Main topic is healthcare here.

Anonymous wrote:Almost every Westernized country says so. It’s (healthcare for its citizens) a sign of a civilized educated nation.

Yeah but the thing nobody wants to mention is how difficult is to immigrate to these countries compared to the US. I tried to see if I could work in Toronto after college - it was next to impossible, I didn’t have the right skills. I’m pretty educated and have a good job in the States.

Anonymous wrote:Almost every Westernized country says so. It’s (healthcare for its citizens) a sign of a civilized educated nation.

A sign of a civilized educated nation is when the full election cycle takes something like 2 months, so you're not in permanent campaign mode.

Another is when most people speak more than a language.

And when they control their borders. And when they don't discriminate human beings on the basis of skin color.

Almost every Westernized country says so. It’s (healthcare for its citizens) a sign of a civilized educated nation.

Anonymous wrote:Evidence Buillds for the ACA
Front page today’s Post

Universal healthcare is our future. And the right thing to do for our country. Just like Canada. The UK. Norway. Etc.

If WaPo says so, it must be true.

My mom on Medicare with a BCBS secondary gets excellent care. My employer sponsored plan is expensive and I pay a ton in copays and coinsurance. It’s basically a catastrophic plan.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sure. You won't specify the diagnosis so an actual comparison can be done here, though?

I'll give one but not the other (coincidence of two uncommon and unrelated illnesses being too telling) Spondyloarthritis. Four years and scores of doctors to diagnose. A painful disorder especially in initial stages. We were told repeatedly the pain was all in the child's head--obviously easier than trying to figure out a cause.

I am really sorry you and your child are dealing with this. It is a painful and debilitating disorder --as you well know! -- and early diagnosis makes a difference in long-term effects.

That being said, the average time from symptoms onset to diagnosis is longer in the US than in the European Union. The average in the US was 13 years and for the EU it was 8-11 years, as of about a decade ago. In more recent years, the US is somewhere in the 6-10 year range, and the average for the EU is right at about 7 years for the most recent data. That does not convince me that the US system is doing a better job for kids with AS than the EU.

https://link.springer.com/article/10.1007%2Fs00296-002-0237-4
https://acrabstracts.org/abstract/prevalence-of-axial-spondyloarthritis-in-the-united-states-among-patients-with-chronic-back-pain-and-other-spondyloarthritis-related-features/
https://www.usa.thisaslife.com/symptoms/ankylosing-spondylitis-patient-journey/

With a huge amount of persistence on my part I was able to bring this down to four years for my child because I was able to pursue alternative diagnoses among various medical providers under my insurance. With Medicare for All I question if this would be possible.

I recognize that Medicare for All likely would do a better job at controlling large disease problems like diabetes for the population as a whole. But I fear it would come at the cost of leaving children like mine on the cutting room floor for the greater good.

Under many people's insurance, provider shopping is not a covered option. If all physicians are providers under universal coverage, everyone can go to anyone who has time to see them.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why are people so convinced that healthcare drives health outcomes? Variety of factors go into health outcomes—especially factors generally outside of the healthcare system like diet, exercise and stress levels.

Has anybody actually shown that access to healthcare will cause health outcomes to improve. The worst possible case would be Euro costs/access and American outcomes.

Because preventative care makes a huge difference both in costs absorbed by all of us and in outcomes. Right now a large portion of our population relies solely on emergency rooms because they can't get preventative care so they can't get help until they are very sick.
Of course access to healthcare improves health outcomes.

Real preventative care takes place at the individual and family level. Requires zero healthcare expense.

Are you Republican by any chance?

DP. Obviously lifestyle choices affect health, but you can’t cure/prevent every condition just by exercising and eating a healthy diet, which is where preventative medical comes in. That’s not. Democrat vs. Republican issue, that’s a basic understanding of healthcare issue.

Evidence Buillds for the ACA
Front page today’s Post

Universal healthcare is our future. And the right thing to do for our country. Just like Canada. The UK. Norway. Etc.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sure. You won't specify the diagnosis so an actual comparison can be done here, though?

I'll give one but not the other (coincidence of two uncommon and unrelated illnesses being too telling) Spondyloarthritis. Four years and scores of doctors to diagnose. A painful disorder especially in initial stages. We were told repeatedly the pain was all in the child's head--obviously easier than trying to figure out a cause.

I am really sorry you and your child are dealing with this. It is a painful and debilitating disorder --as you well know! -- and early diagnosis makes a difference in long-term effects.

That being said, the average time from symptoms onset to diagnosis is longer in the US than in the European Union. The average in the US was 13 years and for the EU it was 8-11 years, as of about a decade ago. In more recent years, the US is somewhere in the 6-10 year range, and the average for the EU is right at about 7 years for the most recent data. That does not convince me that the US system is doing a better job for kids with AS than the EU.

https://link.springer.com/article/10.1007%2Fs00296-002-0237-4
https://acrabstracts.org/abstract/prevalence-of-axial-spondyloarthritis-in-the-united-states-among-patients-with-chronic-back-pain-and-other-spondyloarthritis-related-features/
https://www.usa.thisaslife.com/symptoms/ankylosing-spondylitis-patient-journey/

With a huge amount of persistence on my part I was able to bring this down to four years for my child because I was able to pursue alternative diagnoses among various medical providers under my insurance. With Medicare for All I question if this would be possible.

I recognize that Medicare for All likely would do a better job at controlling large disease problems like diabetes for the population as a whole. But I fear it would come at the cost of leaving children like mine on the cutting room floor for the greater good.

In Canada, you realize that you can see whatever provider you want in the province, since it is a single-payer system, right? There is no "in network" or "out of network." If you don't think your provider is aggressive enough, you go somewhere else without any barriers. And if you are a physician (like me), you just put out your shingle.

Now there are shortages of providers, but that is not due to their coverage plan, but to the tight control the Colleges keep on licensing.

Anonymous wrote:

Anonymous wrote:Why are people so convinced that healthcare drives health outcomes? Variety of factors go into health outcomes—especially factors generally outside of the healthcare system like diet, exercise and stress levels.

Has anybody actually shown that access to healthcare will cause health outcomes to improve. The worst possible case would be Euro costs/access and American outcomes.

Because preventative care makes a huge difference both in costs absorbed by all of us and in outcomes. Right now a large portion of our population relies solely on emergency rooms because they can't get preventative care so they can't get help until they are very sick.
Of course access to healthcare improves health outcomes.

Real preventative care takes place at the individual and family level. Requires zero healthcare expense.

Are you Republican by any chance?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sure. You won't specify the diagnosis so an actual comparison can be done here, though?

I'll give one but not the other (coincidence of two uncommon and unrelated illnesses being too telling) Spondyloarthritis. Four years and scores of doctors to diagnose. A painful disorder especially in initial stages. We were told repeatedly the pain was all in the child's head--obviously easier than trying to figure out a cause.

I am really sorry you and your child are dealing with this. It is a painful and debilitating disorder --as you well know! -- and early diagnosis makes a difference in long-term effects.

That being said, the average time from symptoms onset to diagnosis is longer in the US than in the European Union. The average in the US was 13 years and for the EU it was 8-11 years, as of about a decade ago. In more recent years, the US is somewhere in the 6-10 year range, and the average for the EU is right at about 7 years for the most recent data. That does not convince me that the US system is doing a better job for kids with AS than the EU.

https://link.springer.com/article/10.1007%2Fs00296-002-0237-4
https://acrabstracts.org/abstract/prevalence-of-axial-spondyloarthritis-in-the-united-states-among-patients-with-chronic-back-pain-and-other-spondyloarthritis-related-features/
https://www.usa.thisaslife.com/symptoms/ankylosing-spondylitis-patient-journey/

With a huge amount of persistence on my part I was able to bring this down to four years for my child because I was able to pursue alternative diagnoses among various medical providers under my insurance. With Medicare for All I question if this would be possible.

I recognize that Medicare for All likely would do a better job at controlling large disease problems like diabetes for the population as a whole. But I fear it would come at the cost of leaving children like mine on the cutting room floor for the greater good.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Sure. You won't specify the diagnosis so an actual comparison can be done here, though?

I'll give one but not the other (coincidence of two uncommon and unrelated illnesses being too telling) Spondyloarthritis. Four years and scores of doctors to diagnose. A painful disorder especially in initial stages. We were told repeatedly the pain was all in the child's head--obviously easier than trying to figure out a cause.

Yes. Many doctors are lazy and will always assume it’s a horse even if there is a hint of stripes. Not worth their time to determine if it’s a zebra. I’ve only met a handful of truly great physicians.

That’s why you always have to be your own best advocate - regardless of healthcare system.

This is one of the reasons why, for example, the Canadian pediatric gastroenterologist consortium is piloting a program that lifts out key diagnosis and lab codes to pre-emptively flag inflammatory bowel disease as a potential diagnosis for patients of primary care pediatric providers. (The diagnosis can be delayed by years, but does not average as long as AS -- and early diagnosis means less bowel is lost through eventual surgical removal.) You can do that when all payments are filtering through a single payer system, and "pre-existing conditions" is not a concern.

Mind you, Canada isn't perfect, and I'm not saying it is. There are definite problems with the system. There is also power and benefit to the system that happens at a level many are unaware of, and that influences the outcomes in real ways.

Anonymous wrote:Given how racism and socioeconomics impact everything in the US, isn’t it wise to worry about negative impacts of medical care rationing on low-income and people of color? I’m sure this must have come up in parts of Europe, right?

You mean the people who are least likely to have health insurance or access to healthcare under our current system?

Anonymous wrote:Given how racism and socioeconomics impact everything in the US, isn’t it wise to worry about negative impacts of medical care rationing on low-income and people of color? I’m sure this must have come up in parts of Europe, right?

I lived in the UK for a year and liked the national health service. While it’s not perfect, it’s miles better than the current US system where people of all colors die because they can’t afford basic care or fall into bAnkruptcy following a hospital stay.