, I and my entire family had nothing but excellent experiences with the French health care system, which is often cite as the best in the world.

    The 99% are watching.

    by unclejohn on Tue Jun 17, 2014 at 11:18:21 AM PDT

  •  Please change one of your editorial polices. (0+ / 0-)

    When you quote a study, give us a link to the study. Many of us, I'm sure, want to form our own opinion about what it says. We should not have to search for it.

  •  System? (0+ / 0-)

    What system?  What we have is a mish-mash of insurance companies out to make a profit.  That's a "system"?

  •  so the ACA launched in October 2014 (0+ / 0-)

    and the per capita numbers are from 2011.

    I'll be interested to see how the U.S. numbers are affected this year or the next.

    but don't let a dearth of current stats stop y'all from whining about the ACA - seems fashionable on kos these days. progressives, my ass.

    "Please proceed, Governor"

    by portlandzoo on Tue Jun 17, 2014 at 11:52:30 AM PDT

  •  If you wanted to form your own opinion you coul... (0+ / 0-)

    If you wanted to form your own opinion you could have googled it since this is not the only study

  •  Crown Jewels? (0+ / 0-)

    What, is selling off the crown jewels a serious option? Then by all means, DO get on with it!

  •  It fails because it's not "healthcare"... (0+ / 0-)'s the "Insurance Industry Welfare Program", otherwise known as another extortion racket...

    I'm sorry, but obamacare needs to be dismantled and transitioned to single-payer government-managed real-live BASIC HEALTH CARE.

    no boob jobs allowed...

  •  Healthcare (0+ / 0-)

    OK, so it is the worst of the 11 surveyed - again. But if you are an HMO bigwig or from Big Pharma these are halcyon days, indeed. Salaries and "compensation" are huge and there is no end in sight. It is very profitable to deny people treatment using arbitrary means while extorting maximum premiums for their "coverage".
     Back in the 60s a U.N. declaration  that was worked on by Eleanor Roosevelt stated that heath care was one of a series of basic human rights. The only "right" that seems to have dominated is the right of corporations to make a great deal of money from minimal healthcare.
     Once again, we are witness to the sham of the U.S. capitalist system. Canadians spend half as much per capita on healthcare and achieve better results. The creator of the Health Service in Canada, Tommy Douglas, is considered a national hero. Canadians consistently say that their health service is the thing about their country that they are most proud of. What we got was not healthcare reform but health insurance reform in the guise of Obamacare, a system to ensures that the profit motive is still the basis of healthcare in the U.S. But watch out, Canada, your current Prime Minister, Harper, is a corporatist. He is not only an energy industry hack who denies global warming but he also likes the U.S. healthcare system as well.
     I read recently that among an even larger group of countries surveyed that the U.S. healthcare system was rated number 36 just ahead of Slovenia. Take that, Slovenia!

  •  The UK NHS suffered its first privatisation (0+ / 0-)

    back in 1982, when cleaning and catering services were outsourced to private contractors. So, the privatisation of the NHS started over 30 years ago.

    There was a several-month-long strike over this, with COHSE - the then health workers union - stating that this was a precursor to wholesale privatisation of the NHS. Everyone and his dog called this alarmist, nobody believed COHSE, the union lost, and things have gone downhill ever since.

    Having said that, our NHS is still really good, and, as someone with long-term health problems (back trouble) I am very grateful than, for a few pounds a week from my pay when I'm working, I get what I do get.

  •  Billionaires get Excellent Healthcare (0+ / 0-)

    We have the most sophisticated healthcare apparatus and drugs in the world, but only billionaires can afford them.  It is no wonder we are last.  If a billionaire doesn't like his care here, he/she can have their private ambulance jet fly them anywhere in the world.  Didn't work out too well for Howard Hughes, but he wasn't your usual billionaire.

  •  I've always been insured during my life and yet... (0+ / 0-)

    I've always been insured during my life and yet, my husband and I had to file bankruptcy in 2009 and lose our home of 10 years due to my sudden health woes. Our deductible goes up every single year and is now at $3750/ind. which is still too high for our delicate situation. Having been extremely hard working people, it's like carrying a huge weight of shame and disappointment. Last year I was advised by urgent care to go to the ER for the trouble I was having. Needless to say, we've now got about $3600 in medical bills that I'm working on, but getting threats about getting sent to collections. If it weren't for my husband's job, we'd move to Canada or some other place because I'll most likely always have medical bills until I die. Big kicker, I used to work in the health care industry and have been fighting with it since I became ill. Good times.

    •  Most credit card debt is medical in the US. (1+ / 0-)
      Recommended by:

      The figures are probably worse now, but several years ago the figure was close to 50% credit card debt in the US is directly due to medical expenses not covered by insurance. Medical is also indirectly involved with a large chunk of the rest, as a reason people need to use cards to stay afloat when unemployed or underemployed or drowning in finance charges from past medical adventures. It took me five years to pay off my $15,000 UTI (really! Long story) plus what i had to borrow to keep paying bills when medical incompetence kept me out of action for months. Only a small inheritance let me finally put it to rest (or else several years later, I would still be paying it off). Most bankruptcies are related to medical expenses also. Our lack of sane access to medical care based on reasonable taxes is a huge burden on most of us. We are just one illness or injury away from financial disaster and are driven deeper into debt to try to survive. I've heard Europeans laugh at us for our credit card debt, but they assume it's for non-essentials. They don't realize it's for medical care and trying to avoid eviction. They get so much more than we do for their tax money.

  •  Shameful (0+ / 0-)

    I recall it was approximately 28th or so but, still the Most expensive.

  •  who the hell is. . . (0+ / 0-)

    . . .the "Commonwealth fund". I may like the assertion, but I question the study. . .my built in bullshit detector pegged.

    Just because we want something to be true, doesn't make it so.

  •  I could have told you THAT (0+ / 0-)

    Ever since turning everything over the the HMOs.
    I truly believe that the idea IS "if you get sick, die quickly".

    It's a "useless mouth" sorta of thing

  •  Insufficient polling size (0+ / 0-)

    `A survey released today by the Commonwealth Fund ranks the United States dead last in the quality of its healthcare system compared to ten other developed nations. At the same time, it's also the most expensive in the world.`

    There are more than ten developed nations in the world, and given a guess, the quality of our healthcare system would probably rank around #40.

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