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Post by Fingerplucked on Oct 24, 2012 10:16:13 GMT -5
The Japanese model sounds great, but they have a few things going for them that we don't. Condensed population--Easier to manage a socialized system when the physical boundaries of your nation are small. Homogeneous population--(Mostly one race of people with one set of typical diseases to battle) Healthier population--(I don't recall ever seeing a fat Japanese person, aside from Sumo Wrestlers. I also haven't heard much about high rates of smoking, alcoholism, or drug addiction, though I might not have been paying close enough attention.) Better family planning--I may be wrong, but I think in Japan it's still frowned upon to bring children into the world you can't afford to take care of. Socialized medicine in America is at a disadvantage in every category I listed. Freedom to us is putting whatever we want into our bodies, having children as early and often as we want to with as many partners as we choose to, sitting in front of a TV instead of exercising, and buying a pill to fix everything. (And I say this as someone who could stand to lose quite a few pounds myself. ;-) The numbers will never add up in such a way that everyone can pay into a single gov't managed plan, keep doing whatever the hell they want to their bodies, and live forever. That's the only socialized medicine that would ever meet with approval in America. According to the WHO: JapanTotal population 126,536,000 Gross national income per capita (PPP international $) 34,610 Life expectancy at birth m/f (years) 80/86 Probability of dying under five (per 1 000 live births) not available Probability of dying between 15 and 60 years m/f (per 1 000 population) 86/42 Total expenditure on health per capita (Intl $, 2010) 3,204 Total expenditure on health as % of GDP (2010) 9.5 U.S.Total population 310,384,000 Gross national income per capita (PPP international $) 47,310 Life expectancy at birth m/f (years) 76/81 Probability of dying under five (per 1 000 live births) not available Probability of dying between 15 and 60 years m/f (per 1 000 population) 134/78 Total expenditure on health per capita (Intl $, 2010) 8,362 Total expenditure on health as % of GDP (2010) 17.9 From what I can see, Japan seems to have an alcoholism problem on par with ours. I don't know about drugs. My motivation for tracking down everything you said in your post is less than yours should have been. This part strikes me as wrong, but I'm not going to bother trying to fix it: "Homogeneous population--(Mostly one race of people with one set of typical diseases to battle)" My gut tells me that racial diversity would provide better, not worse health. But my gut has been wrong before. Condensed population: This would lend certain efficiencies, but would also cause quicker and more widespread disease; as soon as one guy sneezes, the whole country catches a cold. We also have a market over twice the size of Japan's, and should reap cost rewards based on that alone. At best, I would call this factor a wash, not an advantage for Japan. Better family planning: I don't think there are any government programs driving family planning. Abortion was (re)legalized in the 50s. Birth control pills weren't made legal until 1999. Abortion is an accepted form of birth control in Japan and accounted for about 1/3 of all pregnancies in 1990. In 2002 the number of abortions had dropped around 25%. I'm not sure where it's at now. I'm also not sure that there's much of a distinction between Japan and the US, other than the higher abortion/lower BC pill rates.
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Post by loopysanchez on Oct 24, 2012 11:20:36 GMT -5
What exactly mean when you say your motivation is less than mine should have been?
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Post by Marshall on Oct 24, 2012 14:30:23 GMT -5
Obesity statistics: www.nationmaster.com/graph/hea_obe-health-obesity# 1 United States: 30.6% # 2 Mexico: 24.2% # 3 United Kingdom: 23% # 4 Slovakia: 22.4% # 5 Greece: 21.9% # 6 Australia: 21.7% # 7 New Zealand: 20.9% # 8 Hungary: 18.8% # 9 Luxembourg: 18.4% # 10 Czech Republic: 14.8% # 11 Canada: 14.3% # 12 Spain: 13.1% # 13 Ireland: 13% # 14 Germany: 12.9% = 15 Portugal: 12.8% = 15 Finland: 12.8% # 17 Iceland: 12.4% # 18 Turkey: 12% # 19 Belgium: 11.7% # 20 Netherlands: 10% # 21 Sweden: 9.7% # 22 Denmark: 9.5% # 23 France: 9.4% # 24 Austria: 9.1% # 25 Italy: 8.5% # 26 Norway: 8.3% # 27 Switzerland: 7.7% = 28 Korea, South: 3.2% = 28 Japan: 3.2% "Healthcare, schmealthcare," pass the pizza.
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Post by loopysanchez on Oct 24, 2012 14:36:08 GMT -5
Thanks, Marshall. That was the main point of my earlier rambling and hypothesizing. Americans want to have their cake and... nah, too easy.
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Post by jdd2 on Oct 24, 2012 16:48:23 GMT -5
FP's and Marshall's posts are fine, but Bruce is right, too (at least for here)--google malpractice japan and you'll see that rewards are low, and that lawyers ask for up-front fees to begin a case rather than working on contingency. (and some horror stories) And the cases sometimes go on forever, and three-judge panel decides, not a jury, and the panel can and does call its own experts, rather than relying on either side's picks.
But also that malpractice insurance is spread evenly over all docs, rather than OBGyn or one type of surgeon or some other specialty being singled out for exorbitant rates vs the comparatively risk-free.
Following Marshall's link to Japan-specific health data, some of it looks completely right (1st in # of doc visits/yr, beds per 1000), but Japan's suicide rate is always characterized as quite high, and the stats in that link don't seem to confirm that.
Obesity: recently japan decided that a BMI of 25+ was the obesity threshold, not 30. I don't think that's reflected in that 3.2%.
Probably since it is a skewed snip of the overall population (more affluent, and able to afford study abroad) some of the Chinese at my uni can be quite heavy.
My wife will be back tonight from a 10-day trip to Indiana & Chicago. (uni-level cultural exchange), and I wonder if she'll comment on people's size.
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Post by timfarney on Oct 24, 2012 17:30:36 GMT -5
The whole malpractice thing has always been a tempest in a teapot. Is there a problem? Sure, sometimes. Whenever you let people sue other people in a free system folks will take advantage of it. But as a % of the cost of healthcare in America, it ain't squat.
Tim
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Post by Deleted on Oct 24, 2012 18:34:25 GMT -5
In the UK we are fat as hell, we have "socialized medicine", it works for us and we love it except when we sue them for fucking up.
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Post by brucemacneill on Oct 24, 2012 18:56:22 GMT -5
In the UK we are fat as hell, we have "socialized medicine", it works for us and we love it except when we sue them for fucking up. Is the U.K. "Loser pays", as in if you sue and lose you pay the other guys expenses as well as your own?
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Post by Supertramp78 on Oct 24, 2012 19:08:42 GMT -5
The whole malpractice thing has always been a tempest in a teapot. Is there a problem? Sure, sometimes. Whenever you let people sue other people in a free system folks will take advantage of it. But as a % of the cost of healthcare in America, it ain't squat. Tim Medical malpractice payouts are less than one percent of total U.S. health care costs. All “losses” (verdicts, settlements, legal fees, etc.) have stayed under 1% percent for decades. Malpractice premiums are also around 1%. In 2004, the CBO calculated malpractice costs amounted to “less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small. Not sure exactly why smart people keep looking at tort reform as a way to save healthcare.
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Post by Deleted on Oct 24, 2012 19:31:08 GMT -5
In the UK we are fat as hell, we have "socialized medicine", it works for us and we love it except when we sue them for fucking up. Is the U.K. "Loser pays", as in if you sue and lose you pay the other guys expenses as well as your own? I think 'no win, no fee' is the way it usually goes with meritorious suits. I don't know a lot about legal fees in medical malpractice suits though. Sorry, Mama Google may help.
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Post by frazer on Oct 25, 2012 4:49:20 GMT -5
Is the U.K. "Loser pays", as in if you sue and lose you pay the other guys expenses as well as your own? I think 'no win, no fee' is the way it usually goes with meritorious suits. I don't know a lot about legal fees in medical malpractice suits though. Sorry, Mama Google may help. Yes, ambulances are also chased in the UK. Every second commercial on tv seems to be for a no win, no fee law company. But how could anyone argue against a health system that produced two such fine people as me and James? ![;)](//storage.proboards.com/forum/images/smiley/wink.png)
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Post by jdd2 on Oct 25, 2012 5:21:52 GMT -5
Big pro: Ambulances are free here.
Big con: They have only primitively 'trained' paramedic staff. Basically just a ride to the hospital.
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Post by millring on Oct 25, 2012 5:59:08 GMT -5
It isn't just malpractice payouts that drive up the cost -- it's malpractice insurance. As Nassim Nicholas Taleb points out in "Black Swan", the cost of prevention is quite often, even if irrationally, tied to the possibility of catastrophe (or the huge law suit), not the probability that it will happen again. That's why insurance companies make money. You don't carry $1,000,000 liability on your homeowners insurance because you are likely to be sued -- the facts are, you are very UNlikely to be sued. But you carry $1,000,000 liability because someone, somewhere, was once successfully sued and it COULD happen to you.
There doesn't have to be a payout for the expense to be exponentially higher than it needs to be.
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Post by millring on Oct 25, 2012 6:00:16 GMT -5
But how could anyone argue against a health system that produced two such fine people as me and James? ![;)](//storage.proboards.com/forum/images/smiley/wink.png) I KNEW it!!! You guys come from the bottom of a long glass tube...........and you didn't even wait for the year 2525!
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Post by brucemacneill on Oct 25, 2012 6:03:07 GMT -5
This is from www.medicalclaims.co.uk/page4.html and appears to say that if you sue and lose you would be required to pay the successful defense's expenses (I assume the amounts are in pounds ): "The next hurdle is funding. Clinical negligence claims are particularly expensive to litigate because of the time needed by your solicitor to obtain and investigate the medical records, find a suitable medical expert or experts, consider the expert�s opinion and, possibly, instruct a barrister. Initial investigation costs alone could exceed �5,000. In the rare case which goes to court, with medical experts giving evidence on each side, your own costs could well exceed �100,000 and the defence costs could be almost as much. So the total financial risk could be �200,000. If you win, most of your costs, provided they are reasonable, would be recoverable from the defence. If, however, your claim failed then under our legal system you would be ordered to pay the costs of the successful defence. If you are funding the case personally that would be in addition to your own costs. Thus, until quite recently a relatively minor injury could, once it got into the hands of the legal process, become a human tragedy of horrific proportions."
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Post by timfarney on Oct 25, 2012 6:15:50 GMT -5
It isn't just malpractice payouts that drive up the cost -- it's malpractice insurance. As Nassim Nicholas Taleb points out in "Black Swan", the cost of prevention is quite often, even if irrationally, tied to the possibility of catastrophe (or the huge law suit), not the probability that it will happen again. That's why insurance companies make money. You don't carry $1,000,000 liability on your homeowners insurance because you are likely to be sued -- the facts are, you are very UNlikely to be sued. But you carry $1,000,000 liability because someone, somewhere, was once successfully sued and it COULD happen to you. There doesn't have to be a payout for the expense to be exponentially higher than it needs to be. Evidently you missed Tramp's post: Tramp, I think it's that they are being distracted from the real issues by even smarter people who don't want to solve the real problems. Tim
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Post by millring on Oct 25, 2012 6:17:17 GMT -5
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Post by brucemacneill on Oct 25, 2012 6:23:42 GMT -5
Let's see, 1% is about 26 billion bucks. It's a start.
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Post by timfarney on Oct 25, 2012 7:23:26 GMT -5
Let's see, 1% is about 26 billion bucks. It's a start. Unless you pretend it's a solution and keep offering it up as one. Tim
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Post by brucemacneill on Oct 25, 2012 7:48:03 GMT -5
Let's see, 1% is about 26 billion bucks. It's a start. Unless you pretend it's a solution and keep offering it up as one. Tim I don't recall ever saying, or thinking for that matter, that it was a solution, just something liberals tend to overlook when comparing healthcare systems. With trial lawyers a big funding mechanism for Democrats, socialized medicine, with its ramifications, isn't possible in the U.S. because you can't sue government employees for actions taken in the course of their duties.
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