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  #4581  
Old Posted Mar 4, 2021, 7:49 AM
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Originally Posted by 10023 View Post
America has excellent healthcare. It’s just expensive.
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).
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  #4582  
Old Posted Mar 4, 2021, 8:04 AM
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Sounds like you aren't/ weren't into the nightclub scene but that doesn't make its hypothetical demise a good thing. Bars, nightclubs and the hospitality industry in general has been decimated...and they were what put a lot of people especially in places like South Florida to work.
I am convinced the reason the twenty-something recent grad techie crowd seems to be fleeing the cities is because they are DEAD. San Francisco feels literally like there should be tumbleweeds blowing down Market St.

People flocked there because (1) there were plentiful well-paying jobs and (2) the place was a fun place to live, especially if you were young and single, whether gay or straight. It was a gourmet paradise, and there was nightlife aplenty. And besides tech, tourism was about the largest economic sector.

Mostly the tech jobs still exist, except you can do them from almost anywhere including Idaho. The restaurants are closed to indoor dining though many have been saved by elaborate outdoor "mini parks". But some have gone under and more may before its over. Meanwhile, the bars and clubs are closed completely; the Symphony/Opera/Ballet (all world class in the "before days") are shut down; there is no theater, live or filmed. And property crime is out of control, from shoplifting to vandalism to burglary. Many businesses are shutting permanently just because they are being robbed blind (there are reasons for this beyond COVID but the empty streets and lack of business aggravates things). And the hotels are closed except the ones the city has filled with the homeless.

I left myself . . . for Arizona where it's easier to isolate (single family home vs middies condo building) and I'm not missing anything because in SF it's all closed anyway. The city just dropped from California's "purple tier"--the worst--to red which allows them to open up restaurants again and also museums, but with lowered occupancy. I've got my fingers crossed that when I go back in April there'll be some life in the old girl.
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  #4583  
Old Posted Mar 4, 2021, 8:08 AM
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2 million shots a day? That is certainly something to be happy about! This thing should be over in no time.

As far as being optimistic about our urban environments? I am far from it. I know we have all shared our opinions on what the future might hold, but I am anything but convinced it will be pretty.

For this, other states and international situation: https://www.bloomberg.com/graphics/c...-distribution/
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  #4584  
Old Posted Mar 4, 2021, 10:49 AM
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Brazil is at 11 million doses, 7.5 million people vaccinated. Watching the US and the UK that were on their worst moments when the program started, Brazil has a painful way ahead. Even today there are too many deaths in the US and the UK. Brazil registered almost 1,900 deaths yesterday. The worst day so far.

About things on the ground, the entire São Paulo state receeded to the “red phase”, when only “essential services” operate such as supermarkets, drugstores, etc. Restaurants and bars only for delivery. Schools will be opened, as they were closed since March 2000.
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  #4585  
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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  #4586  
Old Posted Mar 4, 2021, 1:55 PM
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  #4587  
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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  #4588  
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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  #4589  
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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  #4590  
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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  #4591  
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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  #4592  
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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  #4593  
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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  #4594  
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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  #4595  
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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  #4596  
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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  #4597  
Old Posted Mar 5, 2021, 6:44 PM
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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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  #4598  
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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  #4599  
Old Posted Mar 5, 2021, 7:04 PM
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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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  #4600  
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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