6 ms·

If you get cancer, would you rather be treated in the US or Europe? Survival rates are significantly higher in the US, so I know what I'd choose. And yeah, I'll

If you get cancer, would you rather be treated in the US or Europe? Survival rates are significantly higher in the US, so I know what I'd choose. And yeah, I'll pay more, too, because I want high quality doctors.

tremon 8y ago
Yes, let's turn a multifaceted, fairly objective article into a narrowminded, single-issue catchphrase, and introduce a false dichotomy that isn't even close to the content of the article. It seems like a lot of work just so you can keep beating your chest, or do you have an actual point to make?
- programmarchy 8y ago
  Looks like you worked harder than I did to just come here and whine.
kbcool 8y ago
Europe these days, at least I'd be treated like a human being and not a cash cow. Survival rates in the USA were better in the 1960s but most of the OECD now has much lower mortality rates from a diagnosis of cancer than the USA. One exception is the UK but the margin is very narrow. What the USA is good at is over-treatment which can extend life expectancy of a cancer patient a little bit (days, weeks on average) but you could argue the quality of life is not there. This is a direct a bi-product of an extremely inefficient health system which is designed to make as much money as possible for all of the participants rather than treat patients. As a percentage of GDP health care spending in the USA is completely out of control.
- programmarchy 8y ago
  I can understand that perspective. But are you really treated more humanely in Europe? Instead of a cash cow, you're a statistical number that determines where you will get placed in the queue and how long you'll wait. In the US, you at least have the potential for autonomy to pay the best doctor you can find you to treat you as soon as possible. That autonomy (or illusion thereof if you're a cynic) is a core component of the American identity. That feels more human to me. However, I do agree spending is completely out of control. A big reason is because Americans are extremely unhealthy. Many are obese, don't exercise, and eat like shit. I think those people should be punished with large insurance premiums, instead of being treated equally to someone who proactively takes care of their health and has a higher chance of long-term survival. What's left of the insurance market does still respond to those incentives. There's some fits and starts with this in insurance (e.g. step trackers) but these are values and habits that need to be instilled in people from youth. That is an area I can see the state stepping in, and something they're better equipped to handle than a complex healthcare system. Genetic diseases are a different case, and should be treated differently. There is a huge opportunity for prevention through genetics, but everyone raises a stink because of the "eugenics" bogeyman. This is an area where I agree with the transhumanist types in that we should really be taking a close look at our genetics and taking a scientific approach to improving them for longevity. I'd love to see a Manhattan Project for life extension. The main problem I see with universal healthcare, besides the stupid communistic utopianism, is that it doesn't really fix the underlying problems with the incentive structure. I think we could agree that the incentive structure should revolve around proactive physical fitness and the early prediction and prevention of disease, not pills and palliative care. From my perspective, it looks like European governments are struggling and failing with their systems. They're slow to treat people and are not innovating in medicine at a high level. Yes, corporations want to extract wealth from individuals with high prices but so do government agencies with high taxes. And governments have much less incentive to innovate; they tend to ossify. My point is, Americans have other options other than universal healthcare. I think we should not settle for the European-style socialist system because it relies on a religious holdover manifest in a secular world: that if we treat everyone equally we'll all be magically saved. Instead, Americans should draw from our founding principals of individual autonomy and manifest destiny to form a healthcare system that embodies our ideal future.
  - beagle3 8y ago
    Europeans also have private care, if they so desire and can afford it. I've lived in the US and in more than one country with universal healthcare, and know quite a few people in similar situations. Some prefer living in the US, but I'm not familiar with a single person who, given a choice, would take the US model over the European model. Do you? I wonder if "better cancer outcome in the US" is actually a result of selection bias, because the really poor people don't even get diagnosed, e.g. the money quote from [0]: """Danielle Scott, an employee at the store where Savastano bought the winning lottery ticket, told WABC that Savastano used the money for a visit to the doctor because he was uninsured. It was then he learned he had cancer, she said. """ [0] https://www.usatoday.com/story/news/nation/2018/02/02/lottery-winner-cancer/1088958001/ https://www.usatoday.com/story/news/nation/2018/02/02/lotter...
  - vilmosi 8y ago
    > In the US, you at least have the potential for autonomy to pay the best doctor you can find you to treat you as soon as possible. You can do that in countries with universal healthcare too.
samthecoy 8y ago
"Our results suggest that cancer care in the United States did not always avert deaths compared to Western Europe, and when it did avert deaths, it often did so at substantial cost." https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2014.0174 https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2014.0...
deleted 8y ago
[deleted]
jakelazaroff 8y ago
Are survival rates higher for everyone in the US, or just for those who can afford cancer treatment?
alex_anglin 8y ago
If treatment means bankruptcy, is that much of a choice?
alistairSH 8y ago
Our system is great, as long as you have more to pay.
Escapado 8y ago
Which makes sense if you can pay. But for low income house holds it's a decision between live long poverty or death. Here in Germany I am pretty glad that whatever I have I can go to a doctor or hospital and not get a single bill for it. Tops I have to pay 5€ for a prescription even if the drug is 120€ normally. And surely even in universal health care systems standards can be very high. It's a matter of investment.
gadjo95 8y ago
Not that true: https://www.forbes.com/sites/quora/2017/06/13/why-the-us-has-better-cancer-survival-rates-than-the-rest-of-the-world/#2797890c4b67 https://www.forbes.com/sites/quora/2017/06/13/why-the-us-has...
ljf 8y ago
Survival rates are higher as they are detected earlier. So this should be - where would I rather have my cancer detected. But again it is not that clear: https://blogs.scientificamerican.com/cross-check/cancer-spending-higher-in-u-s-than-in-europe-and-so-is-cancer-mortality/ https://blogs.scientificamerican.com/cross-check/cancer-spen... Quote: A new study shows that the U.S. spends far more than Europe on cancer care but has a higher mortality rate for lung cancer, the leading killer
calcifer 8y ago
> Survival rates are significantly higher in the US Citation needed.
- kbcool 8y ago
  They're not. Any source since the 1980s will tell you pretty much every OECD nation has higher survival rates than the USA.
fsloth 8y ago
"Survival rates are significantly higher in the US, so I know what I'd choose." Uh, something is going to kill me anyway. And the percentage difference isn't that high. I'd much rather have everyone state funded healthcare than a bit higher statistical chances for myself.
blueline 8y ago
>I'll pay more, too, This isn't an option if you are poor
rflrob 8y ago
If you don’t get cancer, where would you rather live? Life expectancy is significantly higher in Europe for lower average cost of medical care. There’s not necessarily a conflict between checkups and chemo, and surely some of the difference is due to population-level differences in poverty, diet, and lifestyle. But it’s worth remembering that it can be rational to trade slightly worse specialty care for better general care. Also, fwiw, what I’m reading (e.g. https://www.npr.org/sections/goatsandsoda/2018/01/30/581914807/whats-the-5-year-survival-rate-for-cancer-patients-around-the-world https://www.npr.org/sections/goatsandsoda/2018/01/30/5819148...) suggests that US cancer survival is better than the rest of the developed world, but not significantly so.
- fortythirteen 8y ago
  > Lower average cost of medical care All derived from figures that don't account for how much more you pay in taxes for that "free or cheap" healthcare.
  - AstralStorm 8y ago
    Actually it is a perfectly visible item in budget. We pay less for whole of medical care than total US budget for just VA. Someone is paying for this in tax.
    - fortythirteen 8y ago
      I think you misunderstand the statement. I wasn't referencing the comparison of the tax costs of different public healthcare systems. But while we're on that subject, I'm willing to bet that your VA comparison isn't per capita, or placed against GDP, rendering it useless. What I was referencing was the per capita or per household total cost of healthcare. The comparisons that say western countries with universal healthcare have "lower costs" generally omit the increased tax burden. If I make $100k a year, for example, and pay ~30% in taxes, but also pay ~$15k a year for total family medical expenses, including premiums, I'm still making out better than if I pay ~60% in taxes, but get "free" healthcare.
AstralStorm 8y ago
You won't be able to pay unless you're filthy rich. A second of care costs something on the order of $40... Medication costs, simple drug imatinib. $28000/annum vs $1000/annum (USA vs Poland, 2000, PPP adjusted.) Control checks, thousands dollars difference and they're the exact same.

tremon 8y ago

Yes, let's turn a multifaceted, fairly objective article into a narrowminded, single-issue catchphrase, and introduce a false dichotomy that isn't even close to the content of the article. It seems like a lot of work just so you can keep beating your chest, or do you have an actual point to make?

programmarchy 8y ago
Looks like you worked harder than I did to just come here and whine.

kbcool 8y ago

Europe these days, at least I'd be treated like a human being and not a cash cow. Survival rates in the USA were better in the 1960s but most of the OECD now has much lower mortality rates from a diagnosis of cancer than the USA. One exception is the UK but the margin is very narrow. What the USA is good at is over-treatment which can extend life expectancy of a cancer patient a little bit (days, weeks on average) but you could argue the quality of life is not there. This is a direct a bi-product of an extremely inefficient health system which is designed to make as much money as possible for all of the participants rather than treat patients. As a percentage of GDP health care spending in the USA is completely out of control.

programmarchy 8y ago
I can understand that perspective. But are you really treated more humanely in Europe? Instead of a cash cow, you're a statistical number that determines where you will get placed in the queue and how long you'll wait. In the US, you at least have the potential for autonomy to pay the best doctor you can find you to treat you as soon as possible. That autonomy (or illusion thereof if you're a cynic) is a core component of the American identity. That feels more human to me. However, I do agree spending is completely out of control. A big reason is because Americans are extremely unhealthy. Many are obese, don't exercise, and eat like shit. I think those people should be punished with large insurance premiums, instead of being treated equally to someone who proactively takes care of their health and has a higher chance of long-term survival. What's left of the insurance market does still respond to those incentives. There's some fits and starts with this in insurance (e.g. step trackers) but these are values and habits that need to be instilled in people from youth. That is an area I can see the state stepping in, and something they're better equipped to handle than a complex healthcare system. Genetic diseases are a different case, and should be treated differently. There is a huge opportunity for prevention through genetics, but everyone raises a stink because of the "eugenics" bogeyman. This is an area where I agree with the transhumanist types in that we should really be taking a close look at our genetics and taking a scientific approach to improving them for longevity. I'd love to see a Manhattan Project for life extension. The main problem I see with universal healthcare, besides the stupid communistic utopianism, is that it doesn't really fix the underlying problems with the incentive structure. I think we could agree that the incentive structure should revolve around proactive physical fitness and the early prediction and prevention of disease, not pills and palliative care. From my perspective, it looks like European governments are struggling and failing with their systems. They're slow to treat people and are not innovating in medicine at a high level. Yes, corporations want to extract wealth from individuals with high prices but so do government agencies with high taxes. And governments have much less incentive to innovate; they tend to ossify. My point is, Americans have other options other than universal healthcare. I think we should not settle for the European-style socialist system because it relies on a religious holdover manifest in a secular world: that if we treat everyone equally we'll all be magically saved. Instead, Americans should draw from our founding principals of individual autonomy and manifest destiny to form a healthcare system that embodies our ideal future.
- beagle3 8y ago
  Europeans also have private care, if they so desire and can afford it. I've lived in the US and in more than one country with universal healthcare, and know quite a few people in similar situations. Some prefer living in the US, but I'm not familiar with a single person who, given a choice, would take the US model over the European model. Do you? I wonder if "better cancer outcome in the US" is actually a result of selection bias, because the really poor people don't even get diagnosed, e.g. the money quote from [0]: """Danielle Scott, an employee at the store where Savastano bought the winning lottery ticket, told WABC that Savastano used the money for a visit to the doctor because he was uninsured. It was then he learned he had cancer, she said. """ [0] https://www.usatoday.com/story/news/nation/2018/02/02/lottery-winner-cancer/1088958001/ https://www.usatoday.com/story/news/nation/2018/02/02/lotter...
- vilmosi 8y ago
  > In the US, you at least have the potential for autonomy to pay the best doctor you can find you to treat you as soon as possible. You can do that in countries with universal healthcare too.

samthecoy 8y ago

"Our results suggest that cancer care in the United States did not always avert deaths compared to Western Europe, and when it did avert deaths, it often did so at substantial cost." https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2014.0174 https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2014.0...

deleted 8y ago

[deleted]

jakelazaroff 8y ago

Are survival rates higher for everyone in the US, or just for those who can afford cancer treatment?

alex_anglin 8y ago

If treatment means bankruptcy, is that much of a choice?

alistairSH 8y ago

Our system is great, as long as you have more to pay.

Escapado 8y ago

Which makes sense if you can pay. But for low income house holds it's a decision between live long poverty or death. Here in Germany I am pretty glad that whatever I have I can go to a doctor or hospital and not get a single bill for it. Tops I have to pay 5€ for a prescription even if the drug is 120€ normally. And surely even in universal health care systems standards can be very high. It's a matter of investment.

gadjo95 8y ago

Not that true: https://www.forbes.com/sites/quora/2017/06/13/why-the-us-has-better-cancer-survival-rates-than-the-rest-of-the-world/#2797890c4b67 https://www.forbes.com/sites/quora/2017/06/13/why-the-us-has...

ljf 8y ago

Survival rates are higher as they are detected earlier. So this should be - where would I rather have my cancer detected. But again it is not that clear: https://blogs.scientificamerican.com/cross-check/cancer-spending-higher-in-u-s-than-in-europe-and-so-is-cancer-mortality/ https://blogs.scientificamerican.com/cross-check/cancer-spen... Quote: A new study shows that the U.S. spends far more than Europe on cancer care but has a higher mortality rate for lung cancer, the leading killer

calcifer 8y ago

> Survival rates are significantly higher in the US Citation needed.

kbcool 8y ago
They're not. Any source since the 1980s will tell you pretty much every OECD nation has higher survival rates than the USA.

fsloth 8y ago

"Survival rates are significantly higher in the US, so I know what I'd choose." Uh, something is going to kill me anyway. And the percentage difference isn't that high. I'd much rather have everyone state funded healthcare than a bit higher statistical chances for myself.

blueline 8y ago

>I'll pay more, too, This isn't an option if you are poor

rflrob 8y ago

If you don’t get cancer, where would you rather live? Life expectancy is significantly higher in Europe for lower average cost of medical care. There’s not necessarily a conflict between checkups and chemo, and surely some of the difference is due to population-level differences in poverty, diet, and lifestyle. But it’s worth remembering that it can be rational to trade slightly worse specialty care for better general care. Also, fwiw, what I’m reading (e.g. https://www.npr.org/sections/goatsandsoda/2018/01/30/581914807/whats-the-5-year-survival-rate-for-cancer-patients-around-the-world https://www.npr.org/sections/goatsandsoda/2018/01/30/5819148...) suggests that US cancer survival is better than the rest of the developed world, but not significantly so.

fortythirteen 8y ago
> Lower average cost of medical care All derived from figures that don't account for how much more you pay in taxes for that "free or cheap" healthcare.
- AstralStorm 8y ago
  Actually it is a perfectly visible item in budget. We pay less for whole of medical care than total US budget for just VA. Someone is paying for this in tax.
  - fortythirteen 8y ago
    I think you misunderstand the statement. I wasn't referencing the comparison of the tax costs of different public healthcare systems. But while we're on that subject, I'm willing to bet that your VA comparison isn't per capita, or placed against GDP, rendering it useless. What I was referencing was the per capita or per household total cost of healthcare. The comparisons that say western countries with universal healthcare have "lower costs" generally omit the increased tax burden. If I make $100k a year, for example, and pay ~30% in taxes, but also pay ~$15k a year for total family medical expenses, including premiums, I'm still making out better than if I pay ~60% in taxes, but get "free" healthcare.

AstralStorm 8y ago

You won't be able to pay unless you're filthy rich. A second of care costs something on the order of $40... Medication costs, simple drug imatinib. $28000/annum vs $1000/annum (USA vs Poland, 2000, PPP adjusted.) Control checks, thousands dollars difference and they're the exact same.