Did you not look at the link in my first article?

Post #64,896 by tuberculosis 11/25/02 10:47:04 AM Reply	Did you not look at the link in my first article? The one that points to world stats on life expectancy and infant mortality gathered by the US government? Because other than that - I don't know how else you can determine what is best objectively. You can never say "if you'd had that cancer in France, you'd be dead now" or "he'd have made it if he were in the US". Because you just never know. The only objective way to tell who has the best care is to see how often the care fails. Still, since you can't be bothered to click - the longest living people in the world are in: \nAndorra\nMacau S.A.R.\nSan Marino\nJapan\nSingapore\nAustralia\nGuernsey\nSwitzerland\nSweden\nHong Kong S.A.R.\nCanada\nIceland\nItaly\nGibraltar\nCayman Islands\nMonaco\nLiechtenstein\nSpain\nFrance\nNorway \nIsrael\nJersey\nGreece\nFaroe Islands\nAruba\nNetherlands\nMartinique\nVirgin Islands\nMontserrat\nMalta\nNew Zealand\nBelgium\nGuam\nAustria\nUnited Kingdom\nSaint Pierre and Miquelon\nMan, Isle of\nGermany\nFinland\nJordan\nLuxembourg\n I'd also like to point out that Cuba is within a hundredth of a percentage point of the good ole USA. Brilliant, huh. Seems they achieve their results by making sure they provide care early rather than wait until its almost too late and then spending the big bucks. Thanks, but I'll prefer care in any of these countries over US crisis managed care every single time. Unless you have a better statistic to show how US technology keeps more people alive longer somewhere..... I thought not. I am out of the country for the duration of the Bush administration. Please leave a message and I'll get back to you when democracy returns.
Post #64,996 by Brandioch 11/25/02 7:14:51 PM Reply	I didn't say that. Unless you have a better statistic to show how US technology keeps more people alive longer somewhere..... I didn't say that. I said the US had the BEST. Not that it provided good care for the MOST PEOPLE. You keep reading "average" when I say "best". When I give an example of a single person with lots of money... You read "entire population". Let me try to chop this up into easily understood chunks for you. Two nations. Each with 100 people. Nation A has 100 coconuts. Each person has one. Nation B has 1000 coconuts. But 999 are owned by 10 of the people and the last coconut is shared between the other 90 people. I say that Nation B has more coconuts. You say that the people in Nation A have more coconuts. Welcome to the real world.
Post #65,011 by boxley 11/25/02 8:11:32 PM Reply	and he whines when I do that :0 will work for cash and other incentives [link\|http://home.tampabay.rr.com/boxley/resume/Resume.html\|skill set] GRAYBOAR-Strangleur Extraodinaire "Have Thumbs Will Travel" Customised Asphyxiations No Gullet Too Big, No Weasand Too small My Motto Satisfaction Garoteed, or the Chokes on Me! Eric Flint
Post #65,029 by Ashton 11/25/02 10:26:15 PM Reply	Afraid I'd have to quibble with 'best' in lots of contexts re American medicine overall. (Leave trauma out of it - that is largely mechanical repair and restoration of known chemical balances, etc. It's not about "retaining good health" generally -- though it IS bloody expensive and to an unnecessary excess, having to do with middlemen. But it is unarguably: the Best trauma care ever.. in certain big city teaching hospitals) Even with your $10 M / and cancer: whether or not surgery, radiation or chemo IS the cleverest, most efficatious treatment for You, next? - that's the sole agenda. Anything not in 'preferred treatment' in the PDR - guaranteed lawsuit territory. And an arsenal of techno- is no match for a wise approach to the entire body: before problems reach a critical stage. (D'Oh) AMA operates a lot like the drones forever enshrined in infamy, via Andy's deathless observation Microsoft offers them the one thing most business people will pay any price for - the ability to say "we had no choice - everyone's doing it that way. So his incisive self-evidently True comment about our herd instinct.. proves applicable quite beyond IT. People who have other promising ideas are often forced offshore (sooner or later) via the pressure to handle all patients exactly according to the Big 3 "procedures". As most patients are even more ignorant of options than their Doctor.. it's Door A, B or C. Within this stifling milieu, much remains mediocre. Until past ~10 years AMA has been actively hostile towards even consenting to look at other countries' records (including overall mortality!) and specifically - approaches to cancer. [link\|http://www.cbsnews.com/stories/2002/06/04/health/main511070.shtml\| Taxol] is just one example of a natural product now proving to be a promising alternative to Big3 re breast cancer (at least that). This substance's use was delayed many years and after very much FUD from the farm-chem folks, from the first. It's about bizness. It always is, here. ANd Med is a >$T/yr. BIZNESS foremost. Natural substances are on NO interst - regardless of efficacy! - in our Corporate medicine - unless there is a patentable lock. There can't be one, if the substance may be used as found and with no reconfiguaration$ to create lock-in. Our habits transcend categories, we see. Expand the topic beyond 'cancer' and there is much else far from 'best' and, the existing 'comparative' stats can hardly be compared with: ideas we won't even look at, now can they? (I think of this as the parallel with quality re software. Quality is not even on the list (beyond 'barely adequate') - the research goes towards achieving lock-in and monopoly. But please to call it 'safety'.) Short form: I'd quibble a lot with any [unqualified] overall characterization of US Medicine as "The Best". (Even for the rich - who may not receive the Best treatment for an individual case: merely very attentive and expensive administration of what is offered.) Ashton
Post #65,107 by tuberculosis 11/26/02 9:01:47 AM 11/26/02 9:04:34 AM Reply	BEST by what measurement? Please cite source. I am out of the country for the duration of the Bush administration. Please leave a message and I'll get back to you when democracy returns. Edited by tuberculosis Nov. 26, 2002, 09:04:34 AM EST Expand All History
Post #65,128 by Brandioch 11/26/02 10:23:01 AM Reply	No source needed. "Best" as is "you couldn't name any country that offered better".
Post #65,139 by bepatient 11/26/02 10:58:46 AM Reply	France. Refute it with facts. You were born...and so you're free...so Happy Birthday! _{Laurie Anderson} [link\|mailto:bepatient@aol.com\|BePatient]
Post #65,147 by boxley 11/26/02 11:07:11 AM Reply	He wouldnt reply to Mexico he doesnt have any facts will work for cash and other incentives [link\|http://home.tampabay.rr.com/boxley/resume/Resume.html\|skill set] GRAYBOAR-Strangleur Extraodinaire "Have Thumbs Will Travel" Customised Asphyxiations No Gullet Too Big, No Weasand Too small My Motto Satisfaction Garoteed, or the Chokes on Me! Eric Flint
Post #65,150 by bepatient 11/26/02 11:12:59 AM Reply	Pick pick pick :-) You were born...and so you're free...so Happy Birthday! _{Laurie Anderson} [link\|mailto:bepatient@aol.com\|BePatient]
Post #65,188 by Brandioch 11/26/02 2:54:04 PM Reply	One more time. Are you saying that Mexico has better health care than the US?
Post #65,196 by Another Scott 11/26/02 3:44:08 PM Reply	Definitions and Metrics. Hi Brandioch and All, Until "better" and "health care" are defined, you folks are going to go round and round. It's not (just) a matter of average versus best particular outcome for a particular person. Average pre-natal care is statistically better in many other countries than in the US. But there are only a few countries that can have septuplets or even octuplets survive (for at least a while) and the US is one of them. Also, those who have nearly infinite resources (e.g. King Hussein of Jordan) commonly come to the US for terminal cancer care, etc. (though I don't know that we'd hear about it if they went to Switzerland instead). So it the US system bad or good? You can't know until the terms are defined. Somebody needs to pick a metric or few. How about: 1) Female life expectancy at [link\|http://www.bartleby.com/151/a29.html\|birth] in 2001 US = 80.05 y, UK = 80.66 y, France = 83.01 y, Switzerland = 82.76 y, Cuba = 78.94 y, Canada = 83.13 y, Finland = 81.36 y, China = 73.59 y, Australia = 82.87 y, Japan = 84.15 y, etc. 2) Life expectancy at 85 in the [link\|http://research.aarp.org/econ/b50_life_expectancy.pdf\|US] in 1997 (PDF) - 6.60 years. (I can't find any comparable data for other countries.) 3) The US ranks 24th according to the [link\|http://www.photius.com/rankings/healthylife.html\|WHO Healthy Life Expectancy] ranking of 2000 - Japan is 1st. Comparing those three figures would give some information about 1) the general nutrition/health of the young women in the population, 2) the ability of the health care system to keep the average elderly person alive, and 3) the ability of the society to prolong the general health of its citizens. Wouldn't that be a simple metric for comparing the US to other countries? At least there'd be something concrete to argue about then! :-) Cheers, Scott.
Post #65,223 by Brandioch 11/26/02 4:57:55 PM Reply	No, I think you've phrased it correctly. Average pre-natal care is statistically better in many other countries than in the US. Yep. But there are only a few countries that can have septuplets or even octuplets survive (for at least a while) and the US is one of them. Yep. Also, those who have nearly infinite resources (e.g. King Hussein of Jordan) commonly come to the US for terminal cancer care, etc. (though I don't know that we'd hear about it if they went to Switzerland instead). When you can afford to send the very best. But your examples go back to averages. And averages aren't a measure of what is best. When something goes wrong, and you have unlimited resources, where do you go? That is BEST.
Post #65,375 by tuberculosis 11/27/02 6:16:23 AM Reply	Silly definition of BEST "When something goes wrong, and you have unlimited resources, where do you go?" Hmm. Weird definition. Certainly it is not best for me. Nor is it (I suspect) for you. Our best bet would be to go somewhere where our resources would buy more care per Euro. Which is not US for anyone with limited resources (which is practically everybody). Technology is one thing - knowledge and know how are something else again. Illustrative joke follows: Man suffers from debilitating headaches and visits doctor after doctor - nothing seems to work - pills work for a short while but he can't function. Finally one doctor tells him there is a cure - but its rather drastic. The doctor concludes that his testicles are pressing against the base of his spine and causing the headaches. Being a crack surgeon, he recommends removal of the testicles. The guy is desperate and agrees. On the way back from the hospital, his head is clear for the first time in months and he's feeling sort of optimistic. He passes a fine clothing store and decides to get a new suit to celebrate. The guy in the store sizes him up by eyeball and says - you look like a 44 long - he grabs a jacket off the rack and guy slips it on. Its perfect! Pants? Sure - inseam is about a 34 he guesses, with a 36 waist - tries em on. Amazing - like custom made! Shirt? Yeah - perfect fit first time? Shoes? Why not - you look like an 11 - exactly so! The guy never guesses wrong. Finally he says - you've gone the whole way - how about some new underwear? "Great" the guys says - "I'd guess 38s". The guy smiles and shakes his head - nope, sorry, I take a 34. The salesman says that can't be right. But the guy insists - "I've worn a 34 since high school". Finally in exasperation the salesman says - "You can't wear a 34. A 34 would press your testicles hard up against the base of your spine and give you one HELL of a headache!" Its a silly joke, but it contains a grain of truth. The technology-focused doctor never thought about a lower tech solution. I suspect, that US doctors are all overly dependent on tech. Anyhow, if I'm terminally ill - the US is about last on my list of places to get treated. I'd rather go somewhere that won't bankrupt me while they kill me. I am out of the country for the duration of the Bush administration. Please leave a message and I'll get back to you when democracy returns.
Post #65,451 by Brandioch 11/27/02 11:52:46 AM Reply	No, that is the definition of "best". Not "what you can afford" which seems to be where you're heading with this. If you can't afford the best, it is still the best. Our best bet would be to go somewhere where our resources would buy more care per Euro. So, when WHAT YOU CAN AFFORD isn't good enough.... You go somewhere where you can afford BETTER treatment. Now, if you have UNLIMITED resources, then you are NOT limited by what you can afford.
Post #65,452 by bepatient 11/27/02 11:56:50 AM Reply	Hardly. That is a definition of "best" in crisis intervention only. Wouldn't it be >better< to not allow the healthcare issues get to that crisis? You were born...and so you're free...so Happy Birthday! _{Laurie Anderson} [link\|mailto:bepatient@aol.com\|BePatient]
Post #65,456 by tuberculosis 11/27/02 12:30:42 PM Reply	All parts of the elephant But I grow weary - his definitions is wacked and I can't help him apparently. I'm sure the view from his side of the argument is equally frustrating. I (and you I think) take the position that the best care would keep a scratch from turning into massive sepsis by effective use of low tech (and cheap) means (basic cleansing, clean dressings, observation). This is the best outcome and hence the best care. His view is, once you've got massive sepsis, the US doctors are more likely to pull you back from the brink of death (most likely with amputation of the affected limb, fancy blood filters, and extensive and elaborate drug regimes) than anyone else. I don't call that good care though and its only a tiny part of the picture. At one single data point, there is a spike in the graph. If you are really screwed up, certain stars might be able to do better than anyone else. I think its fallacious though. If Michael Jordan came to France to play basketball professionally, does that mean that France is now the best in basketball because he brings a million coconuts with him? Er.... you know what I mean. So I think this argument is exhausted and we just don't agree on what "best" is. Next topic. I am out of the country for the duration of the Bush administration. Please leave a message and I'll get back to you when democracy returns.
Post #65,554 by Brandioch 11/27/02 7:32:13 PM Reply	Because my definition does not agree with your opinion.... When you start calculating the AVERAGE of anything, then you're taking the AVERAGE. Average life expectency, etc. The average is not the best. You can have the highest average. But that isn't the best.
Post #65,581 by Silverlock 11/27/02 11:41:23 PM Reply	Lighten up The US's health system may have the "best" in some areas. Not all. Stop trying to infer that since we have the best in some aspect, we have the best in all. A cheap rhetorical device. Why should we ask our military to die for cheap oil when the rest of us aren't even being asked to get better mileage? -[link\|http://www.workingforchange.com/article.cfm?itemid=14107\|Molly Ivins]
Post #65,586 by boxley 11/27/02 11:55:42 PM Reply	never let a cheap rhetorical device hold you back :-) will work for cash and other incentives [link\|http://home.tampabay.rr.com/boxley/resume/Resume.html\|skill set] Opera was the television of the nineteenth century:loud, vulgar and garish with plots that could only be called infantile. "Pendergast"
Post #65,623 by bepatient 11/28/02 11:23:31 AM Reply	He never does ;-) You were born...and so you're free...so Happy Birthday! _{Laurie Anderson} [link\|mailto:bepatient@aol.com\|BePatient]
Post #65,239 by boxley 11/26/02 7:15:03 PM Reply	yes will work for cash and other incentives [link\|http://home.tampabay.rr.com/boxley/resume/Resume.html\|skill set] GRAYBOAR-Strangleur Extraodinaire "Have Thumbs Will Travel" Customised Asphyxiations No Gullet Too Big, No Weasand Too small My Motto Satisfaction Garoteed, or the Chokes on Me! Eric Flint
Post #65,322 by Brandioch 11/27/02 12:08:22 AM Reply	And Mexico's equivalent to the Mayo Clinics is.....?
Post #65,328 by boxley 11/27/02 12:18:00 AM Reply	UNAM Mexico City where Americans go to do post grad tropical and cardiac, thanx, bill will work for cash and other incentives [link\|http://home.tampabay.rr.com/boxley/resume/Resume.html\|skill set] GRAYBOAR-Strangleur Extraodinaire "Have Thumbs Will Travel" Customised Asphyxiations No Gullet Too Big, No Weasand Too small My Motto Satisfaction Garoteed, or the Chokes on Me! Eric Flint
Post #65,371 by Ashton 11/27/02 5:47:57 AM Reply	Heh - once 'made rounds' there complete with white coat, with one Dr. Sodi Pallares (isch\ufffdmic heart disease expert - met in connection with a trip with friend, to a TJ clinic). His bedside manner with an elderly patient was.. like the rumored old days here - before Corporate. I couldn't extrapolate from such little direct experience, of course - but that woman had little/no? money, and I liked what I observed elsewhere. This was over a decade ago - and ideas in his book weren't even being examined here. I checked, on return. (When you haven't money to burn - you Have to work smart. And like Mexican mechanics do, so apparently do the Doctors) Mex. mechanics actually know how to FIX things, how to improvise - not just keep putting in new parts until something sorta seems to work. (I know that too - via a Saab experience) Ashton Viva M\ufffdxico!
Post #65,555 by Brandioch 11/27/02 7:38:28 PM Reply	It looks good. But I'm not finding anything saying it is the best. Got any references?
Post #65,566 by boxley 11/27/02 8:30:01 PM Reply	Its your assertion, you support it. What country developed and did the first heart transplant? What country pioneered lasik and showed us how to do it? What nationality are most american emergency room docs? Who developed xray technology? where can I get lasik for 350USD per eye including hotel stay? who has the most money for r&d in medical technology? The US. One out of 5 aint bad. etc, thanx, bill will work for cash and other incentives [link\|http://home.tampabay.rr.com/boxley/resume/Resume.html\|skill set] GRAYBOAR-Strangleur Extraodinaire "Have Thumbs Will Travel" Customised Asphyxiations No Gullet Too Big, No Weasand Too small My Motto Satisfaction Garoteed, or the Chokes on Me! Eric Flint

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