I essentially agree with you about the preventive side of the issue....
however....both you and fuagf have said "both ways" to me....
you wrote:
You want it both ways again, eh?
I don't understand how you hang that assertion on me....
I don't want the monster you call universal health care....
the major portion of medical practice in this country should be in the hands of the private sector....not government
i believe the role of government is in community service to cover the extremes of medical needs....
they are:
1) the truly impoverised who LEGITIMATELY cannot afford health insurance
2) insurance for catastropic medical needs....IMO....there is no reason a family should have to sell their home or go bankrupt because a family member experienced an extraordinary medical misfortune
ALL ELSE SHOULD BE MAJOR MEDICAL INS. THRU PRIVATE COMPANIES......
you have a belly ache.....you want to see if your blood pressure is too high.....go to the doctor and PAY FOR HIS SERVICE.....just like getting the oil changed in your car....
if you can't pay the full freight....go to the "free clinic".....
Exactly .. this one provides ammo for those interested in talking points on both sides .. it looks like the USA stands out as a plus for hip replacements .. the use of electronic records, one of Obama's targets i believe is mentioned ..
Physicians’ Views On Quality Of Care: A Five-Country Comparison .. two excerpts
Improved use of new information technologies emerged as one strategy. Asked about current use of electronic medical records or electronic prescribing systems, a minority of physicians (17–24 percent) in the United States, Canada, and Australia (three countries reporting frequent use) said that these systems were often used by physicians in their countries. Physicians in the United Kingdom and New Zealand were more likely to indicate current use of such systems, with a surprising majority of generalists in both countries saying that such systems were often used (59 percent and 52 percent, respectively), although only a minority of specialists agreed (22 percent and 14 percent, respectively).
the last bit .. the 2nd paragraph refers to issues you mentioned ..
Summary And Policy Implications
The findings of this five-country survey are stark. Despite increased national spending on health care in each of the five countries and substantial improvements in medical technology, practicing physicians believe that the quality of care provided to their patients is deteriorating. To physicians in these countries, efforts to constrain health care costs are seen as being harmful to patient care. National health systems, often described by experts as efficient and well run, are seen by their own practicing physicians as plagued with shortages of health professionals and inadequate facilities and equipment. Canadian and U.K. physicians expressed the most concern. Of particular note, physicians in all five countries were concerned with a serious shortage of nurses or specialized medical care, or both.
Despite some similarities with the other four countries, the situation for health care in the United States is the exception. Physicians saw problems caused by patients’ inability to pay for needed care. They worried about patients’ going without prescription medications and without other medical care because of their inability to pay for care, rather than overall resource shortages. They also reported having the problem of third-party external review bodies interfering with their ability to provide needed care.
Physicians in all five countries reported a concern that not enough is being done to address the problems of hospital medical errors, an issue gaining visibility in the United States.4 The agreement on a shortage of nurses is also striking. This survey finds physicians reporting a serious nursing shortage in all of the English-speaking countries, a situation that seems to have escaped the notice of many of these countries’ leaders.
Basic issues dominate reporting of quality concerns. Unfortunately, for policymakers, many of these issues can be addressed only by providing more resources to health care in some of the countries surveyed, particularly for hospitals, or to expand insurance coverage more broadly in the United States and provide more comprehensive benefits in New Zealand.
Yet physicians also endorse efforts that would provide new information resources to help them improve quality of care in their practices. In all five countries, computer and Internet revolutions are sweeping into the world of medicine. Physicians place a high priority on using these tools more effectively to prescribe drugs and monitor medical record information. Although these efforts did not have the same level of salience as did reform ideas for increasing resources for care, physicians’ positive support for such measures is notable.
It is important to note that cost containment policies by either governments or private managed care plans are not invisible to practicing physicians. Many see these activities as a direct threat to their patients. Those involved with constraining health expenditures must provide more convincing evidence that limiting resources can still lead to better quality of care. It is striking that physicians in five different health systems feel that their country is headed in the wrong direction on this issue.
The bottom line for me is that in countries with universal care all are covered for healthcare, sure some doctors and some patients abuse the system, but that occurs in the USA, too.
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