I wasn’t as clear as I could have been in my previous post regarding Canadian emergency departments.
The intent of the posts was not to say that one system is “better” than the other. Comparing two completely different medical systems and declaring one “better” is similar to comparing a Hummer to a VW Bug and declaring one “better.” Different people will have different opinions depending on the needs of the user. Where a Hummer would be “better” for towing a boat, a VW Bug would be better for saving money in gas. Similarly, American and Canadian medical systems (as well as others around the world) each have their pros and cons.
When I said that we are kidding ourselves if we think care will be better, I was referring to the silliness of the concept that, once medical care is nationalized, the US will have less waits, more comprehensive care, and a lower price. Because wait times are hitting the headlines in the US right now, I illustrated that wait times are also bad in Canada where they have a national health system, but I didn’t really expand on my thought process. As several people noted in the comments, neither system is perfect.
An article just published in the New York Times illustrates the concept better.
Americans spend more than twice as much on healthcare as many countries in Europe, but we still have a huge void providing care to those who need it. To expand services, we must cut costs. There is no way around it. Cutting costs will necessarily cut services being provided.
Are we ready to give up our designer medications and immediate access to comprehensive testing so that more people have access to care? Are we ready to pay more for the treatment we receive?
As David Newman states in the NY Times article:
“You can make policy changes till you’re blue in the face, but if patients and doctors don’t change the way they think about medicine, we’ll never change medicine.”
We’ll find out soon whether the experiment works.
As an aside, Emergency Physicians Monthly is fortunate to have Dr. Newman as one of its new contributors. He is author of the book “Hippocrates’ Shadow” and is a talented writer. I’ll link to his articles in EPM when they’re published.
Yep – the whole philosophy of how we (the lay public and MD’s) view medicine and health care has to change dramatically or else we are bound to be unhappy and unfulfilled with any new system.
“Are we ready to give up our designer medications and immediate access to comprehensive testing so that more people have access to care? Are we ready to pay more for the treatment we receive?”
For those of us who don’t have need of these things..it is probably a no brainer to say..yes.
But as a patient who has need of these timely tests or procedures..at this time in her life..I don’t know.
It won’t be up to me though.
Do you think that Americans would be more at risk for untreated cancers or other semi/emergent yet elective care because they are on waiting lists for medical services/treatments? Is that what is headed our way?
Do the doctors being consulted for the implementation of the socialized health care have the best interest of medicine and the public in mind..or are they sell outs to a greater agenda?
Throckmorton has an interesting post about “I would love to see is medicine practiced for the good of both the individual and the community” but he has concerns regarding “a nominee for Health and Human Services ” http://throckmortonsothersigns.blogspot.com/2009/02/bogotiphication-by-attorney.html
I just don’t have confidence that the powers that be will take everything into consideration and do what is best for the good of all..which may not be “free” health insurance.
Then again..you all say how our current system is broken.
I know I always say this..but I do wish you blogging docs and other health care professionals could start a grass roots organization so that YOUR voices could be heard too and possibly impact for the better any changes coming our way in the medical system.
And I DO hope..they read the Health plan BEFORE they pass it!
It shouldn’t be about rushing agenda through, but about what is good for the people and our country.
OOOOOh, I love Dr. Newman. He’s great. I had the good fortune to rotate in the emergency department at which he works!
Ugh. Stop talking about US healthcare as a “system.” It’s people providing professional services and medical products to consumers. When you start talking “system” you imply something so big that only the government can fix it, and that means fix it by taking it over.
US healthcare is primarily physicians selling their time and knowledge to each individual consumer. Unfortunately, physicians have given up the right to negotiate the price with the consumer in exchange for the security of negotiating with an entity they know will pretty much always be solvent and can pay, either an insurer or the govt. Still, though, that’s not a “system”. It’s just a bad choice that ought to be undone before it’s too late.
Our economic system is undergoing a “contraction” to correct itself in some part due to people living large and beyond their means. I see healthcare heading that same direction. Massive workups for minor complaints and a pill for every ailment has gotta go. aches and pains are a part of life, kids run fevers, you’re probably gonna pee more often when you get older and grandma isn’t gonna live for ever. Get a grip america, we’ve turned into pansies whose every discomfort must be diaganosed and treated. I may understand how a plane flys but that doesn’t mean I get to be a pilot. eat less, exercise more, stop smoking..keep it simple stupid.
we need to change our expectations, not just our habits. i’m an ER attending in a mid-sized city. the patients in our busy downtown shop all want what they want, right now, and have no concept of what constitutes an emergency. i think this is a very american mentality, where if you don’t get what you want, you just threaten to sue. a woman recently called 911 because her local mcdonald’s just ran out of chicken mcnuggets and she was unhappy (a great example of poor health habits AND unrealistic expectations of public services. she was cited for inappropriate use of 911).
I read ‘but if patients and doctors don’t change the way they think about medicine, we’ll never change medicine.’ as we are using too much medicine and need to get used to using less. So is that an advancement? We’ve spent all this money on these technologies and drugs to make us feel better and live longer and be healthier, but now that it costs too much we should give it up?
The article quotes that as a whole we spend $8,160 a year on health care. Is that really a lot? Compared to what? Is your life/health worth that much?
It’s one thing to expect people to give up unhealthy habits such as over eating and smoking to improve their health, but to ration healthcare because it too expensive for some, that doesn’t sound good to me.
“CYA” Diagnostic testing will continue to drive the cost of care as long as the threat of multi-million dollar settlements looms in the air.
Patients may compromise or change their attitude towards the medications they receive but they will always look for someone to blame for bad outcome. “A little knowledge is dangerous” someone said, and that is so true in todays information overloaded society. Nowadays, almost everybody claims to be an expert at something.
Direct patient advertising of medications is probably one of the worst idea ever, in IMHO.
Wrong blog entry I know but I believe you were keeping up with the Wyeth Phenergan lawsuit. Well they lost so there are now effectively 50 FDAs(well 51 if you count DC, and not sure how many territories) and going to be nearly impossible to do locums work outside of 1 or 2 states as its hard enough to keep up with one state, let alone a dozen.
HyperAl
Keep your voice down. Matt doesn’t believe that lawyers are a problem. He really doesn’t think there is such a problem as defensive medicine. You really don’t want to challenge him… just leave him be…
hahahaha..I love lawyers. I wouldn’t dream of challenging any of them. Why…just last week I attended another funeral….ah, just foolin’ they’re OK. They need to eat and feed their families too. The law is the problem.
Shhhhhhhh!…..No healthcare reform will work without significant tort reform, again IMHO.
Actually, I didn’t say that there weren’t any lawyers who were a problem. I’m sure there is “defensive medicine”, you just have to define it. What’s not clear is that the CYA mentality actually works to CYA.
As for no healthcare reform working without “significant tort reform”, California already has “significant tort reform”. How’s their healthcare?
I think it’s all or nothing. So now they have to reform their healthcare system. Lawyers have their own definition of what is significant.
Everyone has their own definition of what is significant. Yesterday’s meeting at the White House was the beginning of the end for physicians, they just don’t realize it. They’re too busy worrying about lawyers.
Heck Matt, were not worried about lawyer or at least I’m not.
If it’s true that the end for physicians is near then that will be great. I can take care of myself and I can take care of my family. Who’s going to take care of you and your family.
I certainly hope you’re right. From you lips to God’s ears.
We’ll take care of ourselves just as people have always done. Besides there will still be doctors. They will just be employees of the federal govt. I don’t know too many physicians with the business sense to transition to other careers so to take care of yourself and your family you’ll still practice medicine.
Then it is not the end as you said.
“The article quotes that as a whole we spend $8,160 a year on health care. Is that really a lot? Compared to what? Is your life/health worth that much?”
I’d like to see the breakdown of the money spent by income level.
My bet…..that $8160/year is more heavily spent by those making less than $30,000 per year!