Editorial - The Wrong Place to be Chronically Ill | Arthritis Information
http://www.nytimes.com/2008/11/18/opinion/18tue3.html?_r=1&th&emc=th&oref=slogin
Chronically ill Americans suffer far worse care than their counterparts in seven other industrial nations, according to a new study by the Commonwealth Fund, a New York-based foundation that has pioneered in international comparisons. It is the latest telling evidence that the dysfunctional American health care system badly needs reform.
The results of the study, published by the respected journal Health Affairs, belie the notion held by many American politicians that health care in this country is the best in the world. That may be true at a handful of pre-eminent medical centers, but it is hardly true for the care provided to a huge portion of the population.
The Commonwealth Fund’s survey of 7,500 patients in Australia, Canada, France, Germany, the Netherlands, New Zealand, Britain and the United States focused on patients who suffered from at least one of seven chronic conditions: hypertension, heart disease, diabetes, arthritis, lung problems, cancer or depression.
The care they received in this country — or more often did not receive — ought to be a cause for shame. More than half of the American patients went without care because of high out-of-pocket costs. They did not visit a doctor when sick, skipped a recommended test or treatment or failed to fill a prescription. The uninsured suffered most, but even 43 percent of those who had insurance all year skipped care because of costs.
Americans also were most likely to report wasting time because their care was so poorly organized. About a third reported that medical records and test results were not available when needed or that tests were duplicated unnecessarily. A third experienced a medical error, such as being given the wrong medication or test results. Some 40 percent found it very difficult to get after-hours care without going to an emergency room.
The United States did comparatively well in some areas, such as providing relatively prompt access to specialists and clear instructions to patients leaving the hospital. But the nation’s overall performance was abysmal.
By contrast, Dutch patients reported far more favorable experiences with their health care system, largely because the Netherlands provides universal coverage (through individual mandates and private health insurance), a strong primary care system and widespread use of electronic medical records. It should be possible to achieve the same level of performance here.
I remember a few years back that a coworker returned to his native Germany to have surgery even though he was fully insured through the company. As a German citizen he was entitled to full heath care plus they sent him to a spa-like convalescent place for several weeks afterward. It was almost a vacation for him/
All I would like to see here is access to medical coverage for everyone and help for those who cannot afford the horrendous copays or whose meds are not on the formulary and therefore not covered at all.
Ann
i can tell you from experience that all you have to do is say you have severe RA and no body wants to touch you and your RA doctor only wants to treat you for your RA which makes things complicated. and if i was well i would not be brushed off the other doctors are afraid to treat you so therefore we just attribute everything to our RA. i have a friend from Germany and her parents go to the spa every year for a week or two... it is vacation. she could not believe we did not offer any kind of treatment like that here in the U.S.I certainly don't doubt all the info in the article but the "spa" stuff seems like a waste. I don't think "spa vacations" in other countries should have any bearing on the quality of our health care.
Not that I wouldn't want a fully paid vacation, mind you...
This was a great editorial and I e-mailed a copy to a couple of people, including my mother. She asked if people from other countries were on this forum and whether they had better experiences or have more treatments available.
Here was my answer to her..."Well I do talk to ppl in other countries, but mainly Canada, UK and Australia. They do sometimes have issues with universal care where either it takes a long time or they can't get approved for a certain med. But they also have access to things earlier than we do, such as Actemra is already approved in UK and Australia (not sure about Canada). I think it sucks to have a chronic illness with any health care system, it just might be different degrees of "suckage"."
If you're interested in learning about health care delivery sytems in Germany and other countries that provide health access to ALL their citizens, see the links below. Other democratic, capitalist countries spend from 6 to 12% of their GNP (economy) on health care, covering everyone, with better health outcomes than the US who spends 16% of the GNP and leaves 45 million w/out insurance and millions more underinsured. 50% of people filing for bankruptcy do so because of medical expenses and 75% of them had insurance at the time they became sick or injured.
This website from a PBS Frontline program discusses health care in the UK, Germany, Japan, Taiwan, and Switzerland:
This website from National Public Radio discusses health care in Germany, France, Netherlands, the UK and Switzerland.
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