"Why Not the Best" The 2008 National Scorecard on Healthcare

[SpiritKeeper]

i would be interested to see what positive results this scorecard saw within the american system. Sure the insurence system is bollocks - but does that affect the quality of care? Within britain we have private health insurence agencies - as well as the national health service. those who want to can go private if they want and in all likelyhood they get more attention - but the quality of the proceedures and doctors is the same.

[ICharmaine]

@SpiritKeeper There have been several studies done by other researchers and agencies that shows that quality of care does vary amongst those that are insured vs those that are uninsured "The Institute of Medicine" has done research and released several reports on the subject. "The Kaiser Family Foundation" has done research related to it. Then there are also several individual peer-reviewed studies that also back up health care disparities related to being uninsured.

[SpiritKeeper]

@ICharmaine

i know the reprieve has said it is important to maintain personal responsibility - but if someone gets turned away from insurence because of a pre-existing condition, its rather hard to take those steps. So this bill should help them - or at least it will come 2014, in the meantime some insurers continue to turn their nose up. In the case of conditions people are born with - it flat out lacks compassion to tell them to go it alone.

[ICharmaine]

@SpiritKeeper Yes, many argue that the brunt of the uninsured here in the USA are poor and should take personal responsibility, as well as it will be like giving them a handout. However this isn't the case. In fact, many of the uninsured are blue-collar workers. And that is a good point you make rearding infants born with illnesses

[ICharmaine]

@SpiritKeeper "In the USA uninsured adults rated highest at going without needed care and/or experiencing fragmented or disconnected care ; 74% having difficulty receiving care after hours, 26 percent experiencing delay in obtaining medical records, 26 percent not receiving test results and/or not having tests explained, 35 percent significantly more likely to leave the office without having questions answered (Huynh, Schoen, Osborn, & Holmgren, 2006).

[ICharmaine]

@SpiritKeeper A Report put out by The Kaiser Commission on Medicaid and the Uninsured in 2003 documented that 35% of the uninsured experienced needing care, but did not get it; and 37% did not fill a prescription because of cost (The Kaiser Family Foundation, 2003).

[ICharmaine]

@SpiritKeeper Reference for this study: Huynh, P. T., Schoen, C., Osborn, R., & Holmgren, A. L. (2006, April). The U.S. health care divide: Disparities in primary care experiences by income. Retrieved April 7, 2006 Sorry but the comment section won't let me post the link, but I can send it to you if you want it.

[thereprieve]

More issues as I study this scorecard:

Under "The Right Care" heading, an indicator was "children received recommended immunizations and preventive care". Most health departments in the US provide free immunizations. Many more parents, as they get informed on the dangers of vaccinations, are choosing to not vax their children. So the statistics relating to this figure will be misleading...

more to come...

[thereprieve]

It also gives high marks for patients leaving hospitals with prescriptions? First of all, no man-made artifical drug cures a natural disease. Second, leaving the hospital without a prescription can (and most likely is) a good thing.

[thereprieve]

"Medical, Medication, and Lab Errors Among Sicker Adults."

Those who were insured ranked within the margin of error over those that are uninsured. So, again, how does government takeover of healthcare solve a problem like this? Most of these mistakes are made beacuse a doctor attempts to treat so many patients in one day. When every American can drop by the doctors office whenever he/she wants, do you think this number will decrease?

[thereprieve]

I have found SO much more that this healthcare bill does nothing to address. I have taken up enough of your comment section. Hopefully others will join the discussion or take me to task on what I've said so far.

Until then, take care!

[ICharmaine]

It's nice to see that you are doing research on this. I like this! However, not all the points you address are related to the topic at hand and the reason for the health care bill, which is the access to care piece (ie uninsured/underinsured)

[ICharmaine]

The fact still remains that 75 million people in the USA are either uninsured or underinsured.

[ICharmaine]

@thereprieve You have to understand what is being graded with regard to this. Sometimes people DO NEED medicine. There are studies that link reoccurance of illness as being related to lack of proper treatment, as well as education on the medicines.

[ICharmaine]

Oftentimes uninsured aren't provided with needed prescriptions

[SpiritKeeper]

@thereprieve

informed of the dangers of immunisation?

hmm

[thereprieve]

My initial research on The Commonwealth Fund finds that their mission statement is "to promote a high performing health care system that achieves better access, improved quality, and greater efficiency". So when they write a "scorecard" and find deficiencies in efficiency, access, and quality, should we be suprised?

If my mission was, say, to get a better car, would you be suprised that my "scorecard" on my current vehicle was poor?

[thereprieve]

On that scorecard, the US ranks last in infant mortality. I can give you literally hundreds of reasons that this is true, none of which relate to access to healthcare or insurance. My wife and her mother are in the "child-birth" business. M-I-L is a OB/Gyn, and my wife is a Doula, studying to become a midwife. Why is it, do you suppose, that infant mortality in midwife care is less than 1% compared to doctors?

[ICharmaine]

I understand the point you are making here, and it is correct, however, a portion of infant mortality rates also comes from lack of good prenatal care related to being uninsured. I am quite certain that your wife and MIL can back this up.

[thereprieve]

@ICharmaine - My wife has vowed, as many midwives do, to not turn away women seeking her care. As a Doula, she has yet to decline a client on the basis of her ability to pay. In fact, it bacome a tax write-off for a doctor or a midwife to work like this, it then becomes charity. I will ask my MIL what her policy is and get back to you.

[ICharmaine]

So, you are claiming that they are bias? Actually, their goal was to see improvement within the results of this study, but instead they found deficiencies. This is not the only organization that has reached these figures. Furthermore their resoucres come from various agencies, like CDC & WHO. Are you going to call every organization that does research out there biased just to account for your point of view? If you can give me a day or so I will get out all of the other research I have on this.

[thereprieve]

@ICharmaine - Every medical study has a bias to some degree. The best way to understand is to ALWAYS follow the money. See who invested in this research. Learn that person or groups agenda, and you will learn a lot about the outcome.

I will read whatever information you want to send to me. Keep in mind that my opinion, like yours, will be biased as I read it. But I promise to be as open minded as I know how to be when I do formulate a response.

[ICharmaine]

@thereprieve Do you have a problem with The Institue of Medicine Research?

"uninsured adults have a 25% greater mortality risk than adults with coverage, and it is estimated that approximately 18, 0000 excess deaths among people younger than age 65 are attributed to lack of coverage every year. They are more likely to receive too little care, too late; therefore they present as sicker and die sooner (IOM, 2004, p. 1).

[ICharmaine]

@thereprieve reference for IOM:

The Institute of Medicine (2004, Updated January 13). Fact sheet 5. Uninsurance facts and figures. Sorry but the comment section won't let me post the link. I'll send it to you if you want it.

[ICharmaine]

@ICharmaine Plus, I am sure there is now an updated one