US Universal Healthcare: How are we going to pay for it?

[famousringo]

Kasz216 said:

famousringo said:

This hit a bit of a nerve with me, since my grandfather spent a couple decades fighting off cancer that started in his prostate before succumbing to it at the respectable age of 86, all in Saskatchewan. Prostate cancer is used often in these examples, because it is a slow-growing cancer and can often be left to wait with little consqeunce, so jurisdictions looking to save a little money do exactly that. It seems that US cancer survival rates might not be all they're cracked up to be:

http://blog.washingtonpost.com/fact-checker/2007/10/rudy_miscalculates_cancer_surv.html

The latest official figures for five-year "survivability" rates for men diagnosed with prostate cancer are around 98 per cent in the United States and 74 per cent in England.

More importantly, the survivability figures tell us little about the differences in the quality of treatment received by prostate cancer patients in the United States and Britain. Doctors in the two countries have different philosophies about how to treat prostate cancer, and these differences have greatly influenced the "survivability" statistics.

In the United States, there has been a big emphasis since the early 1990s on early screening through PSA (prostate-specific antigen) testing. Five-year survivability rates have increased simply because men are being diagnosed with prostate cancer at a very preliminary stage of a slow-developing disease. If you are diagnosed early on, your chances of surviving for another five years are close to 100 percent. Britain is several years behind the United States in the widespread use of PSA testing.

"When you introduce screening and early detection into the equation, the survival statistics become meaningless," said Howard Parnes, chief of the Prostate Cancer Research Group at the National Cancer Institute. "You are identifying many people who would not otherwise be diagnosed."

Another way of comparing treatment of prostate cancer in the U.S. and Britain is to look at the mortality rates from the disease. Here the two countries are much closer. The graph below shows deaths per 100,000 males in each country. About 25 men out of 100,000 are dying from prostate cancer every year in both the U.K. and the U.S.

Brantley Thrasher, chairman of the Department of Urology at the University of Kansas, said it was "impossible to say" on the basis of the statistics whether a prostate cancer patient had a better chance of surviving under a "capitalistic" or "socialistic" medical system. American doctors tend to be more "interventionist" and more likely to advocate surgery than their counterparts in Britain or Canada, where greater emphasis is put on "active surveillance." In the United States, a patient with a good health care plan is "more empowered to make decisions" for himself.

"You can't say that it's better to have prostate cancer here or in some other country," with a developed health care system, said Dr Thrasher, who also serves as a spokesman for the American Urological Association.

While doing this research, I also turned up this surprising study which shows that the US health system actually offers fewer services in many categories than other OECD countries (fewer doctors, nurses, bed), despite paying so much more:

http://www.medicalnewstoday.com/articles/27348.php

My answer to the thread topic itself is a combination of rationing, price controls, and improved efficiency. Increased tax revenues shouldn't even be necessary, though it's always an option. The United States already spends more public money on health as a share of GDP than Canada, and it obviously isn't getting enough value for that money if so much more private money gets spent along side. If the governments of Canada can provide universal coverage for 6.84% of GDP, I see no reason why the US shouldn't be able to for 6.88% of GDP, except perhaps a lack of political will.

You missed a vital part of information in there.

According to Patrick Walsh, professor of urology at Johns Hopkins, the British data probably understate the number of people who have died from prostate cancer in Britain. Some prostate cancer-related deaths in the U.K. were classified as deaths from pneumonia before 1984 and after 1992.

 

Additionally what is being ignored is that the United States accounts for over 70% of the worlds medical research.  How does anyone plan replace all that private spending that will dry up from the lack of profits?

To use cancer as an example... how many more years would we have to wait for gold nanorods to replace other more dangerous treatments?

 

I don't see how that information is relevant, actually. Three key facts remain:

1. The mortality rates remain very comparable, including during an eight- year period when there were no prostate cancer-related deaths reported as pneumonia in the UK.

2. The appearance of high survival rates in the US is an illusion caused by early detection more than a result of treatment outcomes. Not that anybody would argue that early detection isn't a good thing.

3. A spokesman for the American Urological Association states that you cannot draw the conclusion that the United States has better prostate cancer outcomes than other developed countries.

As to medical research, even America's substantial spending amounts to less than 1% of GDP, and almost half of that is public money. If the United States coud bring its health spending in line with the second biggest health spender in the world, it could quadruple research spending and still save money.

In the specific matter of cancer research, just today I stumbled across a promising, publicly funded research project using "nanobees" to target cancerous tumors. If you look at their paper published in The Journal of Clinical Investigation, they cite the NIH as a source of funding:

http://www.theregister.co.uk/2009/08/11/cancer_nanotech_bees/