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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Alastair McIntosh who wrote (11375)	11/16/2009 5:33:21 PM
From: i-node	Respond to of 42652

Thanks. Having read only the conclusion, it almost sounds defensive -- as though the authors set out to PROVE America doesn't have the best health care in the world. The conclusion itself certainly has no reference to factual information that would seem to support the conclusion, but perhaps that is provided in the full report, I don't know. For example, they say -- that U.S. physicians’ practices are more limited in information capacity, provide less patient access outside of traditional work hours, and are among the least likely to work in teams or to receive financial rewards for quality, all factors that could bear on the quality of primary care furnished. No idea what is mean by limitations in "information capacity", but the rest of the paragraph is really just a regurgitation of the WHO conclusions. All factors that could bear on the quality, etc. Then, they shoot themselves in the foot with this -- In particular, there is no data or evidence by which to answer the question of whether the United States is a place where one finds health care that exceeds the quality of the best care available elsewhere in the world — in other words, whether the “best U.S.health care is the best in the world.” So, in effect, this is a non-conclusive conclusion. Oh, well. Thanks for posting it anyway. Was working and didn't want to stop and wade through it.

To: Alastair McIntosh who wrote (11375)	11/17/2009 7:42:28 AM
From: Lane3	Respond to of 42652

Let me start by saying that I am not among those who claim the US has the world's best healthcare and I won't argue that question. "and less well in others — such as mortality from conditions amenable to prevention and treatment" What I will argue is the framing of the question. For those inclined toward a nanny approach to health care, the above represents a failure of the health care system. For individualists, of whom there are many in the US, it represents an individual failure of responsibility and is only a marginal reflection on the health care system. The answer to the broader question is largely a function of what you consider to be the scope of the health care system. I have argued here repeatedly that judging in on political factors is utterly inappropriate. Judging it on how well it handles prevention IMO is less inappropriate but not of the weight with how well it handles emergencies and critical illnesses, where it has control. As someone experienced with performance management systems, I know that it's iffy to judge anyone or any program on things outside their control. One of the many problems with prevention in the US is the fault of the agriculture system and the politics surrounding it. Sure, US patients pay the price for that but attributing that price to the health care system is not analytically sound.