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  #4581  
Old Posted Mar 4, 2021, 1:24 PM
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Originally Posted by Pedestrian View Post
This gets political but since the Moderator in Chief introduced the issue, the main shortcoming of the US healthcare system is access. Something like 90% of people have insurance and for them it's excellent and if they have good health insurance it's about the best in the world.

But for those without insurance it's very problematic. And the hodge-podge of payment systems generally is insane. Also, the really good care is pretty much concentrated in urban areas. Plenty of people in rural areas, especially in the West, live miles, even hundreds of miles, from fairly mediocre care.

So if you can access the system and someone else (government or insurer) is paying most of the bills, it's hard to beat . . . anywhere.

As someone who is retired military and on Medicare, I haven't paid a dime for healthcare in years and I've had a couple of major operations and spent several weeks in the hospital during that time. Also, I regularly see a specialist at UCSF which usually ranks in the top 5 or 10 hospitals in America which means among the best in the world (there's a reason the world's super-wealthy often come here for care).
Thanks. I’m aware of the dynamics but was simplifying for the sake of brevity.

But yes, as I have explained countless times to Brits, American healthcare is better than British healthcare for 90% of the population, and catastrophically bad for that small minority.

Fixing the latter issue is a better approach however than switching to a system more like the UK’s, where everyone has access to the same mediocre medical care (and really, because of limited resources and rationing, only the elderly have access to anything, whereas younger people are just told to rest and drink lots of water unless they have cancer).
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  #4582  
Old Posted Mar 4, 2021, 1:55 PM
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  #4583  
Old Posted Mar 4, 2021, 3:53 PM
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Originally Posted by 10023 View Post
America has excellent healthcare. It’s just expensive.

The UK literally does not have sufficient (or modern enough) hospitals, or enough nurses, to deal with high rates of hospitalisation. This isn’t just a Covid issue, it’s almost every winter flu season. See: https://www.theguardian.com/society/...-overstretched

And people aren’t getting Covid in restaurants, bars and gyms. Offices were responsible for more cases than all of those last fall, and the majority of cases by far are occurring in people’s homes. Just as in the US, there is media coverage of higher rates of infection in minority communities, but this is mostly because big South Asian families have 14 people over for Sunday lunch and they all get Covid.

If anything, the fact that basic NHS healthcare is free further reduces the disincentive to take risks created by the prospect of huge medical bills.
People absolutely are getting COVID in restaurants, bars, and gyms. Especially bars and gyms, each of which have documented cases of super spreader activity.
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  #4584  
Old Posted Mar 4, 2021, 5:41 PM
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Originally Posted by Pedestrian View Post

For this, other states and international situation: https://www.bloomberg.com/graphics/c...-distribution/
This is nice but I’m concerned we are going to hit a ceiling some time this summer, with all of those dolts who will refuse the vaccine
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  #4585  
Old Posted Mar 4, 2021, 5:48 PM
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Originally Posted by Pedestrian View Post
This gets political but since the Moderator in Chief introduced the issue, the main shortcoming of the US healthcare system is access. Something like 90% of people have insurance and for them it's excellent and if they have good health insurance it's about the best in the world.

But for those without insurance it's very problematic. And the hodge-podge of payment systems generally is insane. Also, the really good care is pretty much concentrated in urban areas. Plenty of people in rural areas, especially in the West, live miles, even hundreds of miles, from fairly mediocre care.

So if you can access the system and someone else (government or insurer) is paying most of the bills, it's hard to beat . . . anywhere.

As someone who is retired military and on Medicare, I haven't paid a dime for healthcare in years and I've had a couple of major operations and spent several weeks in the hospital during that time. Also, I regularly see a specialist at UCSF which usually ranks in the top 5 or 10 hospitals in America which means among the best in the world (there's a reason the world's super-wealthy often come here for care).
Yeah, I've always heard that there are three goals of healthcare to be good:

1. Access
2. Quality
3. Affordability (which relates to access)

America has an amazing quality, we just suck in the other two categories.
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  #4586  
Old Posted Mar 4, 2021, 5:52 PM
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Originally Posted by the urban politician View Post
This is nice but I’m concerned we are going to hit a ceiling some time this summer, with all of those dolts who will refuse the vaccine
Ah, I am not too worried about that.

First, most of the people refusing the vaccine probably aren't 65+, so this should keep our deaths low.

Second, most people in dense cities will get their vaccines, which have been hot spots for spread.

Third, and this is messed up, the rest of us will be vaccinated, so...Darwin and all.
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  #4587  
Old Posted Mar 4, 2021, 8:11 PM
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Efforts to limit spread of COVID have just about eliminated flu this year. In a big way that's reassuring--to me it shows most of us are doing what we should do to stop COVID.


Newsletter, AZ Dept of Health Services
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  #4588  
Old Posted Mar 4, 2021, 10:56 PM
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Originally Posted by Pedestrian View Post
Efforts to limit spread of COVID have just about eliminated flu this year. In a big way that's reassuring--to me it shows most of us are doing what we should do to stop COVID.


Newsletter, AZ Dept of Health Services
Also really drives home how much more contagious COVID is than the flu!
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  #4589  
Old Posted Mar 5, 2021, 4:24 AM
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Originally Posted by SIGSEGV View Post
Also really drives home how much more contagious COVID is than the flu!
Covid measures effectively killed the flu. I don't think I've even had a cold since I started working from home a year ago. Those crammed cubicle farms really are a germ bath.
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  #4590  
Old Posted Mar 5, 2021, 5:56 AM
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https://www.bbc.com/news/world-us-canada-56288038

Quote:
Baby bust: US birth rate falls during pandemic

US births have been falling for nearly a decade and 2019 saw the fewest births in 35 years, but the final numbers for 2020 could slip even lower.

An estimated 300,000 fewer babies are expected in 2021, according to a study by Brookings Institution think tank.

It comes as the pandemic has created a turbulent labour market that has disproportionately hurt working women.
Quote:
Surveys revealed that many couples are delaying pregnancies, having sex less often and want fewer children because of the pandemic and its economic costs, according to the Guttmacher Institute.
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  #4591  
Old Posted Mar 5, 2021, 2:34 PM
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Originally Posted by jtown,man View Post
Ah, I am not too worried about that.

First, most of the people refusing the vaccine probably aren't 65+, so this should keep our deaths low.

Second, most people in dense cities will get their vaccines, which have been hot spots for spread.

Third, and this is messed up, the rest of us will be vaccinated, so...Darwin and all.
I am relying on anecdotes for this one, but just in the past week I saw multiple patients over 65 who seemed very reluctant to get vaccinated.

My aunt and uncle living in Queens, NY are also very reluctant to get the vaccine, and they are in their 80’s
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  #4592  
Old Posted Mar 5, 2021, 4:57 PM
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Originally Posted by jtown,man View Post
More people over 100 have died in the US from Covid than people aged 40-49. Comparing the young dead to 9/11 numbers is insane. We have more 100-year-olds who have died from Covid in the US than everyone who died on 9/11. That's a crazy statistic seeing as 100-year-olds make up a TINY portion of our population. But we keep trying to get young people scared. It's silly. It's why the news keeps posting stories of kids dying from this. Why? Statistics show kids are the best equipped to fight this off yet they keep scaring parents into submitting to irrational ideas.
As stated, older age groups and those with pre-existing conditions will be more susceptible to succumbing to the virus because their weaker immune systems are less able to mobilise an effective response. I think some are failing to see the wood for the trees, irrelevant of age or condition, any loss of life where preventable is unacceptable.

That the number of victims in the US who have succumbed to Covid-19 within the 25-34 age group is similar to the toll from 9/11 shouldn't be seen as insane or fear mongering, but a dire perspective of the inadequate response to this disaster. This isn’t even a problem unique to the US, the UK and countless other so-called developed countries have failed their citizens. The shambolic response to this crisis is going to have ramifications lasting decades.


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Originally Posted by 10023 View Post
But yes, as I have explained countless times to Brits, American healthcare is better than British healthcare for 90% of the population, and catastrophically bad for that small minority.

Fixing the latter issue is a better approach however than switching to a system more like the UK’s, where everyone has access to the same mediocre medical care (and really, because of limited resources and rationing, only the elderly have access to anything, whereas younger people are just told to rest and drink lots of water unless they have cancer).
”Told to rest and drink lots of water” , this is a poor attempt at comedy surely…

The NHS is far from being a utopian healthcare service provider and it has significant issues to resolve, but this ”mediocre” system ends up with average life expectancies 3 years above of those in the US, despite per capita healthcare expenditure being a staggering 2.3x higher in the US. Those exorbitant medical costs are inflated out of all proportion, even for basic drugs and procedures. Those same excessive costs and grossly inefficient medical insurance sector probably go a long way to explaining why medical costs are the leading contributor behind bankruptcies in the US are; a staggering half a million families per annum.

If this crisis has demonstrated anything, it is when you strip the politics out and let the NHS get on with managing healthcare - as it is with the Covid-19 vaccination programme - it excels. The UK is third in the world for vaccinations (33.0 per 100 people); far ahead of most of Europe and a third higher than the US.
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  #4593  
Old Posted Mar 5, 2021, 6:44 PM
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Originally Posted by the urban politician View Post
I am relying on anecdotes for this one, but just in the past week I saw multiple patients over 65 who seemed very reluctant to get vaccinated.

My aunt and uncle living in Queens, NY are also very reluctant to get the vaccine, and they are in their 80’s
What reasons do they give and were you able to talk sense into them?

Frankly, I am coming to accept that we will just have to go with Darwin in quite a few of these cases. Vaccinate or, well, you know. The "fittest" are getting their shots.
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  #4594  
Old Posted Mar 5, 2021, 7:01 PM
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Originally Posted by iheartthed View Post
People absolutely are getting COVID in restaurants, bars, and gyms. Especially bars and gyms, each of which have documented cases of super spreader activity.
Far fewer cases are coming from these places than from people meeting inside their own homes. That’s based on actual studies, not the ill-informed pronouncements you repeatedly make. (I still can’t believe you suggested their was a vaccine for Spanish flu in 1918).

Offices are also a much larger source than these places that have been closed:
https://www.bbc.com/news/uk-55843506
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  #4595  
Old Posted Mar 5, 2021, 7:04 PM
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Originally Posted by nito View Post
As stated, older age groups and those with pre-existing conditions will be more susceptible to succumbing to the virus because their weaker immune systems are less able to mobilise an effective response. I think some are failing to see the wood for the trees, irrelevant of age or condition, any loss of life where preventable is unacceptable.
The "it's their immune system" thing is only part of it and when you're talking about 90+ individuals, maybe the least of it. These people have very tenuous respiratory and circulatory systems as well. It doesn't take a lot of the sort of stress that COVID causes to just cause multiple system failure.

Quote:
That the number of victims in the US who have succumbed to Covid-19 within the 25-34 age group is similar to the toll from 9/11 shouldn't be seen as insane or fear mongering, but a dire perspective of the inadequate response to this disaster. This isn’t even a problem unique to the US, the UK and countless other so-called developed countries have failed their citizens. The shambolic response to this crisis is going to have ramifications lasting decades.


”Told to rest and drink lots of water” , this is a poor attempt at comedy surely…

The NHS is far from being a utopian healthcare service provider and it has significant issues to resolve, but this ”mediocre” system ends up with average life expectancies 3 years above of those in the US, despite per capita healthcare expenditure being a staggering 2.3x higher in the US. Those exorbitant medical costs are inflated out of all proportion, even for basic drugs and procedures. Those same excessive costs and grossly inefficient medical insurance sector probably go a long way to explaining why medical costs are the leading contributor behind bankruptcies in the US are; a staggering half a million families per annum.

If this crisis has demonstrated anything, it is when you strip the politics out and let the NHS get on with managing healthcare - as it is with the Covid-19 vaccination programme - it excels. The UK is third in the world for vaccinations (33.0 per 100 people); far ahead of most of Europe and a third higher than the US.
People who don't live in the US, and even many who do, simply don't understand the place.

It's a huge country with huge empty places--places where the nearest little community hospital may be hundreds of miles away and there may be no doctor at all. I once was sent by the state of Florida to staff a little clinic in a house trailer in a part of the state where there were no practicing doctors in 4 adjacent counties (and, of course, no hospital). Florida is not one of our most rural states. There are even very affluent communities--one I can think of is among the homes of the Walton family who own Walmart--that have pretty rudimentary medical services. In the case I'm thinking of, if you need real specialty care you have to be FLOWN out to get it.

The simple remoteness of medical care and the lack of sophistication about medical matters in some portions of the population accounts for a lot of the lower life expectancy rates IMHO. COVID is an example--anyone who has COVID needing hospitalization and showing up at a capable hospital is going to be provided care regardless of insurance or other ability to pay. But if you don't HAVE a local hospital or if you are stubborn and think you can tough it out, you won't get care.

As far as the treatment given people for whom cost or accessibility is not any issue, in the case of COVID, in the early days, there wasn't much unless you needed mechanical respiratory support. People need to accept that even with modern science, we don't have specific therapies for everything and especially in the case of entirely new diseases, it often takes a while to understand the pathophysiology well enough to know what to do for them. Actually, the learning curve with COVID has been very steep. Consider that in ONE YEAR we have effective monoclonal antibody therapies (and one of the scandals is those aren't being used enough), multiple highly effective vaccines and we understand the role the immune system plays in the disease and how to modify it much better than we did a year ago. Far from having to be embarrassed, the biomedical sciences of today have a lot to be very proud about.

Where there has been failure has been where most of us would have expected: The economics of it all. In countries like the UK, governments have simply been too parsimonious with their medical systems. In countries like the US, in order to avoid what Americans see as Brave New Worldish government control, a creaky and wasteful system of payment has been created (although, remarkably, we have a parallel system for the elderly called Medicare that works very well yet we refuse to extend it to everybody).
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  #4596  
Old Posted Mar 5, 2021, 7:05 PM
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Originally Posted by nito View Post
”Told to rest and drink lots of water” , this is a poor attempt at comedy surely…

The NHS is far from being a utopian healthcare service provider and it has significant issues to resolve, but this ”mediocre” system ends up with average life expectancies 3 years above of those in the US, despite per capita healthcare expenditure being a staggering 2.3x higher in the US. Those exorbitant medical costs are inflated out of all proportion, even for basic drugs and procedures. Those same excessive costs and grossly inefficient medical insurance sector probably go a long way to explaining why medical costs are the leading contributor behind bankruptcies in the US are; a staggering half a million families per annum.

If this crisis has demonstrated anything, it is when you strip the politics out and let the NHS get on with managing healthcare - as it is with the Covid-19 vaccination programme - it excels. The UK is third in the world for vaccinations (33.0 per 100 people); far ahead of most of Europe and a third higher than the US.
Clearly I’ve hit a nerve. That’s what happens when you question national myths.

I don’t know a single person who has experienced both the US and UK healthcare systems and doesn’t prefer the US. All of these people had insurance in the US, of course. Brits just don’t know what they’re missing, and think having to show up at the local GP nearest their home address in the middle of the workday to sit in a dilapidated waiting room in order to ask for a referral to see the specialist they already know they need to see is normal (for example).
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  #4597  
Old Posted Mar 5, 2021, 7:26 PM
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Originally Posted by 10023 View Post
Clearly I’ve hit a nerve. That’s what happens when you question national myths.

I don’t know a single person who has experienced both the US and UK healthcare systems and doesn’t prefer the US. All of these people had insurance in the US, of course. Brits just don’t know what they’re missing, and think having to show up at the local GP nearest their home address in the middle of the workday to sit in a dilapidated waiting room in order to ask for a referral to see the specialist they already know they need to see is normal (for example).
What an American finds fascinating about the British system (and are we getting too close to "politics here"?) is some of the ancient buildings, albeit modernized inside to some extent I'm sure, still in use.

In CA, there's a law that every hospital in the state has to be "seismically safe" by 2030 (I believe is the date)--capable not only of withstanding the maximal predicted earthquake but continuing to function. Since many of the older buildings would be very expensive to bring up to this standard, a very high proportion of hospitals in the state are being replaced, not rebuilt. In San Francisco, at least 4 of the hospitals are or will be brand new. And these buildings are totally different from the hospitals of past eras. Mostly, they contain only private rooms (often with facilities for relatives to stay in the room with the patient). Many of the rooms can be set up with negative pressure to make them suitable for isolating infectious people (as for COVID). Naturally, all the equipment, operating suites and the rest are brand new. And they are designed for maximum efficiency so that nurses sitting at their station can monitor many more patients (often with the help of electronic monitoring equipment) than in older facilities.

In the rest of the US, the dominance of privately owned hospitals means those in a community compete. It's not a totally efficient competition because the typical sick person isn't competent to judge hospital quality, but their doctors decide for them. And they can judge the hospital based on things like the comfort of rooms (again, those private rooms) and quality of food (excellent chefs are getting common too). Typically, the BUILDINGS in many communities are privately owned (often by public REIT corporations) while the actual medical care is managed by a non-profit company or medical group) though in some cases the whole thing is for-profit. But it's all kept modern and up to current standard because patients have alternatives and hospitals in urban communities get reputations for be good places for care or bad.

Then there's the training of the doctors. It's pretty simple. Doctors come from around the world for US training and many US specialists these days were born abroad (as with tech, South Asia seems an especially common place of birth) and trained in the US. I don't think there's any question that the best of US care is the best there is. The average standard is, of course, lower but certainly as good as the average in other developed countries. And for those sophisticated enough to seek it out, the best is accessible because it's usually at a teaching hospital that's part of the state public university system (which means it takes Medicare, Medicaid and just about all other forms of insurance).
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  #4598  
Old Posted Mar 5, 2021, 7:31 PM
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Originally Posted by 10023 View Post
Far fewer cases are coming from these places than from people meeting inside their own homes. That’s based on actual studies, not the ill-informed pronouncements you repeatedly make. (I still can’t believe you suggested their was a vaccine for Spanish flu in 1918).

Offices are also a much larger source than these places that have been closed:
https://www.bbc.com/news/uk-55843506
White collar offices have mostly been closed in the U.S. for a year, while gyms have been mostly opened. I'm not sure what point you're trying to make.

Quote:
C.D.C. Traces Covid Outbreaks in Gyms, Urging Stricter Precautions

Public health officials on Wednesday urged gym-goers to wear masks when they work out and to remain six feet apart, as new research described the rapid spread of coronavirus infections during high-intensity exercise classes at gyms in Honolulu and Chicago.

...

At a gym in Chicago, Dr. Teran and his colleagues identified 55 coronavirus infections among 81 people who attended high-intensity, in-person fitness classes between Aug. 24 and Sept 1.

...

In Hawaii, public health investigators linked 21 infections to a 37-year-old male fitness instructor in Honolulu who taught at several facilities and developed symptoms of Covid-19 — body aches, chills, headache and cough — at the end of June, according to a C.D.C. report published on Wednesday.

https://www.nytimes.com/2021/02/24/h...outbreaks.html
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  #4599  
Old Posted Mar 6, 2021, 3:27 AM
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Add a third state, Connecticut, to the list of states to 100% open. Masks are still mandatory, and physical distancing is still required.

https://www.ctpost.com/news/coronavi...e-16000493.php
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  #4600  
Old Posted Mar 6, 2021, 6:15 PM
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Originally Posted by iheartthed View Post
White collar offices have mostly been closed in the U.S. for a year, while gyms have been mostly opened. I'm not sure what point you're trying to make.
In the UK, the advice has been to work from home, but some people and companies have still been going in to the office. For example call centres haven’t seemed to figure out a work from home setup (as simple as this should be). And even with a very limited number of white collar employees going to their offices, there were still more infections stemming from these environments in the fall than from all of the leisure activities that were open then but have been closed again.

Restaurants have been really unfairly penalized throughout. It’s a scandal.
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