HyperionMark
Member
Are you implying every doctor and nurse is in it for the money?Unfortunately, the medical industry is just about making money. It is not a "health" industry.
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Are you implying every doctor and nurse is in it for the money?Unfortunately, the medical industry is just about making money. It is not a "health" industry.
I'm sure that every doctor and nurse appreciates getting paid for their work. Very few would work for free.Are you implying every doctor and nurse is in it for the money?
Would caution painting most or all physicians under that brush. Fee for service is common in the U.S. but by no means universal.I'm sure that every doctor and nurse appreciates getting paid for their work. Very few would work for free.
However, in the US, doctors, hospitals, insurance companies, pharmaceutical companies, medical device companies, etc. all are in a position where there are very few limits on their greed. They can charge just about anything they want and also sell procedures and treatments without any effective limit on the number, appropriateness or price. (I'd leave nurses out of this since they are salaried employees and not in a position to generate extra revenue.)
All other developed countries regulate medical care prices and procedures. They manage to cover everyone and spend less than half what we pay in the US. The US has the lowest health indicators of the 20 developed countries and the highest cost.
And I agree with @iPlug that you paint with way too broad a brush. pharma spends more on marketing than R&D. Disgusting.
... in the US, insurance companies, pharmaceutical companies, medical device companies, etc. all are in a position where there are very few limits on their greed. They can charge just about anything they want.
I had Kaiser insurance for a few years. Yes, they seem to be paid a fixed salary so the high charges are set by Kaiser ($500 for a 10 minute "annual physical"). Doctors do have discretion on recommending procedures and treatments and their behavior is monitored.Would caution painting most or all physicians under that brush. Fee for service is common in the U.S. but by no means universal.
I am a physician in one of the largest vertically integrated health care systems in the U.S.. We are not fee for service and have ~12.5 million members. As physicians we can not charge anything whether we want to or not, can not sell any procedures or treatments of any kind or at any price. We are salaried and earn no productivity. Our costs are lowest by focusing on patient health and not providing unnecessary services which allows our health foundation to offer some of the lowest premiums to our members.
As for health indicators, most of this is driven by public health which is almost completely disconnected from the “health care” mentioned here.
Nearly comparatively so and never been afraid to talk about it. Compared to “public health”, “health care” has a small impact on reducing morbidity and mortality. There is a role for health care but our rightful place is in the shadow of public health.On "public health": So you're saying that the medical care you provide doesn't have any effect on patient's health?
Call it whatever you like. I can write descriptions too. Sharp and pointy is for meat. Dull and flat is for vegetables.Here's a tip: your "canine" teeth are that in name only. If you'd like to see real canines, designed over millions of years for carnivores to rip flesh off bones, see the mouths of bears, lions, tigers, and other carnivores. You do NOT have "canines."
Thank you. Having worked in international public health for 30 years, it's good to see acknowledgement.Nearly comparatively so and never been afraid to talk about it. Compared to “public health”, “health care” has a small impact on reducing morbidity and mortality. There is a role for health care but our rightful place is in the shadow of public health.
To cite a very recent and ongoing public health issue, consider COVID-19. The single best metric to see how the U.S. compares to other countries is excess COVID deaths per capita. COVID reporting data, including deaths, is measured very differently and inconsistently in many countries. Not so for body counts where it doesn’t get any more apples-to-apples. Yet of all the countries who report such data, we’re currently the 20th worst. That's much better than commonly reported, but we should be much better. Our current 168 excess deaths per 100k people means we had ~550k excess deaths over the last rolling year.
Tracking covid-19 excess deaths across countries
Most of reduced morbidity and increased life spans have been from public health with some but significance but relatively little from health care. It's tempting to link spending to health care with (good or poor) health outcomes. Way too much noise there. Public health is where the answers are.
Ten Great Public Health Achievements --- United States, 2001--2010
Background: Historical analysis of health data suggests the majority of the life expectancy increase that occurred during recent centuries was caused by improvements in public health and social determinants of health. The purpose of this study was to assess lay public perceptions regarding why life expectancy has increased. Methods: A nationally representative sample of 705 adults were surveyed to determine which factors people credit for the 40 plus year increase in life expectancy that occurred since the mid-1800s. Survey items included open-ended questions, rank ordering of possible explanations, and numeric estimates of attribution. Results: Participants in the study rarely attributed increased life expectancy to public health measures or improvements in social health determinants. In contrast, subjects believed that medical care, by far, played the predominant role and attributed medical care for causing 80% of the life expectancy increase. Conclusion: The public grossly overestimates how much of our increased life expectancy should be attributed to medical care and is largely unaware of the critical role played by public health and improved social conditions determinants. These misperceptions may hinder adequate public health funding and efforts to address important health-related social issues. Misattribution of credit may also contribute to overfunding the medical sector of the economy and impede efforts to contain health care costs.
The Contribution of Public Health and Improved Social Conditions to Increased Life Expectancy: An Analysis of Public Awareness
Call it whatever you like. I can write descriptions too. Sharp and pointy is for meat. Dull and flat is for vegetables.
You corn chips with legs sure are a passionate bunch! (I'm only on chapter one)
Honestly? No, i got bored after all the description of teeth. I don't think of it as a "world view." I just follow my stomach. If it looks like a duck, quacks like a duck, and walks like a duck. Its roast duck and its delicious.Wow, did you happen upon the rest of the paper?
They ship it to CanadaThe US produces as much horse meat as Canada. But we don't eat it, so i guess nobody really cares much.
If only they could farm ahi... and feed them plant based food. Then I could have sushi almost daily without accumulating enough mercury to be my own thermometer.That Salmon on Your Plate Might Have Been a Vegetarian That Salmon on Your Plate Might Have Been a Vegetarian
Twenty years ago, as farmed salmon and shrimp started spreading in supermarket freezers, came an influential scientific paper that warned of an environmental mess: Fish farms were gobbling up wild fish stocks, spreading disease and causing marine pollution. This week, some of the same scientists who published that report issued a new paper concluding that fish farming, in many parts of the world, at least, is a whole lot better. The most significant improvement, they said, was that farmed fish were not being fed as much wild fish. They were being fed more plants, like soy.
I see a very slow, boil the frog approach that PITA advocates: First, show how cruel the veal industry is, so don't eat veal. Then, how cruel the beef industry is, so don't eat beef. Then, how cruel the pork industry is, so don't eat pork. And now, the coup de gras is, don't eat fish.Seaspiracy shows why we must treat fish not as seafood, but as wildlife | George Monbiot
But one of our bubbles of ignorance has just been burst. On a small budget, with the first film they’ve ever made, Ali Tabrizi and Lucy Tabrizi have achieved what media giants have repeatedly failed to do: directly confronted power. Their film Seaspiracy has become a huge hit on Netflix in several nations, including the UK. (Disclosure: I’m a contributor.) At last people have started to wake up to the astonishing fact that when you drag vast nets over the seabed, or set lines of hooks 28 miles long, or relentlessly pursue declining species, you might just, well, you know, have some effect on ocean life.
But the thrust of the film is correct: industrial fishing, an issue woefully neglected by the media and conservation groups, is driving many wildlife populations and ecosystems around the world towards collapse. Vast fishing ships from powerful nations threaten to deprive local people of their subsistence. Many “marine reserves” are a total farce, as industrial fishing is still allowed inside them. In the EU, the intensity of trawling in so-called protected areas is greater than in unprotected places. “Sustainable seafood” is often nothing of the kind. Commercial fishing is the greatest cause of the death and decline of marine animals. It can also be extremely cruel to humans: slavery and other gross exploitations of labour are rampant.
It’s time to see the oceans in a new light: to treat fish not as seafood but as wildlife; to see their societies not as stocks but as populations; and marine food webs not as fisheries but as ecosystems. It’s time we saw their existence as a wonder of nature, rather than an opportunity for exploitation. It’s time to redefine our relationship with the blue planet.