[ExI] Private and government R&D [was Health care in the USA]

[Mirco Romanato]

Stathis Papaioannou ha scritto:
> 2009/7/17 Rafal Smigrodzki <rafal.smigrodzki at gmail.com>:

> Charity won't reliably cover everyone.

Neither do nationalized health care or welfare.
A news of a few days ago tell that 30% of the people with heart health
problems in UK will not be able to receive treatment (pacemaker,
defibrillator, surgery, etc.)  due to long waiting lists and not enough
funding.

> Charity is fickle and demeaning, although better than nothing.

Charity is fickle mainly because don't give blindly to anyone asking
without minding at the real needs.

> I know a lot of people who on principle would not accept charity, but
>  do accept government provided services, since they are provided 
> under a binding and reciprocal agreement: i.e., if they earn enough 
> money, they will also contribute to these services.

Nonsense.
If they don't accept charity, they don't need charity. But they don't
need welfare also. This stance is only a facade.

> In Canada, you pay less tax for public health care per capita than 
> you do in the US and you get high quality universal health care, with
>  minimal need to rely on charity or private insurance. Why is the 
> Canadian system so much more efficient?

Because they rationed the health care.
http://edition.cnn.com/2009/POLITICS/07/06/canadian.health.care.system/index.html

>> "My family doctor at that time tried to get me in to see an 
>> endocrinologist and a neurologist," Holmes recalled. "It was going 
>> to be four months for one specialist and six months for the other."
>> Even with the warning from U.S. doctors in hand, Holmes said she
>> still couldn't get in to see Canadian specialists. Because the
>> government system is the only health care option for Canadians, she
>> says she had no choice but to have the surgery in the U.S.


http://www.cbc.ca/health/story/2007/10/15/waittimes-fraser.html

>> A typical Canadian seeking surgical or other therapeutic treatment 
>> had to wait 18.3 weeks in 2007, an all-time high, according to new 
>> research published Monday by independent research organization the 
>> Fraser Institute.


http://content.nejm.org/cgi/content/full/331/16/1068

>> Conclusions Waiting times for initial orthopedic consultation and 
>> for knee-replacement surgery were longer in Ontario than in the 
>> United States, but overall satisfaction with surgery was similar.

>> The median waiting time for an initial consultation was two weeks 
>> in the United States and four weeks in Ontario (Table 1). The mean
>>  waiting time was consistently shorter in each U.S. survey area
>> than in Ontario (P = 0.009 for the national sample, and P<0.001 for
>>  Indiana and western Pennsylvania). The median waiting time for
>> knee replacement from the time surgery was planned was three weeks
>> in the United States and eight weeks in Ontario (Table 2). The mean
>>  waiting time was consistently shorter in each U.S. survey area
>> than in Ontario (P<0.001). Because some people did not proceed with
>>  surgery immediately after the initial consultation, we did not 
>> calculate the median total waiting time.
> 
>> In the United States, 98.4 percent of patients in the national 
>> sample considered the waiting time for an initial orthopedic 
>> consultation acceptable, as compared with 91.5 percent in Ontario 
>> (Table 1). In the United States, 95 percent of patients in the 
>> national sample considered the waiting time for surgery acceptable,
>>  as compared with 85.1 percent in Ontario. Overall satisfaction 
>> with surgery (85.3 percent of U.S. respondents and 83.5 percent of
>>  Ontario respondents were "very or somewhat satisfied") was not 
>> associated with the duration of the wait for surgery (Pearson R = 
>> -0.14, P = 0.23).
> 
>> In both the United States and Canada, the proportion of patients 
>> who considered their waiting times to be acceptable declined as the
>>  duration of the wait increased (Figure 1 and Figure 2). For 
>> patients facing similar waiting periods, the acceptability of 
>> waiting times did not differ significantly between the countries. 
>> For example, the acceptability of waiting times for patients in the
>>  U.S. national and Ontario samples who waited no more than four 
>> weeks for knee replacement was 97.0 percent and 92.7 percent, 
>> respectively (P = 0.09). Similar results were obtained for the 
>> Indiana and western Pennsylvania samples (data not shown).

Canadian system could be "more efficient" on a $/procedure basis, but
the average patient will pay the difference in 10 weeks more time to
obtain a knee replacement surgery (that is a elective surgery that is
easy to plan and are done a lot).

This is interesting:
http://books.google.it/books?id=A4ytL9h0wYgC&pg=PA85&lpg=PA85&dq=waiting+time+heart+surgery+US&source=bl&ots=0RLmzYQbGc&sig=mK5M-qj9D9zUqfIIZoBGXgHtODU&hl=it&ei=52NkSqG4KYarjAf6-Yj8Dw&sa=X&oi=book_result&ct=result&resnum=10


http://www.wales.nhs.uk/documents/NHS_Wales_meets_heart_surgery_waiting_times_target-e.htm

>> NHS Wales meets heart surgery waiting times target
> 
>> Long waits for heart surgery have been eliminated in Wales. No one
>> in Wales is waiting over 12 months for heart surgery, the latest 
>> quarterly waiting times figures show. This meets the target agreed 
>> with the health service last year.

How efficient is waiting for 12 months for a hearth surgery procedure
instead of 3 like in the US?

Mirco