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Please drop your pride for a second and take a look how things proceed in Europe in terms of healthcare. There is no waiting lists or rationing and many countr

Please drop your pride for a second and take a look how things proceed in Europe in terms of healthcare. There is no waiting lists or rationing and many countries do well with this setup. It has been years since Soviet Union collapsed, it is amazing to see same boogeyman yet again.

stupidhn 9y ago
>There is no waiting lists or rationing and many countries do well with this setup. Look at Canada, where this stuff is happening in spades. I'm living it.
- pikzen 9y ago
  Do you realize that this is happening in Canada because certain people are pushing for privatized health care, draining more and more resources away from the public health services, causing the service quality to go down? It's a tried and tested technique. Take a well working system which doesn't generate profits, push to reduce costs, entirely destroying the service then point it out and say "See? It doesn't work. Better privatize it!"
  - refurb 9y ago
    Wow! That's a serious stretch. There is almost no private healthcare in Canada right now. Doctors are banned from "straddling the fence". They either have to go 100% public or 100% private. The reason for the waitlists in Canada are complex, but cost control is one of the reasons.
dagw 9y ago
Which European country has no waiting lists for non-trivial procedures?
- panzer_wyrm 9y ago
  How often do you need non trivial procedures? Surgical operations are split into 2 groups - planned and unplanned. In planned enter people that could wait a bit. If there is good medical reason that you cannot wait you get the treatment on the spot. You only have real waiting lists for transplants.
  - dagw 9y ago
    In planned enter people that could wait a bit. And in what way is that not a waiting list?
    - panzer_wyrm 9y ago
      Because waiting lists imply shortage or rationing. Here this is not the case. It is mostly optimization of utilization of existing capacity. It is best for both the purse of the system and the patient if needed but not urgent stuff is done at time convenient to all parties. This way everybody could be prepared. The hoapitals will stock the right amount of supplies, the bloodbanks will know how much and what kind of blood is needed in advance and so on. The patient will make sure all mission critical projects are taken care of for the rehabilitation time etc.
      - chimeracoder 9y ago
        > Because waiting lists imply shortage or rationing. Here this is not the case. It is mostly optimization of utilization of existing capacity. Call it what you want, but that is literally rationing a scarce resources
        panzer_wyrm 9y ago
        Scarce resources are kidneys. There are not enough of them to go around. Not all people that need kidneys will get them in any time frame. They are also rationed - you get one kidney transplant and that's it. On the other hand the people that need lets say hip replacement will get it. The system have enough capacity and budget to serve their medical needs. But it works better if the people are properly spaced.
- bonzini 9y ago
  What is a non-trivial procedure? In fact the issue would be trivial (or unjustified) procedures, since anything life threatening would obviously have priority over anything else. In northern Italy I have seen two "simple" (easily removed surgically) cancer cases going through all diagnostic steps in less than 2 months (including ultrasound, biopsies, CT scans), followed by surgery and/or radiotherapy, all at absolutely zero cost for the patient. If you need heart surgery (valve replacement, coronary stents, stuff like that), your GP can get you an ambulance straight to the ICU, and you can stay there for free until everything is ready for surgery, maybe in a couple days.
- soundwave106 9y ago
  The United States doesn't have waiting lists either? See http://content.healthaffairs.org/content/early/2005/11/28/hlthaff.w5.509.short http://content.healthaffairs.org/content/early/2005/11/28/hl... page W.519. We fare badly in particular on getting access to a primary care doctor quickly (or other general care, if you Google articles). We have the highest percentage response for the question "Went to ER for condition that could have been treated by regular doctor if available" of the countries surveyed. And we have the highest response for people unable to get medical care due to cost. When it comes to specialists and elective surgery, we definitely have much less issues with waiting lists there. IMHO general health care is much more important; this is another indicator of the perverse incentives of the current US health care structure.
humanrebar 9y ago
> There is no waiting lists or rationing This is nonsense. Someone has to decide if a procedure is worth the cost. If it's not the patient (who isn't paying) and it's not an insurer (though who wants that?), it's the government. Deciding a procedure isn't appropriate or worth the cost is rationing. In a bureaucratic system, you have bureaucrats deciding what procedures are for whom and when.
- pg314 9y ago
  > This is nonsense. No it isn't. > Someone has to decide if a procedure is worth the cost. If it's not the patient (who isn't paying) In Belgium, it is the doctor together with the patient. If a procedure is medically justified, cost doesn't factor into the equation. > In a bureaucratic system, you have bureaucrats deciding what procedures are for whom and when. That is simply false.
  - humanrebar 9y ago
    > If a procedure is medically justified, cost doesn't factor into the equation. Of course it does. There are rules saying what procedures are urgent, which ones are legitimate, and which treatments are covered and at what prices. The government doesn't write a blank check for doctors and patients to fill out.
    - pg314 9y ago
      I didn't say the government writes a blank check. They have a list of legitimate procedures, and fix a price for them. The administration is able to get a good price because it is in a strong bargaining position against pharmaceutical companies. However, price has historically not been a factor in deciding the medical effectiveness of a treatment. There is currently a debate on whether it should be: is it justified to cover cancer medicine costing 500.000 EUR per patient per year for life ([1], in Dutch)? [1] http://www.mloz.be/nl/art/dure-geneesmiddelen-structurele-maatregelen-om-de-solidariteit-onder-de-belgen-te-garanderen http://www.mloz.be/nl/art/dure-geneesmiddelen-structurele-ma...
- d4rti 9y ago

stupidhn 9y ago

>There is no waiting lists or rationing and many countries do well with this setup. Look at Canada, where this stuff is happening in spades. I'm living it.

pikzen 9y ago
Do you realize that this is happening in Canada because certain people are pushing for privatized health care, draining more and more resources away from the public health services, causing the service quality to go down? It's a tried and tested technique. Take a well working system which doesn't generate profits, push to reduce costs, entirely destroying the service then point it out and say "See? It doesn't work. Better privatize it!"
- refurb 9y ago
  Wow! That's a serious stretch. There is almost no private healthcare in Canada right now. Doctors are banned from "straddling the fence". They either have to go 100% public or 100% private. The reason for the waitlists in Canada are complex, but cost control is one of the reasons.

dagw 9y ago

Which European country has no waiting lists for non-trivial procedures?

panzer_wyrm 9y ago
How often do you need non trivial procedures? Surgical operations are split into 2 groups - planned and unplanned. In planned enter people that could wait a bit. If there is good medical reason that you cannot wait you get the treatment on the spot. You only have real waiting lists for transplants.
- dagw 9y ago
  In planned enter people that could wait a bit. And in what way is that not a waiting list?
  - panzer_wyrm 9y ago
    Because waiting lists imply shortage or rationing. Here this is not the case. It is mostly optimization of utilization of existing capacity. It is best for both the purse of the system and the patient if needed but not urgent stuff is done at time convenient to all parties. This way everybody could be prepared. The hoapitals will stock the right amount of supplies, the bloodbanks will know how much and what kind of blood is needed in advance and so on. The patient will make sure all mission critical projects are taken care of for the rehabilitation time etc.
    - chimeracoder 9y ago
      > Because waiting lists imply shortage or rationing. Here this is not the case. It is mostly optimization of utilization of existing capacity. Call it what you want, but that is literally rationing a scarce resources
      - panzer_wyrm 9y ago
        Scarce resources are kidneys. There are not enough of them to go around. Not all people that need kidneys will get them in any time frame. They are also rationed - you get one kidney transplant and that's it. On the other hand the people that need lets say hip replacement will get it. The system have enough capacity and budget to serve their medical needs. But it works better if the people are properly spaced.
bonzini 9y ago
What is a non-trivial procedure? In fact the issue would be trivial (or unjustified) procedures, since anything life threatening would obviously have priority over anything else. In northern Italy I have seen two "simple" (easily removed surgically) cancer cases going through all diagnostic steps in less than 2 months (including ultrasound, biopsies, CT scans), followed by surgery and/or radiotherapy, all at absolutely zero cost for the patient. If you need heart surgery (valve replacement, coronary stents, stuff like that), your GP can get you an ambulance straight to the ICU, and you can stay there for free until everything is ready for surgery, maybe in a couple days.
soundwave106 9y ago
The United States doesn't have waiting lists either? See http://content.healthaffairs.org/content/early/2005/11/28/hlthaff.w5.509.short http://content.healthaffairs.org/content/early/2005/11/28/hl... page W.519. We fare badly in particular on getting access to a primary care doctor quickly (or other general care, if you Google articles). We have the highest percentage response for the question "Went to ER for condition that could have been treated by regular doctor if available" of the countries surveyed. And we have the highest response for people unable to get medical care due to cost. When it comes to specialists and elective surgery, we definitely have much less issues with waiting lists there. IMHO general health care is much more important; this is another indicator of the perverse incentives of the current US health care structure.

humanrebar 9y ago

> There is no waiting lists or rationing This is nonsense. Someone has to decide if a procedure is worth the cost. If it's not the patient (who isn't paying) and it's not an insurer (though who wants that?), it's the government. Deciding a procedure isn't appropriate or worth the cost is rationing. In a bureaucratic system, you have bureaucrats deciding what procedures are for whom and when.

pg314 9y ago
> This is nonsense. No it isn't. > Someone has to decide if a procedure is worth the cost. If it's not the patient (who isn't paying) In Belgium, it is the doctor together with the patient. If a procedure is medically justified, cost doesn't factor into the equation. > In a bureaucratic system, you have bureaucrats deciding what procedures are for whom and when. That is simply false.
- humanrebar 9y ago
  > If a procedure is medically justified, cost doesn't factor into the equation. Of course it does. There are rules saying what procedures are urgent, which ones are legitimate, and which treatments are covered and at what prices. The government doesn't write a blank check for doctors and patients to fill out.
  - pg314 9y ago
    I didn't say the government writes a blank check. They have a list of legitimate procedures, and fix a price for them. The administration is able to get a good price because it is in a strong bargaining position against pharmaceutical companies. However, price has historically not been a factor in deciding the medical effectiveness of a treatment. There is currently a debate on whether it should be: is it justified to cover cancer medicine costing 500.000 EUR per patient per year for life ([1], in Dutch)? [1] http://www.mloz.be/nl/art/dure-geneesmiddelen-structurele-maatregelen-om-de-solidariteit-onder-de-belgen-te-garanderen http://www.mloz.be/nl/art/dure-geneesmiddelen-structurele-ma...
d4rti 9y ago