Healthcare & rationing

[Skipjack]

I think I already proved that. I'm guessing our nurses are better, too.

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But please, show me the statistic that says that yours are better


I've already posted several.

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Transplants per capita dont count. As you put it, we might simply need less of those


Ha, not twice as few. Face it, you just can't afford them. We can.

I have not seen any statistics that say your doctors are better than ours.
Yes, twice as few. There is no reason for anyone not getting a transplant here (it does not cost anything and the government pays for all and especially life saving measures), sorry AND I have not even seen the statistics that say you have twice as many transplants per capita than Austria, btw.
Our medical doctors are world renowned, actually. We are a small country, but we are world leaders in several areas of medical technology. Laser brain tumor treatment was developed in Austria, e.g.

[TallDave]

I have not seen any statistics that say your doctors are better than ours

Sure you have. The cancer survival rates. The MRIs per capita. The innovation numbers. The Nobels. Our doctors do much better diagnostics than yours.

Yes, twice as few. There is no reason for anyone not getting a transplant here

LOL no, I don't think we just "need" twice as many. Let's not play dumb, there is a very good reason: you can't afford them. We give them to people you wouldn't.

http://en.wikipedia.org/wiki/Organ_tran ... mographics

it does not cost anything

Ah, the eternal delusion of the socialist. There is no free lunch. Everything costs something. It's just a question of who pays.

[Skipjack]

That is a ridiculous thing to say and you are the one who is playing dumb here my friend.
None of these statistics say anything about the quality of the doctors, sorry.
Our country has 8 million inhabitants, yours has 300 million. Naturally you have more Nobel laureates and you contribute a higher percentage to the worlds medical science.

We can very much afford transplants, of course we can. Noone has been declined a transplant here for financial reasons, that is ridiculous!
Actually it would be a public outcry here, if that happened!
The number of transplants depend more on the number of donors and the number of patients that require a transplant. If you dont have a donor, the best doctor can not do a transplant. Sorry, but your assumptions here are just plain ridiculous and childish.

[Skipjack]

I should also add, that I dont see any numbers for Austria here. Putting Austria into a bag with the rest of Europe would be like putting the US into a bag with Mexico.

[TallDave]

That is a ridiculous thing to say and you are the one who is playing dumb here my friend. None of these statistics say anything about the quality of the doctors, sorry.

Sigh. So despite having worse outcomes, you claim your system is superior because you have more doctors doing a worse job. I'm starting to think you're from another planet rather than another country.

We can very much afford transplants, of course we can.

No, you can't. You don't spend enough.

Noone has been declined a transplant here for financial reasons, that is ridiculous!

Of course they have. They don't tell you that, of course, they say they were too old or too sick. But gov't does not have unlimited funds. Hard choices must be made.

Maybe Austria does more transplants than most of Europe. I doubt they're at the U.S. number, though.

[Skipjack]

Dude, that is ridiculous. Noone is Austria is denied a life saving procedure out of monetary reasons. The same is true in Germany. I have two doctors in my family (father and sister) that will hapilly confirm that to you. I really wonder where you are getting this horror delusions from!
People even get (non life saving) cornea transplants here and often without wait time actually (my cousin got one in an emergency procedure and that was 25 years ago!)

What worse outcomes do we have? Cancer is not everything, there is also heart desease and other illnesses. Show me the statistics for those.
In the "preventable deaths" statistics, the US is way behind us.

[TallDave]

Did you not see the statins statistics? We get better heart disease care too.

Dude, that is ridiculous. Noone is Austria is denied a life saving procedure out of monetary reasons.

Of course they are, everyone is in every system. Resources are finite and all health care is of marginal benefit; it's just a question of where you draw the margins. Do you give an 80-year-old a new kidney? We do more MRIs, more transpants, give more statins, etc.

[Skipjack]

And let me emphasize this again: The number of transplants also depends on the amount of transplantable organs that you have available. Without enough organs you cant do transplants. The US has a lot more people die from gunshot wounds than we have. I assume that the heal organs of these deaths make for usable transplants, though I might be completely off here. I would have to ask some people about that.

[Skipjack]

Well, we must have more resources for healthcare than you think. People get procedures financed by the government here that I would never allow to be payed for. This includes sex changes and cosmetic surgery (you simply need to find a shrienk that says you need it for psychological reasons, since our socialist idiots believe that crap, they pay for it). That is actually one of my big points of critizism about our system. The system is more expensive than it has to be, because a lot of bullshit is being paid for that should not be.
Transplants and MRI are definitely not bullshit and they get paid for, of course. I have yet to encounter an instant where an MRI was denied. Note that I make software for MRI and CT data and so I get into contact with that a lot.
I had an MRI myself for something as harmless as a nasal polyp.

[TallDave]

Our country has 8 million inhabitants, yours has 300 million. Naturally you have more Nobel laureates and you contribute a higher percentage to the worlds medical science.

I was speaking of Europe in general. Europe has more people than the U.S., yet:

Since the mid- 1970s, the Nobel Prize in medicine or physiology has gone to U.S. residents more often than recipients from all other countries combined. In only five of the past thirty-four years did a scientist living in the United States not win or share in the prize. Most important recent medical innovations were developed in the United States

Anyways, that "only 8 million" and "better than Europe" thing cuts both ways. I can pull out, say, Minnesota, as a comparable region here, and the difference in LE disappears despite our higher IM standards.

[Skipjack]

Yes, but as I said earlier, judging Austria by using the values of all Europe, would be like throwing the US and Mexico into one bag, maybe even worse actually. There are many countries in Europe that are not doing well. Especially countries of the former eastern block. They are also much poorer. They of course also lower our other statistics like science and technology.
So be careful with that.

[TallDave]

Transplants and MRI are definitely not bullshit and they get paid for, of course.

You can only do as many MRIs as you have machines to do them. So you're either not doing them as often as we are or waiting longer or both.

But I"m not sure you follow the marginal issue. Let's say there's only a .00001% an MRI is going to find something (say for instance patient just has a mild headache, not chronic). Do you do the MRI? Well, no, because there's only one chance in a million you find something useful.

Now realize, this means one time in a million you are missing something useful. But since you don't have an infinite supply of MRIs you have to make cost/benefit decisions.

So where do you draw the line? .1%? 1%? 10%? To some extent the answer must be limited by the availability of MRIs.

[gblaze42]

. Naturally you have more Nobel laureates and you contribute a higher percentage to the worlds medical science.

Yes you should ask why though? It's typically because the US is focused on the pursuit of Research and Development as compared to most other countries.

Almost 50% of the worlds Nobel winners are from the US.
http://www.nationmaster.com/graph/peo_n ... -laureates

If we were to adopt some form of social medicine this would be drastically changed and we would literally become much like Europe, as some would say, "past our glory days" and others would call "has-been's"

All due respect, 9 months isn't much. My wife is also from the US. That is just one view of 300 million, you'll need some than that to get a good understanding of what life is like here.

[vankirkc]

Transplants and MRI are definitely not bullshit and they get paid for, of course.

You can only do as many MRIs as you have machines to do them. So you're either not doing them as often as we are or waiting longer or both.

But I"m not sure you follow the marginal issue. Let's say there's only a .00001% an MRI is going to find something (say for instance patient just has a mild headache, not chronic). Do you do the MRI? Well, no, because there's only one chance in a million you find something useful.

Now realize, this means one time in a million you are missing something useful. But since you don't have an infinite supply of MRIs you have to make cost/benefit decisions.

So where do you draw the line? .1%? 1%? 10%? To some extent the answer must be limited by the availability of MRIs.

I'll link this again since you obviously didn't read it last time:

http://www.npr.org/templates/story/stor ... d=89626309


You keep going on about MRI machines as if it is some kind of conclusive proof of superiority. That article there, which is based in fact, says Japan enjoys 2x the actual scans per capita as the U.S. I think that's a more relevant metric, don't you?

Having more machines doesn't matter in the slightest if they're mostly idle?

[MSimon]

Transplants and MRI are definitely not bullshit and they get paid for, of course.

You can only do as many MRIs as you have machines to do them. So you're either not doing them as often as we are or waiting longer or both.

But I"m not sure you follow the marginal issue. Let's say there's only a .00001% an MRI is going to find something (say for instance patient just has a mild headache, not chronic). Do you do the MRI? Well, no, because there's only one chance in a million you find something useful.

Now realize, this means one time in a million you are missing something useful. But since you don't have an infinite supply of MRIs you have to make cost/benefit decisions.

So where do you draw the line? .1%? 1%? 10%? To some extent the answer must be limited by the availability of MRIs.

I'll link this again since you obviously didn't read it last time:

http://www.npr.org/templates/story/stor ... d=89626309


You keep going on about MRI machines as if it is some kind of conclusive proof of superiority. That article there, which is based in fact, says Japan enjoys 2x the actual scans per capita as the U.S. I think that's a more relevant metric, don't you?

Having more machines doesn't matter in the slightest if they're mostly idle?

Not really. Fully utilizing the machines would be inefficient in terms of the practice of medicine. You need open slots to handle emergencies and variations in the (hopefully short) que.

It is like any factory. If it operates at the 99% utilization level any small disruption will cause material to pile up.

Ideally the utilization factor should be such that the average time to process a "unit" is small.

So in fact "wasting" resources can give a better outcome if done intelligently. It is the principle behind the Just In Time (JIT) factory. [I'm surprised no manufacturing engineers have jumped in here. I guess as a contractor I have been very lucky. I have been exposed to many facets of business. My employers educated me. Of course I have been a willing student. On one of my first EE jobs I learned how to troubleshoot a production line. Very short version: look for the places material is piling up and find out why. Fix the problem if it is machinery or method. Load balance - i.e. try to find the best way to deploy the available labor. ]

Any one familiar with the ins and outs of an Ethernet bus could explain it. To get maximum throughput in a multidrop bus you keep loading generally at or below the 10% level. You can go higher (~ 80%) if the bus is strictly point to point.

If you keep the loading high with a priority scheme there are some messages (people) that will never get through. Which is one reason why the internet can't guarantee delivery of a given packet especially at high load times.

If the Japanese are getting 2X the MRIs per machine the Americans do (did I read that right?) the Americans probably have a better system in terms of medicine. And we have that all important surge capability.

A really high quality medical system is not going to rate high in terms of use of resources. Machines will sit idle and doctors will be overpaid (it attracts brains with the requisite manual dexterity to the field). Of course those same symptoms in a different system could be signs of waste.

So are Americans getting their money's worth? About 80% of Americans with health insurance think so. Cut that back to about 60+% for all adult Americans.

So what is to be done? Fixes at the margins only. No grand schemes. Treat it like a business - keep the happy customers. Figure out how to attract new ones.

Looking at raw numbers (life expectancy) is a mug's game. You have to go deeper (the critical one is survival rates for various problems and other things - like % of the population needing treatment that actually get it in a timely fashion).

I'm sure the rest of the wold (because they are poorer) can't afford the waste that makes the American system so efficient in terms of outcomes.

Perhaps a little cowboy capitalism is in order. It might mean better medical treatment.