This is the first post in what will become a regular feature on this blog: A look back at previous posts that are related to newly-discovered content.
Further support for prediction markets.
Trading on the Wisdom of Crowds (Wall Street Journal)
How accurate are prediction markets in U.S. elections? (Yahoo! Answers)
Earlier: How to predict the future
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What are your odds of dying from a given injury?
Odds of Dying (National Safety Council)
Earlier: Suicide hotlines
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Economists, on the question of organ markets as a solution to the organ donor shortage.
Human Organs for Sale, Legally, in ... Which Country? (Freakonomics Blog)
Financial Compensation for Organ Donors is Working (Marginal Revolution)
Earlier: Kidneys for sale?
Showing posts with label health. Show all posts
Showing posts with label health. Show all posts
Tuesday, April 29
Friday, March 28
Sicko and health care: Guest post #3
Post by Dr. Kao-Ping Chua, M.D.
About the Canadian health care system:
Pros: Universality, administrative simplicity, equality, high quality, free choice of doctors and hospitals (not true in the U.S.)
Cons: Quickly escalating costs (because doctors are paid fee-for-service and have an incentive to over-order), rationing of health care results in wait lists for elective surgeries (but this is completely blown out of proportion by the American media - you don't wait for emergnecies).
Is it a better system? Depends on your definition of "better." If by better, you mean more affordable and equitable, then definitely. If by better, you mean more technology, then definitely not. By my criteria, I think Canada has a better health care system for the vast majority of diseases, but if I had a rare disease or needed super-specialized care, I'd opt for the U.S. As an average citizen, though, I'd much rather deal with the Canadian health care system than the American one. As a doctor, I'd also much rather deal with Canada since there'd be fewer insurance hassles and you wouldn't have to worry about your patient's financial status - they'd get the care they need.
About the British health care system:
The British health care system (NHS) is an incredibly inexpensive, economically efficient system. It has one of the strongest primary care/preventive care systems in the world. Unfortunately, it suffers from massive wait lists, old facilities, and a lack of specialists. This is mostly due to a lack of funding, though the recent British government has been putting a lot of money into the system. I think Sicko portrayed only the good parts of the NHS, but it portrayed them very well - virtually free care, strong popular support, good pay for doctors (not quite as good as the U.S. but not bad either).
About the French health care system:
I don't have first-hand knowledge of the French health care system, but it's regarded to be the best in Europe by the WHO [World Health Organization]. It's true that people pay taxes out the wazoo for the system, but on the other hand, they got extremely high quality care.
About the American health care system:
Obviously, this movie was up my alley since I worked on universal health care in DC for a year. I think it did a great job of humanizing the problem - the stories that I heard were all very familiar, but that didn't make them any less devastating. I don't think the movie was intended to give a fair comparison of the American health care system to other systems - I think Moore intended to just shatter some illusions that Americans have about third-world health care in socialized systems like England/France, and he did that very well. The best part of the movie in my mind was the end where Moore had a monologue about American values (e.g. why can't we be a place that's willing to take care of others). Changing values is the crux of all social change, and I was thrilled that Moore seemed to recognize that.
Did I think the movie is fair? Of course not - it's liberal propaganda, in some ways. But like I said, I don't think it wasn't supposed to be intellectually fair, but rather about raising awareness, changing perceptions, and hopefully chipping away at some of our misguided social values.
Kao-Ping received his medical degree from Washington University in St. Louis and is currently a resident at Boston Children's Hospital. Previously, he worked for the American Medical Student Association on the issue of universal health care.
Earlier: Sicko: Is Michael Moore right?
Earlier: Sicko and health care: Guest post #1
Earlier: Sicko and health care: Guest post #2
About the Canadian health care system:
Pros: Universality, administrative simplicity, equality, high quality, free choice of doctors and hospitals (not true in the U.S.)
Cons: Quickly escalating costs (because doctors are paid fee-for-service and have an incentive to over-order), rationing of health care results in wait lists for elective surgeries (but this is completely blown out of proportion by the American media - you don't wait for emergnecies).
Is it a better system? Depends on your definition of "better." If by better, you mean more affordable and equitable, then definitely. If by better, you mean more technology, then definitely not. By my criteria, I think Canada has a better health care system for the vast majority of diseases, but if I had a rare disease or needed super-specialized care, I'd opt for the U.S. As an average citizen, though, I'd much rather deal with the Canadian health care system than the American one. As a doctor, I'd also much rather deal with Canada since there'd be fewer insurance hassles and you wouldn't have to worry about your patient's financial status - they'd get the care they need.
About the British health care system:
The British health care system (NHS) is an incredibly inexpensive, economically efficient system. It has one of the strongest primary care/preventive care systems in the world. Unfortunately, it suffers from massive wait lists, old facilities, and a lack of specialists. This is mostly due to a lack of funding, though the recent British government has been putting a lot of money into the system. I think Sicko portrayed only the good parts of the NHS, but it portrayed them very well - virtually free care, strong popular support, good pay for doctors (not quite as good as the U.S. but not bad either).
About the French health care system:
I don't have first-hand knowledge of the French health care system, but it's regarded to be the best in Europe by the WHO [World Health Organization]. It's true that people pay taxes out the wazoo for the system, but on the other hand, they got extremely high quality care.
About the American health care system:
Obviously, this movie was up my alley since I worked on universal health care in DC for a year. I think it did a great job of humanizing the problem - the stories that I heard were all very familiar, but that didn't make them any less devastating. I don't think the movie was intended to give a fair comparison of the American health care system to other systems - I think Moore intended to just shatter some illusions that Americans have about third-world health care in socialized systems like England/France, and he did that very well. The best part of the movie in my mind was the end where Moore had a monologue about American values (e.g. why can't we be a place that's willing to take care of others). Changing values is the crux of all social change, and I was thrilled that Moore seemed to recognize that.
Did I think the movie is fair? Of course not - it's liberal propaganda, in some ways. But like I said, I don't think it wasn't supposed to be intellectually fair, but rather about raising awareness, changing perceptions, and hopefully chipping away at some of our misguided social values.
Kao-Ping received his medical degree from Washington University in St. Louis and is currently a resident at Boston Children's Hospital. Previously, he worked for the American Medical Student Association on the issue of universal health care.
Earlier: Sicko: Is Michael Moore right?
Earlier: Sicko and health care: Guest post #1
Earlier: Sicko and health care: Guest post #2
Saturday, March 22
Sicko and health care: Guest post #2
Post by Laurin Taylor
I've lived in London for nearly 7 years now and I was entitled to NHS health care as soon as I got here (as I was a student planning to stay for more than 6 months). I haven't seen the film so I apologize if I am telling you something you already know.
The way it works is that you register at a doctor's office in your borough (an administration area, kind of like a county), and all your medical records get transferred there. When you need to see a doctor, you call and are given an appointment. There is a lot of whining about waiting lists and substandard care, and to be sure, the NHS IS underfunded - BUT I have never had to wait more than a few days to see a doctor for a non-urgent situation. And the two times that I have had an urgent situation, I went to a hospital and was seen right away. AND when you're done seeing your doctor, you walk out and go home. There is no money involved. I pay money when I need a prescription filled. I think the current rate is £7.80, which is about the same as my parents pay co-pay on my dad's insurance. If I were pregnant or had recently given birth, or if I were over or under a certain age, or disabled or on income support, I would not pay for my prescriptions.
I also pay for my NHS dental treatment - I think a check-up and clean cost me £15 last time. That might have included X-rays. I cannot remember.
The NHS also covers more specialist treatment, surgery, mental healthcare and abortions. I have heard a lot of tales about 18 month waiting lists to see a mental health specialist, but I seem to recall that when I needed this service, I was given a referral by my GP and was seen within a month.
The lack of universal healthcare is on the list of my major reasons I have no plans to ever move back to the States. I no longer understand the mentality that people should have to choose between buying food, or paying the rent, and being able to go to the doctor when they get sick.
And by the way, my take home pay is about 70% of my gross monthly salary. That's AFTER tax, national insurance and my pension contribution.
I was always on my dad's insurance when lived over there [the U.S.], so I never really thought about having to pay for health care. I think I was kicked off the plan when I turned 22. Is that the age that people are expected to have decent jobs by? What happens if you want to go to grad school or travel? And how easy is it to get a job that provides affordable health insurance right after you graduate from college? I'm honestly asking, because I don't know.
Just as a PS - I've had the flu for the past three days. I read this morning that 3.6 million people in this country have rung in sick to work this week. With such an epidemic, you'd think that doctor's offices would be swamped, right? I rang mine at 8:30 AM and was offered an appointment at 11:30 AM.
Laurin grew up in the U.S. and is now a British citizen living in London.
Earlier: Sicko: Is Michael Moore right?
Earlier: Sicko and health care: Guest post #1
I've lived in London for nearly 7 years now and I was entitled to NHS health care as soon as I got here (as I was a student planning to stay for more than 6 months). I haven't seen the film so I apologize if I am telling you something you already know.
The way it works is that you register at a doctor's office in your borough (an administration area, kind of like a county), and all your medical records get transferred there. When you need to see a doctor, you call and are given an appointment. There is a lot of whining about waiting lists and substandard care, and to be sure, the NHS IS underfunded - BUT I have never had to wait more than a few days to see a doctor for a non-urgent situation. And the two times that I have had an urgent situation, I went to a hospital and was seen right away. AND when you're done seeing your doctor, you walk out and go home. There is no money involved. I pay money when I need a prescription filled. I think the current rate is £7.80, which is about the same as my parents pay co-pay on my dad's insurance. If I were pregnant or had recently given birth, or if I were over or under a certain age, or disabled or on income support, I would not pay for my prescriptions.
I also pay for my NHS dental treatment - I think a check-up and clean cost me £15 last time. That might have included X-rays. I cannot remember.
The NHS also covers more specialist treatment, surgery, mental healthcare and abortions. I have heard a lot of tales about 18 month waiting lists to see a mental health specialist, but I seem to recall that when I needed this service, I was given a referral by my GP and was seen within a month.
The lack of universal healthcare is on the list of my major reasons I have no plans to ever move back to the States. I no longer understand the mentality that people should have to choose between buying food, or paying the rent, and being able to go to the doctor when they get sick.
And by the way, my take home pay is about 70% of my gross monthly salary. That's AFTER tax, national insurance and my pension contribution.
I was always on my dad's insurance when lived over there [the U.S.], so I never really thought about having to pay for health care. I think I was kicked off the plan when I turned 22. Is that the age that people are expected to have decent jobs by? What happens if you want to go to grad school or travel? And how easy is it to get a job that provides affordable health insurance right after you graduate from college? I'm honestly asking, because I don't know.
Just as a PS - I've had the flu for the past three days. I read this morning that 3.6 million people in this country have rung in sick to work this week. With such an epidemic, you'd think that doctor's offices would be swamped, right? I rang mine at 8:30 AM and was offered an appointment at 11:30 AM.
Laurin grew up in the U.S. and is now a British citizen living in London.
Earlier: Sicko: Is Michael Moore right?
Earlier: Sicko and health care: Guest post #1
Saturday, March 15
Sicko and health care: Guest post #1
Post by Larry Markham
Here are a few comments about the Canadian system, especially from experience with my mother:
Earlier: Sicko: Is Michael Moore right?
Here are a few comments about the Canadian system, especially from experience with my mother:
- When you're sick and need to be in the hospital, there is no wait. They take care of you and keep you as long as necessary. The quality of care is very good, just as good as the U.S. The cost is minimal, unless you choose to pay extra for a private room.
- Poor people and rich people are treated the same.
- There is a waiting list for elective stuff like hip transplants. Rich people can go to other countries if they want it done quickly.
- I've heard that certain equipment (MRI?) is much less plentiful in Canada.
- No paperwork. No insurance companies aguing about everything. This is a big cost saving, and a huge time saving for the consumer.
- The doctors make less money, and some leave for the U.S. to make the big bucks.
- Some people have a hard time finding a doctor who will take new patients.
- Nobody goes bankrupt because of medical bills. This factor alone justifies using the Canadian system.
- People retire early because they don't have to worry about medical costs. This is a huge difference. People in the U.S. are afraid to retire before 65 when Medicare kicks in.
- The government decides when and where new hospitals are built.
Earlier: Sicko: Is Michael Moore right?
Sunday, March 9
Sicko: Is Michael Moore right?
Michael Moore's 2007 film Sicko about the American health care system took me a bit by surprise when I first watched it: I thought it was smart, well-made, and actually quite funny. But I still came away from the film with a fundamental question that many others have also posed: To what extent is Sicko "correct" in its judgment that the American health care system is inferior to systems found in countries such as Canada, France, and the United Kingdom? I'm sure that in any country, you can find both horror and success stories about the quality and accessibility of their health care, and Moore did indeed find many compelling examples of how the American system fails people in ways that other systems do not. But what is missing from the picture he paints?
Criticism of Sicko is not hard to find; here is one of the more thoughtful pieces I read, and here is a longer piece by MTV's Kurt Loder. But I tend to trust people I know much more than any random article on the Internet, which is why I am calling on those of you with experience with other health care systems to contact me with your comments:
e-mail: contact [at] kevinmarkham [dot] com
Or, just post your comments below.
These reactions will be featured in a series of guest posts on this blog. I look forward to your thoughts!
Criticism of Sicko is not hard to find; here is one of the more thoughtful pieces I read, and here is a longer piece by MTV's Kurt Loder. But I tend to trust people I know much more than any random article on the Internet, which is why I am calling on those of you with experience with other health care systems to contact me with your comments:
e-mail: contact [at] kevinmarkham [dot] com
Or, just post your comments below.
These reactions will be featured in a series of guest posts on this blog. I look forward to your thoughts!
Wednesday, February 20
Culture of an epidemic
Death March (New York Times)
South African journalist Jonny Steinberg, in a new book about the AIDS epidemic in Africa, wanted to find out why people in his country still aren't getting tested for HIV and/or obtaining treatment for AIDS, despite the presence of strong AIDS treatment programs in certain areas. His answers are a stark reminder of how much the practice of medicine is a function of culture as well as science.
South African journalist Jonny Steinberg, in a new book about the AIDS epidemic in Africa, wanted to find out why people in his country still aren't getting tested for HIV and/or obtaining treatment for AIDS, despite the presence of strong AIDS treatment programs in certain areas. His answers are a stark reminder of how much the practice of medicine is a function of culture as well as science.
Thursday, November 22
Kidneys for sale?
Kidney Shortage Inspires A Radical Idea: Organ Sales (Wall Street Journal)
Flesh Trade (New York Times Magazine)
Two great articles about the lack of kidneys available for transplant in the U.S., and the potential solution of a regulated organ market. While I haven't completely made up my mind about organ markets, I am definitely a big fan of two other ideas: paired exchange (graphical explanation), and changing to an opt-out system of organ donation.
One of the main arguments against a market for organs is that the poor might feel unduly pressured into selling a kidney. Stephen J. Dubner argues the opposite, that the poor would actually benefit the most from a kidney market.
Flesh Trade (New York Times Magazine)
Two great articles about the lack of kidneys available for transplant in the U.S., and the potential solution of a regulated organ market. While I haven't completely made up my mind about organ markets, I am definitely a big fan of two other ideas: paired exchange (graphical explanation), and changing to an opt-out system of organ donation.
One of the main arguments against a market for organs is that the poor might feel unduly pressured into selling a kidney. Stephen J. Dubner argues the opposite, that the poor would actually benefit the most from a kidney market.
Wednesday, November 21
Food for thought
You Call That Health Food? (Men's Health)
It can be hard to walk through a grocery store and actually understand what is good for you. Setting aside misleading food marketing, you've got a media that picks up on every new food-related scientific study and reports it as fact, and you've got a community of scientists and nutritionists that can't even agree on what type of fat you need or what the latest additive (aspartame, olestra, etc.) will do to your body.
Author Michael Pollan (The Omnivore's Dilemma) offers the following nugget of wisdom, as a way to cut through all of the confusion: If your grandmother wouldn't recognize what you're eating, it's probably not good for you.
It can be hard to walk through a grocery store and actually understand what is good for you. Setting aside misleading food marketing, you've got a media that picks up on every new food-related scientific study and reports it as fact, and you've got a community of scientists and nutritionists that can't even agree on what type of fat you need or what the latest additive (aspartame, olestra, etc.) will do to your body.
Author Michael Pollan (The Omnivore's Dilemma) offers the following nugget of wisdom, as a way to cut through all of the confusion: If your grandmother wouldn't recognize what you're eating, it's probably not good for you.
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