Tag: International

QUALITY/INTERNATIONAL: More confusing international comparisons

I don’t know much about medical care, but I do remember that in Lynn Payer’s Medicine and Culture the most amusing factoid was that German doctors put people whose blood pressure was too low on medication to raise it. Does that mean that the study of blood pressure control reported on by the AP, which suggests that it’s lower here because of more aggressive prescribing than in 4 other countries, means anything in terms of reducing poor health outcomes? I doubt it. What about in increasing or reducing costs? I suspect you can guess my answer!  Here’s the abstract.

This stuff always reminds me of the Philip Morris study of the costs of smoking in the Czech Republic. Hint: smoking lowers societal costs cause the smokers pay more taxes than anyone else then die off quick before they cost the taxpayers much!

INTERNATIONAL/POLICY: Canadian health care must be better!

If I was David Gratzer or John Graham’s alter egos I’d be using these two stories to good effect.

The first one one proves that Canadians are getting healthier and living longer than before they had a universal single payer system. And this one shows that your typical heart transplant patient from Canada ends up so healthy that he climbs huge mountains in Antarctica, and the only reason he didn’t get to the top is that the two doctors escorting him up couldn’t keep up the pace!

So by extrapolation the Canadian system must be perfect! With evidence like that, I should write a few op-eds saying so!

OFF-TOPIC: Which side of the great divide is more intelligent and civilized?

Apparently Gywnny’s dissing her heritage

But the question remains: was Gwyneth Paltrow on to something when she noted (or didn’t) that “the British are much more intelligent and civilized than the Americans,” and that “people here don’t talk about work and money; they talk about interesting things at dinner”? Whether Britons are objectively cleverer and more amusing than Americans, or whether they just sound that way, is one of the deep mysteries of British life for expatriates like Ms. Paltrow, who lives in London with her husband, the British rock star Chris Martin, and their children, Apple and Moses.

Of course I have my own opinions and can legitimately talk out of both sides of my mouth on this one. But then again, I can introduce you to some extremely uncivilized and unintelligent citizens of both nations!

INTERNATIONAL: This is why we have trial lawyers

Man changes sex, parents sue hospital

A couple whose only son underwent a sex change operation has sued a hospital for compensation and to have the surgery reversed because their “family line” was broken, a Chinese newspaper reported.The Yancheng Evening News said the parents and relatives of a person whose name the newspaper gave as Xie Xiaoxin also became violent and occupied a ward at the hospital for 11 days in September in an attempt to get US$3.6 million in compensation and their son’s gender changed again.

I guess there’s also some issues around who exactly gets to consent to "informed" consent!

INTERNATIONAL/POLICY: Compare and contrast the attitudes

Crowd Protests Health Care in China (in the New York Times)

Some 2,000 people mobbed and ransacked a hospital in southwestern China on Friday in a dispute over medical fees and shoddy health care practices……essential medical care was denied the boy until his grandfather, who was taking care of him, could pay for the treatment. The boy died after the grandfather left to raise money, the group said. An official report from the New China News Agency confirmed that a dispute over medical fees erupted at the hospital, but also said doctors there had treated the boy even though the grandfather did not have $82 to pay for the service.

But no one seems to care in the US, in fact it’s fine and legal in the Sacramento Bee

And then one day my husband was in excruciating pain and the morphine we had at home, nothing I could do would relieve his pain, so I called Cedars Sinai to say I’m bringing him in, he needs — he needs something. He needs to be relieved of this pain. And they said I’m sorry Mrs. Christensen you guys are not allowed through these doors anymore, your insurance has capped out, they’re not paying us anymore and your bills are high. And we can’t allow you to come through these doors anymore. So I had to take my husband to an emergency room where he sat for about eight hours, you know, which is the worst place for a cancer patient to be.

POLICY/INTERNATIONAL: Damn communists with endowments, again

So the Commonwealth Fund is at it again. Notice how “Commonwealth” has the same root as “Communist”? I thought you did.

Why else would they come out with yet another study showing that compared to other parts of the world that spend a whole lot less money, the U.S. Lags in Several Areas of Health Care. But don’t worry. If you get cancer here and have insurance, you might outlive those damn foreigners…or at least that’s what David Gratzer thinks is the main result of those studies.

If you want to see the whole article in Health Affairs, this is the link. But it doesn’t tell you anything we didn’t already know.

INTERNATIONAL: Cuba exporting doctors

Here’s a long and interesting article on Cuban Medical Diplomacy. Essentially Castro has been exporting doctors all over the place, and now Chavez is using Venezuela’s oil money to pay for it. I was reading along wondering why we hadn’t imported a few Cuban MDs to handle the US inner cities when I discovered that apparently they offered to send 1,000 to Louisiana after Katrina, but were turned down.

The article is pretty favorable, even though it’s clear that the export of doctors and concentration on the medical care system is at least partly a propaganda stunt by the Cuban government. A couple of things worth noting, though.

First, sending doctors overseas to help other poor people may be worthy and all that (and has the positive benefits of upsetting foreign medical associations, as it’s done in Venezuela) but it doesn’t mean that human rights within Cuba are respected any more than there were during the Cold war. And sometimes the lack of human rights compounds the medical problems there. For example a colleague of mine’s daughter went to Cuba  to do a medical mission/training and met and married a Cuban doctor while there. That doctor was not allowed to leave with her to go to the US, and when he formally applied to do so, was fired from his job, and no longer allowed to practice. Thankfully he escaped by sea, after several, several terrifying attempts. But there is no justification for refusing to allow people to leave a country; and in this case it caused his medical training to be wasted.

Second, and this is my cynical side talking—isn’t excessive spending on health care something that only rich country like ours can afford? What has a poor country like Cuba gone without to provide doctors for the rest of the developing world?

INTERNATIONAL: Health care costs, and not just here!

I spent rather more than I’d like of my Thursday night writing a piece I promised ABCNews for their week-long series on the health care system that starts Sunday. As I was finishing up I saw this. It’s not exactly what I was writing about, but it’s not far away—Medical costs push 78 million Asians into poverty

International health experts have estimated that 78 million more Asians than previously thought are living in poverty because of healthcare costs. Many people in Asian countries do not have health insurance and pay for doctor bills and medical treatments. But the out-of-pocket health expenses they incur are not included in conventional estimates of poverty.When researchers deducted the medical costs from total household resources in 11 Asian countries, millions more people fell below the internationally accepted poverty threshold of $1 per head per day. "If you allow for direct out-of-pocket healthcare payments, there are another 78 million counted as poor," said Dr Eddy van Doorslaer, a health economist at Erasmus University in the Netherlands who headed the research team."We calculated that an additional 2.7 percent of the population under study ended up with less than $1 a per day after they had paid for healthcare." The figures, which are reported in the Lancet medical journal on Friday, are based on information from national expenditure surveys of what people spend on medical care in the various countries. The researchers extrapolated the national, representative samples to cover the entire population. Overall the study showed the prevalence of poverty was 14 percent higher than other estimates that did not include out-of-pocket healthcare costs.


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