Talk:Healthcare in the United States/Archive 2

Archive 1

Archive 2

Archive 3

Veterans Health Administration

Veterans Health Administration is a major part of public health care in the US. It belongs in the Public Health Care infobox at the top right of the article, but I do not know how to enter that bullet. Can somebody smarter than me please fix this?DiverDave (talk) 11:23, 3 August 2009 (UTC)

That is a navigation box template rather than an infobox. Somebody has already fixed it apparently.--Jorfer (talk) 02:03, 4 August 2009 (UTC)

Reform

Obama wants to reform the USA health care, should we update this?

(217.42.240.189 (talk) 16:35, 14 August 2009 (UTC))

That's covered in the article on Health care reform in the United States. EastTN (talk) 14:17, 15 August 2009 (UTC)

References

Any objection to formatting it to run in three columns rather than two? The Squicks (talk) 22:02, 26 August 2009 (UTC)

Why doesn't anyone ask the critical questions concerning the COST of health care?

Questions like "Why DO we rack our brains on finding out how to PAY for healthcare?" "Why does healthcare cost so much that so many people incur personal bankruptcy?" (Because of exhorbitant costs) And here's a question that can start off a slew of other questions such as "Why does healthcare cost so much in the first place?" Rediculous lawsuits, "Big Pharama"...and why is the pharmaceutical industry so big in the first place? Keep drilling down deeper and deeper into these issues and I'm sure one can uncover a lot of answers. They won't find easy answers...they won't be convenient...some people wouldn't be making as much money as they had before...but there will be answers.

I think if a nation really wants to do something about a system that is not as effective as it should be (well that's a bit of an understatement for our healthcare system!), it needs to critically analyze everything that's involved. Easier said than done, but it has to be done. —Preceding unsigned comment added by Needthetruth (talk • contribs) 13:13, 30 August 2009 (UTC)

Cadillac Tax

that will tax employers and insurers. Employers will have to reduce wages or benefits or increase cost sharing. Employees will now blame employers and not the government. Glen Beck, web exclusive —Preceding unsigned comment added by Stang5litre (talk • contribs) 15:18, 19 November 2009 (UTC)

No Mention of Free Clinics

There are free clinics in the U.S. which provide substantial healthcare for the uninsured/underinsured and this article doesnt mention them at all.

-gEM —Preceding unsigned comment added by 76.166.243.56 (talk) 21:08, 29 June 2009 (UTC)

The free clinics do not provide "substantial" healthcare, and they are rare. The ones you hear of are more often a state or locally funded venture. The only federal "free" healthcare is Medicaid, and only a small percentage of the population is eligible. I have no health insurance (pre-exisiting condition) and have never been able to go to a free clinic. ReignMan (talk) 09:01, 20 December 2009 (UTC)

Why I reverted the article to the last good version by Dhakk

Some anonymous idiot (who refuses to create an account and log in) keeps editing out certain key points about why Americans are so wedded to their current health care system, dysfunctional as it is.

The point is that whether one agrees with free-market libertarianism or not (or its academic companion, the law and economics school), or the conclusions drawn by its adherents, it is a major factor in the internal politics of the United States.

Like the flawed concept of race, it is like a self-fulfilling prophecy in the circular sense that it still matters because people take it seriously, and people take it seriously because it matters. Therefore, it needs to be mentioned in any serious discussion of anything that affects the American economy, including healthcare (which as we all know is a huge component of American GDP).

Yes, I will personally concede that perhaps some of the fears of libertarians are exaggerated, but for better or worse, libertarianism and the political consequences of its views are dominant in the U.S. and should be incorporated into any serious discussion of American economic issues, especially healthcare. Otherwise, a neutral student of these issues will not be able to understand what the hell is going on when they are trying to comprehend the crazy American healthcare system (and the last time I checked, enlightenment is a major goal of an encyclopedia).

--Coolcaesar 00:53, 19 Jan 2005 (UTC)

Why would people want to keep a system that is overly regulated because it is more "libertarian"? Are you trying to say that the U.S. has a free market in health care and that is why people want to keep it? As far as I can tell the U.S. government spends more on health care than almost any other country and the industry is so regulated that people are shielded from the actual costs which drives up prices in the long run. What exactly does our system have to do with libertarianism anyway? --Jayson Virissimo 21:20, 27 July 2007 (UTC)

Please refrain from name calling in discussions. Thank You.
Also, talk pages are for discussion of development of the article itself, and not to be used for discussions about opinions, theories, or debates of the subject being written about.
Howaboutyouthinkaboutit (talk) 05:07, 19 September 2009 (UTC)

Articles needs to be NPOVed

elaborate please....

This article has a lot of useful information about the U.S. health care system, but it needs a good NPOVing (made neutral in point-of-view) as it's rather slanted against the methods of managed health care. Bumm13 15:12, 12 May 2005 (UTC)

I think the outline has gotten rid of NPOV problems I am going to remove that in a few days/Mrdthree 13:43, 15 July 2006 (UTC)

Slanted? How can lack of health care for millions be a neutral issue?! How can people going bankrupt because they have cancer be a neutral issue either?

Generally, uninsured statistics represent a snapshot. Many uninsured people are reinsured in less than a year; The same people are not uninsured year in and year out. And what makes you think a National Healthcare system would fix the money problem for cancer patients, et al? National Healthcare would make medical services seem free, which pushes demand beyond what this county can currently supply. Govt's deal with that by limiting what's available, hence less cancer care for everybody. Less cancer care means higher fatalities overall. Joe Christl (talk) 15:48, 19 February 2008 (UTC)

Screw HMO's and the sociopaths that run them. Sean7phil (talk) 19:18, 15 January 2008 (UTC)

This article sounds like it was written by socialists. Please correct it towards a more NPOV immediately!! Joe Christl (talk) 15:48, 19 February 2008 (UTC)

The article still sounds like it's being written by socialists, and does not appear to actually contain information on "Health Care" as much as it seems overall to be concerned with "Health Care Reform". Either additional information needs to be provided in the main body of the article pertaining to Health Care, with any perceived flaws and problems contained solely within the section on Health Care Reform, or the title itself should reflect that the article is indeed intended to be a discourse on Health Care Reform In The United States.Howaboutyouthinkaboutit (talk) 05:26, 19 September 2009 (UTC)

The first paragraphs of this article read like a direct copy and paste of talking points from many of the proponents of the proposed legal reforms and single-payer/socialist medicine/universal health care ideas. This is clearly not a balanced point of view, and the statistics and facts appear to have been picked just to push one point of view. For example, the statistics on infant mortality of the U.S. vs. other countries are given, but no statistics about better cancer survival rates in the U.S., or the ongoing debate about external (i.e., non-medical) factors in infant mortality are mentioned. In another example, the statistical methods for the claim that more than half of all bankrupticies in the U.S. are caused by medical bills is also disputed (see http://www.aei.org/speech/100071, for example), but no mention of this is made. More importantly, this topic discusses overall medical care in the U.S., and the ongoing debate about reforms are one small facet of that. The opening paragrphs do not discuss anything but the current criticisms by one particular gruop. This is clearly an attempt to hijack this topic for political purposes. 66.192.138.228 (talk) 17:26, 30 November 2009 (UTC)JEG66.192.138.228 (talk) 17:26, 30 November 2009 (UTC)

Arguably the best of all indicators regarding the overall health of a society is the average life expectancy, this is inclusive of all major illness groups. It may not be a perfect measure, but it is certainly the fairest measure. It is also one of the most easily universally available measures across the globe, and so makes for the best comparator at a global level. The problem with cherry-picking specific illness groups is that you are open to accusations of distorting the true situation. It may well be true that cancer survival rates are higher in the US, but do we then include all of the lower survival rates for other illnesses? There are too many illnesses to cover; this article would turn into a book. Dbnull (talk) 15:14, 16 December 2009 (UTC)

With Bumm13, I agree, but disagree

I agree with Bumm13 that this article needs to have its "ranting" quality restrained. But I feel it was, as are all Wikipedia articles comparing the US and Canada, slanted (tremendously) in favor of the Canadian institution. I guess it's to be expected, considering the European/Canadian left-wing-dominated contribution to Wikipedia. -Justin T.—The preceding unsigned comment was added by 65.33.245.150 (talk • contribs) 09:03, 11 June 2005 (UTC).

The reason there's a "slant" towards the Canadian system is not bias, but the fact that statistics favor it. Canadians live longer (72 to 69.3), pay less (2,535 to 4,631 in U.S. $), and are generally healthier. It's not slant, but a representation of reality based on the best available facts and figures. The reason any people find a source to be biased is because their own perspective represents "neutral", and anything that doesn't match it appears to be biased. If you deeply believe in something, then factual information countering it seems like bias, no matter what the issue. ReignMan (talk) 09:12, 20 December 2009 (UTC)

You have got to be kidding, correct? Have you been to the Clinton page at Wikipedia? It rehashes every single nutcase right-wing-radio allegation ever made against Clinton. Meanwhile, Wikipedia's entry for George W. Bush carefully sanitizes his record (and could well have been written by Karl Rove).—The preceding unsigned comment was added by 71.86.119.156 (talk • contribs) 22:50, 6 June 2006 (UTC).

Shorten Intro

I am going to shorten the intro. It starts arguing a political case before the appropriate section. Mention facts leave argument for those interested in that part of the topic.Mrdthree (talk) 13:49, 27 August 2008 (UTC)

According to WP:LEAD, the lead section "should establish context, explain why the subject is interesting or notable, and summarize the most important points—including any notable controversies that may exist." The last paragraph of the lead, which provides an overview of the controversies around healthcare in the US, is essential, in my opinion. We might be able to trim some of the statistics, but in the past, attempts to do that have been difficult, because each side in the debate has their favorite stats, and trimming them in a balanced way that achieves consensus has been nearly impossible. Please suggest specifics. --Sfmammamia (talk) 15:22, 27 August 2008 (UTC)

I concur. Given the importance of the question, dedicating a paragraph to summarizing the issues doesn't seem excessive to me. Compared to the amount of material in sections 4, 5 and 6 (Overall system effectiveness, System inefficiencies and inequities & Regulatory inefficiencies and inequities), it really is just a summary. That doesn't mean we can't improve it, but we really should provide the reader with an overview of the key issues. EastTN (talk) 21:02, 27 August 2008 (UTC)

I went back and reread the intro and added a few things. Here is my suggestion as to the shortened intro( with explanations for edits):

Health care in the United States is provided by many separate legal entities and the U.S. is the only wealthy, industrialized nation that does not have a universal health care system.

The U.S. spends more on health care, both as a proportion of gross domestic product (GDP) and on a per-capita basis, than any other nation in the world. Current estimates put U.S. health care spending at approximately 16% of GDP. In 2007, the U.S. spent a projected $2.26 trillion on health care, or $7,439 per person.

Here I excluded a projection because trending is not a science and 'it hasnt happened yet':

The health share of GDP is expected to continue its historical upward trend, reaching 19.5 percent of GDP by 2017.

I also omitted the attribution since it is covered by the citation and doesnt seem to rely on any special scientific knowledge (it is as valid a source as any other)

According to the Institute of Medicine of the National Academy of Sciences, the U.S. is the only wealthy,

In the United States, around 84.7% of citizens have some form of health insurance; either through their employer (59.3%), purchased individually (8.9%), or provided by government programs (27.8%; there is some overlap in these figures). U.S. government programs accounted for over 45% of health care expenditures, making the U.S. government the largest insurer in the nation.

Here I omitted details of the government programs, their purpose seems to be to illustrate the poor have access to healthcare, something that could be read in the body or inferred from the large government expenditures

Certain publicly-funded health care programs help to provide for the elderly, disabled, children, veterans, and the poor, and federal law mandates public access to emergency services regardless of ability to pay.... Per capita spending on health care by the U.S. government placed it among the top ten highest spenders among United Nations member countries in 2004.

I omitted the following paragraph altogether because the percentages can be deduced

Americans without health insurance coverage at some time during 2007 totaled about 15.3% of the population, or 45.7 million people. Health insurance costs are rising faster than wages or inflation, and "medical causes" were cited by about half of bankruptcy filers in the United States in 2001.

The debate about U.S. health care concerns questions of access, efficiency, and quality purchased by the high sums spent. The World Health Organization (WHO) in 2000 ranked the U.S. health care system first in both responsiveness and expenditure, but 37th in overall performance and 72nd by overall level of health (among 191 member nations included in the study). However, the WHO study has received criticism for both its methodology and for a lack of correlation with user satisfaction ratings.

Here I omitted details of the criticism of the WHO report, which can be rad in the body:

The CIA World Factbook ranked the United States 41st in the world for lowest infant mortality rate and 45th for highest total life expectancy. A recent study found that between 1997 and 2003, preventable deaths declined more slowly in the United States than in 18 other industrialized nations. On the other hand, the National Health Interview Survey, released annually by the Centers for Disease Control's National Center for Health Statistics reported that approximately 66% of survey respondents said they were in "excellent" or "very good" health in 2006.

Mrdthree (talk) 12:34, 28 August 2008 (UTC)

Thanks for laying out your suggested edits so clearly - that's very helpful. I do have a different perspective on much of this, though.

The health share of GDP is expected to continue its historical upward trend, reaching 19.5 percent of GDP by 2017.

This is the official government projection performed by the CMS Office of the Actuary, provides baseline assumptions for the Medicare Trustees Reports, and provides the baseline for most public policy discussions of likely future health care spending. The relentless upward trend in health care spending is absolutely central to the current health care debate, and this is as close to a gold standard projection as we have in the U.S.

According to the Institute of Medicine of the National Academy of Sciences, the U.S. is the only wealthy . . .

This particular sentence has been the center of a great deal of discussion. Not everyone agrees with the formulation. The U.S. is not the only nation without national health care. All of the qualifications: "wealthy," "industrialized," come directly from the source. Others may disagree with me, but the sourcing for this seems to have been a significant factor in the discussions of what to say.

"Here I omitted details of the government programs, their purpose seems to be to illustrate the poor have access to healthcare, something that could be read in the body or inferred from the large government expenditures" Certain publicly-funded health care programs help to provide for the elderly, disabled, children, veterans, and the poor, and federal law mandates public access to emergency services regardless of ability to pay.... Per capita spending on health care by the U.S. government placed it among the top ten highest spenders among United Nations member countries in 2004.

Everything in the lead can be read in the body of the article. The fact that the U.S. has made a significant - albeit not universal - commitment to providing health services to the poor is significant. Frankly, I'm going to have a problem with a lead that highlights the lack of a universal coverage system but doesn't talk about the safety net programs the U.S. does have - that would seem to me to create a pretty badly unbalanced picture. It's also important to explain how the government spends so much in the absence of a universal health care system.

Americans without health insurance coverage at some time during 2007 totaled about 15.3% of the population, or 45.7 million people. Health insurance costs are rising faster than wages or inflation, and "medical causes" were cited by about half of bankruptcy filers in the United States in 2001.

The percentage of the uninsured can be deduced, but it's also the single greatest criticism of the current system. If we report how many people are covered, we pretty much have to report how many people aren't. Beyond that, the fact that insurance premiums are rising faster than CPI can't be as easily deduced, and the bankruptcy figures (though I have some technical doubts about the way they're used - from what I've seen the "medical" bankruptcies are more driven by long-term disability than hospital or doctor's bills) have become almost emblematic of the debate over the uninsured.

I'm actually o.k. with dropping that last paragraph. EastTN (talk) 15:45, 28 August 2008 (UTC)

In general, I agree with EastTN. The Institute of Medicine attribution is necessary, as it was arrived at through consensus (rather than deleting the statement altogether, which was what some editors wanted us to do.) Summary that highlights who the government covers and how many people in the US lack health insurance are absolutely necessary. I think the last paragraph would be acceptable with the deletion proposed, so long as those details are in the body of the article. --Sfmammamia (talk) 15:59, 28 August 2008 (UTC)

I wanted to add a sentence to teh intro. Maybe someone should rewrite it.Mrdthree (talk) 14:53, 22 June 2009 (UTC)

It seems there is general agreement here by a number of parties that the article is actually about the issue of Health Care Reform in the United States and not a general article about Health Care in the United States, with emphasis on the "care of health" side of things. A number of people have already commented on this and suggested either the title be changed to better reflect the content of the article, or the content expanded to more correctly address the health aspects of health care in the U.S. I would also agree that one or the other should be done.
Howaboutyouthinkaboutit (talk) 08:15, 22 September 2009 (UTC)

This article is terrible

I just wanted to simply know how the US health care system works, but I won't read this whole big article to make any sense. Why isn't here an understandable lead which would tell me simplified how the money and services flow in this system? I see only badly hidden or neutralized opinions.

The 1st paragraph is about the spending. That should be maximally one sentence. The second paragraph is about the reform intentions and criticism. But why is it there if I don't know yet what is criticized and what should be reformed. The third paragraph is on the spending again.

I don't know. Maybe it's because for the authors of the article it's naturally to know, how it works, but I live in Europe and have no clue and this article doesn't help me at all. 81.182.237.202 (talk) 22:24, 28 March 2009 (UTC)

I agree with you entirely, and am from the U.S. myself. So, no, it's not because you live in Europe that the article seems to be more about healthcare reform intentions and criticism, as that is it's primary point. It is not about health care services in the USA in general. It is oriented primarily toward costs and comparisons, and is, in effect, an argument for government run healthcare, which I have no problem with if it were titled as such. I believe your critique to be valid, as well as appropriate. Howaboutyouthinkaboutit (talk) 14:15, 22 September 2009 (UTC)

Opening Statement Incorrect.... Legal Entities Don't Provide Healthcare...

This article is so poorly written and obviously biased on the Obamacare issue, that even the first sentence doesn't make sense.

The opening sentence currently reads - "Health care in the United States is provided by many separate legal entities."

Legal Entities Don't Provide Healthcare.

Medical Professionals provide healthcare.

These professionals provide healthcare through many different methods such as private practice, through HMO organizations, through clinics both free and on a pay as you go basis, through hospitals, through home care and hospice services, and through paramedic services.

71.192.142.226 (talk) 09:29, 15 September 2009 (UTC)

The first sentence is based on a version I drafted years ago. The sentence is correct. It's like how fast food is provided by many different legal entities (McDonald's, Burger King, Taco Bell, etc. and thousands of local franchisees) versus having one big government-run fast food agency or a fast food monopoly. --Coolcaesar (talk) 15:33, 15 September 2009 (UTC)

Regardless of what you drafted years ago, "legal entities" do not provide healthcare. Doctors, nurses, surgeons, and other medical professionals provide healthcare. The "entities" as you refer to them are the various avenues through which these medical professionals provide their services such as private practice, clinics, hospitals, and so on. The statement as it stands, that somehow "legal entities" provide healthcare, makes no sense, is vague, confusing, and incorrect. Howaboutyouthinkaboutit (talk) 01:24, 16 September 2009 (UTC)

Article Title Is Misleading... Article Is About Healthcare Reform and Is Highly Biased.

The Title of this article is misleading and indicates that the topic is about the subject of Health Care itself, as in discussing what kind of care is available, how one attains such care, the various avenues by which care is provided, and so on.

Upon review one finds the topic being written about extensively is actually about Health Care Reform, and is being written by one or more individuals with a highly biased viewpoint regarding socialized or nationalized healthcare. To accomplish this agenda the article meanders into areas such as what the people want, whether government run health care is a good or bad thing in comparison to other countries, statistics on waiting times for various services, and so on, all highly controversial and questionable subjects which the author(s) appear to be quite defensive over, apparently removing anything which does not strengthen their viewpoint on the issue.

This article amounts to a virtual debate being drawn out on wikipedia regarding one or more individuals view regarding Health Care Reform, and despite the rightness or wrongness of making such an entry into Wikipedia, at the least the individual should be honest enough to accurately include the words "Health Care Reform" in the title of the article, otherwise the article should include a more comprehensive and accurate explanation of Health Care regarding various types of healthcare, where this care can be attained, the amount of training health care professionals typically go through before being allowed to practice, people from other countries coming to the USA for medical treatments, and so on, as well as other benefits and medical advances due to the Health Care system in the United States. This information is largely missing from the article at this time, and it appears the author(s) are not interested in pointing out anything of merit with the health care as much as establishing a foundation for a predominately liberal viewpoints regarding the issue of Health Care Reform in the United States. Apparently, in an attempt to gain validity for their viewpoint (i.e. "look up Health Care in the United States on Wikipedia and see what they say about it")

In an article which speaks primarily about the issue of Health Care Reform in the United States, it is dishonest and deceiving to not provide an accurate title which reflects what is being written about clearly. As it currently is written, this does not appear to overall be an article about Health Care itself, but primarily about Health Care Reform throughout its content. As such it should be titled to reflect its content accurately, or have additional content included in the main body which might reflect what the title indicates the article is about with all bias regarding healthcare reform removed (other than in the section which is titled "Health Care Reform" itself). Howaboutyouthinkaboutit (talk) 02:04, 16 September 2009 (UTC)

edit out or move the politics then. 69.211.104.84 (talk) 03:22, 17 September 2009 (UTC)

The article provides a clear and balanced overview of the U.S. healthcare system. The only part focusing on healthcare reform is the last part. Also, your level of education is indicated by your limited understanding of the rules of capitalization (it's "health care reform," not "Health Care Reform"). --Coolcaesar (talk) 05:27, 17 September 2009 (UTC)

WP:BITE and WP:CIVIL...no need for ad hominum arguments here...this is a talk page and not the actual article...it is not necessary that discussion be formally formatted (as in my informal use of ellipses to separate clauses), just understandable.--Jorfer (talk) 19:51, 17 September 2009 (UTC)

A valid approach to editing the intro would be to analyze it and see if it is a fair representation of article content. This could be done by looking at the outline and the amount of space devoted to topics. Or you could list topics you think are not health care related. Mrdthree (talk) 21:05, 17 September 2009 (UTC)

I tend to agree that the article strays too far into the reform arguments. Given the arguments about cost and coverage presently under way in the U.S. it is hard to imagine that these issues could be ignored. A section of restricted length should summarise the issues with a link to the main article covering reform. Haen't got the time to do it myself tho.--Hauskalainen (talk) 00:44, 18 September 2009 (UTC)

"Health Care Reform" would actually be proper formatting, as words in a title commonly have their first letters capitalized, though as Jorfer pointed out, lets not lose sight of the item being discussed, which is whether the article even addresses the subject of Health Care as the title indicates, as much as in it's current form it primarily addresses the problems with the health care system and the need for health care reform, in general. Howaboutyouthinkaboutit (talk) 06:23, 19 September 2009 (UTC)

If This Article Is About "Health Care", Then...

...consider adding information at the beginning of the article about the actual subject of Attaining Care for one's Health in the United States at the beginning of the article.

Although you may disagree with the viewpoint, I provide the following as an example of an article that is actually about "Health Care" for those who are actually interested in an article on that subject -

____________________________________________________________________________________________________

Health care in the United States is provided by highly trained members of the medical profession, as well as through numerous alternative health care professions. These professionals provide health care through many different avenues such as private practice, through HMO organizations, through walk-in clinics both free and on a pay-as-you-go sliding-scale basis, through hospitals, through home care and hospice services, and through paramedic services. The services these professionals provide range from the General Practitioner who diagnoses and treats patients for a broad range of illnesses, to specialists who treat a specific area of the body or a particular type of disease such as cancer, allergies, heart disease, or skin problems. In addition, there are also professionals who provide alternative methods of healing, such as chiropractors, acupuncturists, naturopaths, and others.

While the medical profession generally operates using the "disease model" where they attempt to diagnose a patients condition according to their symptoms and provide relief by means of various pharmaceutical medicines and drugs, assist the immune system through use of antibiotics, burn off diseased cells through radiation and chemotherapy, or cut off diseased or damaged body parts using surgery; there are other holistic healers who treat diseases naturally using the "health model" [Reference] where their goal is to maintain or return a patient back to optimal health using the most natural and least invasive procedures possible. There is a wide variety of professionals to choose from and the choice of what type of treatment, where to attain treatment, which professional they will be treated by as well as the cost of the treatment is in most cases the patients choice. If a doctor recommends a course of treatment, the individual has a right to agree or disagree with the treatment and is free to go to another doctor for a second opinion or a different treatment altogether.

In the United States, care is commonly available within a very short timeframe, sometimes on the very same day the healthcare professional is contacted. Once a healthcare professional is contacted, one makes an appointment for an agreed upon date and time, generally within a few days of the initial contact although sometimes it may be a week or two, depending on the healthcare professional's availability. It is not uncommon to hear of someone going to a doctor and being rushed immediately to the hospital for surgery or treatment after discovering they have a life threatening illness without being sent home or put on any kind of waiting list . This is quite good compared to other countries with other health care systems such as Canada, where the median waiting times from a patient's referral by a GP to treatment by a specialist, depending on the procedure averages from five to 40 weeks. [Reference] By comparison, it's three times more likely for Canadian and United Kingdom citizens to wait more than a month to see a specialty physician, as compared with the U.S. [Reference]

Medical Care in the United States is considered to be amongst the best in the world, and many people from Canada, England, and other countries regularly come to the United States for treatment [Reference]. Despite the high quality of treatment available, the costs of medical care have been steadily increasing over recent decades, making the cost of health care in the United States a concern for a high percentage of it's citizens, reaching a peak as a national issue in 2009 when the government introduced a bill which would nationalize the health care system if passed. (see Section on Health Care Reform) [Reference] Howaboutyouthinkaboutit (talk) 06:00, 19 September 2009 (UTC)

[edit] If you think that your proposed is About "Health Care in the United States", then... if you put it in the article I would probably delete it! It does not address the topic fairly, it points to a promotional website and engages in blatant politiking. What has Canadian wait times got to do with health care in the united States? It alleges that many Brits and Canadians fly to the U.S. for health care but gives absolutely no evidence for this. Holistic healing may be part of the U.S. health care system but it is not a mainstream part and therefore risks making the text unbalanced. Actually people do flock to the UK for treatment, especially from the Middle East. You seem to be under some misunderstanding about the UK. Many UK facilities (including, the NHS has it happens) offers fee for service health care to people outside the UK and the UK has a very high reputation for its surgical centres. I have a feeling that, for its size, the UK handles MORE overseas patients than does the U.S. if only because of its proximity to so many foreign countries.

While I'm sure that you find Hauskalainen's determination to put his own personal unsourced opinion into articles to be against the spirit of Wikipedia, all of the articles that you have cited are either blogs, opinion columns, or personal websites (which are not very reliable). The WSJ story, for example, quotes a Republican Congressperson making the waiting times comparison rather that stating the issue as a matter of fact. Better sources are needed. The Squicks (talk) 19:54, 19 September 2009 (UTC)

There's no need for getting personal, nasty, or threatening here. I thought I had very clearly stated that I did not intend what was written to be put in the article verbatim, but merely provided it as a suggestion and example of information which the title suggests the article is all about, yet seems to almost entirely be missing information on, namely "health-care". Obviously this was lost on the respondent above who was so quick to make threats of deletion and criticize rather than contribute to the improvement of the article, which is what these talking pages are supposed to be for. To be honest, I have no idea what Hauskalainen has done or not done, and I'm not sure why that was even brought up, as it has nothing to do with the matter at hand. Simply put, an article proclaiming to be about health care, should provide information on the health aspects of the subject, as well as information on who provides the care, where the care is attained, what kind of experience someone coming to this country for care might experience, and so on. How can this be so willfully and consistently overlooked or objected to is beyond me, and has been pointed out by quite a number of people I've noticed when reading previous discussions over quite a period of time.

As far as the references, I'd actually appreciate if someone would either explain or point me to an article which explains what are considered proper sources of references for a wiki article. That would be far more helpful than simply criticizing and making vague statements such as "better sources are needed". I'd prefer to be informed and provide valid sources rather than play some kind of game with these continued responses on a personal level. The purpose of any discussion here is supposed to be for the improvement of the article, not to attack individuals in myriad ways. Again, I thought I had made it clear that the references used in the example were only for the purpose of example, and were never intended to be the references used in the actual article. Whoever writes the actual material which is so blatantly missing would be expected to provide appropriate references themselves, of course. (note: located a tutorial regarding good reference sources here - http://en.wikipedia.org/wiki/Wikipedia:Referencing_for_beginners#Good_references though I'm still working on understanding if an article about the failing Canadian Healthcare system such as this would be a good reference according to Wiki - http://www.cbsnews.com/stories/2005/03/20/health/main681801.shtml)

Now, having addressed those items, let's return back to the point - as the article claims to be about the type and quality of care people might find should they visit or come to live in the United States, it would seem to only make sense that information about that subject should be included in the main body of the article. How does that not make sense to those who appear to be so prone to biting others here in WikiLand? I really don't care who writes the information. The individual who responded above can write it if they'd like. Just make some attempt to actually cover the subject of "health care" in the article as the title claims is the subject (and not simply go on about problems and statistics, and how somehow mysterious "entities" provide this care), and cover the subject fully and completely. Write it from the more neutral point of view of what someone coming to this country for the first time might experience, and what they might expect should they need to go to a doctor or go to a clinic or a hospital over here for the first time. Write about what kind of "health care" they might expect and might experience here in the United States, just like the title claims the article is about. I don't know why this seems to be so hard to understand.
Howaboutyouthinkaboutit (talk) 01:06, 20 September 2009 (UTC)

Please read core Wikipedia policies like Wikipedia:Verifiability, Wikipedia:What Wikipedia is not and Wikipedia:No original research, as well as Wikipedia:Reliable sources. Wikipedia is not a how-to guide or a travel guide; your proposed edits are more appropriate for other wiki projects like Wikibooks. If you are unable to understand the essential nature of the encyclopedia and make meaningful encyclopedic contributions in good faith, your edits will be classified as vandalism and reverted on sight. --Coolcaesar (talk) 07:53, 22 September 2009 (UTC)

Ceasar, that is not very cool at all. I have not made any edits to the article itself other than once upon seeing the wiki notice that said "anybody can edit" and before I learned about the talking pages, so don't make such gross accusations of vandalism against me here. It is quite inappropriate. What I have done is used the talking pages to make suggestions, provided explanations, given examples, and attempted to have discussions on the talk pages. I have no idea why you feel such a need to make personal threats with every post... Please stop with the threats and accusations, there is no need for them, as well as being against wiki etiquette and policy, which has been pointed out to you previously by others. Thank you.
Howaboutyouthinkaboutit (talk) 08:56, 22 September 2009 (UTC)

Suggested New Article Title: The Need for Health Care Reform in the United States

After reading this article over many times, and reading others comments, it's obvious that the title of the article is simply not descriptive enough and is misleading to many viewers in its current form.

A number of people, including myself, have commented on expecting to find information on aspects of the various types of care available in the US, where that care can be attained, who it is that provides various types of care, and so on, starting with the very first comment.

Those involved in writing this article are so focused on the debate they're engaged in, that they can't even conceive of what's being commented on in regards to the article being negative or biased which have come from those who are unaware that the authors are concerned with Health Care Reform, and not with the general subject of Health Care, which is what is actually indicated in the current title.

If the authors want to argue and focus on making their case for the issue of Health Care Reform, then the article title should accurately state that that is what the article content is specifically about. I would once again suggest a more accurate and appropriate title be used, such as -
"The Need for Health Care Reform in the United States"
or...
"The Issue of Health Care Reform in the United States"
Howaboutyouthinkaboutit (talk) 08:42, 22 September 2009 (UTC)

Again, I see practically no bias. The very first titled section of the article describes in a neutral fashion how care is provided through various types of facilities and with the assistance of pharmaceutials and medical devices. That's about as clear as one can get. The article goes on to neutrally describe what the system is. The only sections where I see some pro-reform bias are in "overall system effectiveness" and some parts of "system efficiency and equity."--Coolcaesar (talk) 02:49, 23 September 2009 (UTC)

The article is clearly not about the subject of health care itself, but instead is highly focused on the issues of health care cost and affordability. This constitutes bias in relation to the subject itself, not providing full coverage of the stated subject. Again, this has been pointed out by others previously. The lead paragraph (or introductory section) is supposed to provide an overview of the subject and a preview of what is to follow in the article. The lead of this article starts right off presenting statistics on health care coverage, costs, and affordability and numerous references with statistics, which, again, is not a full overview of the subject of health care, but rather a discourse on the need for health care reform which, again, constitutes bias. Lastly, the only information which seems to be presented is from those who are arguing that government is the solution to the many problems cited throughout the article, rather than addressing direct solutions for the many issues which have caused the escalating costs of health care and health care insurance, which once again, is what is referred to as bias. Howaboutyouthinkaboutit (talk) 09:14, 23 September 2009 (UTC)

You are correct when you say this "article is clearly not about the subject of health care itself". For an article about the subject of "health care itself", please see Health care. An article about health care in the United States presumes that the US has an approach to health care, a method of operation if you will, in comparison to other countries, else the title would be meaningless and just another recitation of the article about health care generally. The very words "health care in the United States" in today's public discourse immediately bring up a number of issues, as discussed in countless reliable sources, central among them being attempts by a large number of commentators, legislators and other policymakers to describe and try to find solutions for well documented issues regarding health care in the United States. For this WP article to completely sidestep comparative measures of effectiveness and/or to fail to cover the very basics of the intense debate about whether and/or how to attempt to resolve such well documented issues would be completely remiss, a whitewash which a significant number of WP contributors from both the US and other nations have already made eminently clear would be a totally unacceptable presentation of the topic. The highly publicized issues in today's public discussion about healthcare in the US include, very notably, extremely high cost, the highest in the world, paid in exchange for benefits and results that are well documented to be, at present, far less than competitive with what other industrialized nations manage to accomplish for far less money. This article briefly discusses these issues, along with a thorough introduction to many various aspects of health care in the United States, referring the reader where appropriate to more specific articles such as Health care reform in the United States, medical centers in the United States, health insurance in the United States, uninsured in the United States, various articles about health care oversight in the United States, etc. Of course the article can and should be much further improved. But to avoid or whitewash the well documented areas where the US system isn't providing health care results that are competitive with those in other major industrialized nations, and to neglect that there is currently a debate unique to the United States about what to do about those things?-- such an approach would not be an improvement to the article. ... Kenosis (talk) 16:27, 23 September 2009 (UTC)

Post natal care in the United States

I am looking for information about post natal care service in the United States. This article does not seem to cover them. In the UK for example, the responsibilty for post natal care is shared between community nurses, personal physicians, and midwives and the standard of care and recommendations laid down by NICE runs to 393 pages. See for example http://www.nice.org.uk/nicemedia/pdf/CG037fullguideline.pdf All parents receive a free booklet called Birth to Five to help them through the process of parenting (see http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/dh_074924 for a copy) Finland, Sweden, Norway, Denamrk, France and Germany have similar services. Where can I find out about how post natal care sevices are provided in the U.S.? Are post natal services covered by insurance in the U.S. whether private or Medicaid? Are there mother and baby services run by the States or at a more local level? Or do people just have to pay if they need professional help? Are there programs that ensure that all children receive their vaccinations at the appropriate time and if so who runs them?--Hauskalainen (talk) 23:49, 4 October 2009 (UTC)

My personal experience (one son born in UK and one in USA) is that there isn't really any structured post-natal care within the US outside of scheduled checkups with a GP. Obviously, if there are known problems your situation would be different, but for normal, uncomplicated births you're sent home and that's it. —Preceding unsigned comment added by Dbnull (talk • contribs) 18:53, 18 December 2009 (UTC)

That's exactly how it works. Unless you're a member of one of the few integrated HMOs that provides almost decent follow-up care, vaccinations, preventive care, and monitoring (like Kaiser Permanente, about which there are also a lot of horror stories), the vast majority of U.S. residents are insured by various insurance plans operating under the fee-for-service system. Meaning that once you're discharged from the hospital, whether you were in there for pregnancy, a car accident, or whatever, the burden falls on the individual patient and their family to seek follow-up care (assuming their plan provides coverage for whatever additional services they need). --Coolcaesar (talk) 05:22, 20 December 2009 (UTC)

Health care nobel

In ref to [1] and [2]: The first part is unsourced and needs to be removed. The Nobel part is easy to verify and probably doesn't need much more, so doesn't really need much more, however I see it as misplaced and not relevent to the section. The section was trying to suggest that expensive pharmaceuticals beings in more research, but that doesn't make the Nobel prize relevant.Scientus (talk) 13:29, 16 October 2009 (UTC)

You are right. I would add that if one takes relative population size into account Switzerland and the UK both received relatively more mentions in the Nobel prize for medicine and physiology in that period relative to their population size. The people that go around touting researchers achievements as somehow indicating the value or achievement of their medical care delivery systems are confusing two very different things.if I were inclined to do so (which I am not) I could equally say that the socialized health care system in the UK brings about better research results than the U.S. Its nonsense of course. As to the first claim about medical research in the top 5 hospitals, that may or may not be true, because unfortunately we do not know who the original source is. It may be the author of the piece in the reference though I have my doubts because using time banded searching on Google, the earliest reference traced back to an anti health care reform web site suggesting questions to be put up at those Town Hall meetings. If it is him, it is I think WP:OR unless it has been formally published in a peer reviewed journal. --Hauskalainen (talk) 15:53, 16 October 2009 (UTC)

Sections and Related articles on Current Debate in desperate need of overhaul

I have added this note to all major articles related to the current healthcare reform debate. The related sections in this article and all related articles on the current healthcare debate desperately need to be overhauled and expanded. There is practically nothing in this article about the ongoing major events around the current debate, a subject area that is absolutely required.

The main discussion around generating an overhaul effort is on the talk page on the main article: Health care reform debate in the United States

For now, for this overhaul effort, please discuss anything not pertaining specifically to this article on that talk page.

NittyG (talk) 05:04, 27 October 2009 (UTC)

Removed one-sentence paragraph about H1N1

I've removed a one-sentence paragraph on Kathleen Sibelius' signing of a document relating to H1N1, "protecting vaccine makers and federal officials from prosecution related to the administration of the swine flu vaccine" here. The removed material reads as follows:

In June 2009 as allowed under the Public Readiness and Emergency Preparedness Act, Secretary of Health and Human Services, K. Sebelius, signed a document protecting vaccine makers and federal officials from prosecution related to the administration of the swine flu vaccine.<ref>{{USFedReg|74|30294}}, [[Federal Register]]: June 25, 2009 (Volume 74, Number 121), pp. 30294-30297.</ref>

I'm putting it here on the talk page to make it easier to find if it's needed on a more specific article, e.g., about H1N1, aka "swine flu", or another more specific article. ... Kenosis (talk) 02:02, 12 November 2009 (UTC)

I beg to differ only on the grounds that everything else in that section is basically surrounding the FDA and its actions, or however one wishes to describe the content, but what "got lost" is the fact the FDA's parent agency is HHS which Ms. Sebelius happens to head at the moment. The distinction being made is that while one set of standards are normally applied, some of which are a result of court decisions, the same does not hold true when health emergencies are declared - as allowed for by standing law. I'm not at all concerned about the HHS Secretary or the past, previous & future Administrations themselves as much as the Department of HHS itself and what may seem to some as a duality in policy & practice. I can live with the reference to PREPA and the clarification or inclusion of H1N1 under it as the section currently reads pretty much FWIW. 68.237.235.127 (talk) 23:58, 12 November 2009 (UTC)

Article reform proposal: Healthcare and other topics

I propose to take the outline of the article and identify all the companion articles that can serve as see alsos where longer arguments about a topic can be developed. The goal will be to shuttle details to these related articles and then make this a shorter article that functions more as a directory for these other articles. Mrdthree (talk) 17:39, 1 December 2009 (UTC)

Outline and relevant articles for outsourcing (consider adding or reoutlining):

1. 1 Health care providers Health care industry, Medical centers in the United States, Health care provider
   1. 1.1 Facilities For-profit hospital Non-profit hospital
   2. 1.2 Medical products, research and development Medical device, Pharmaceutical drugs, Research funding, biomedical research
2. 2 Health care spending Health economics, Healthcare rationing in the United States, Prescription drug prices in the United States
3. 3 Health care payment Health insurance in the United States
   1. 3.1 PrivateHealth_insurance_in_the_United_States#Private_health_care_coverage
   2. 3.2 Public Health_insurance_in_the_United_States#Public_health_care_coverage
   3. 3.3 The uninsured Uninsured in the United States
   4. 3.4 Role of government in health care market Health care markets
4. 4 Health care regulation and oversight United States Department of Health and Human Services, Medical malpractice, American Board of Medical Specialties, United States Medical Licensing Examination, National Association of Insurance Commissioners
5. 5 Overall system effectiveness
6. 6 System efficiency and equity Health economics
   1. 6.1 Efficiency
      1. 6.1.1 Value for money
      2. 6.1.2 Delays in seeking care and increased use of emergency care
      3. 6.1.3 Shared costs of the uninsured
      4. 6.1.4 Variations in provider practices
      5. 6.1.5 Care coordination
      6. 6.1.6 Administrative costs
   2. 6.2 Overall costs
   3. 6.3 Equity Race and health in the United States, Healthcare inequality
      1. 6.3.1 Coverage
      2. 6.3.2 Mental health
      3. 6.3.3 Medical underwriting and the uninsurable
      4. 6.3.4 Demographic differences Health disparities
7. 7 Regulatory efficiency and equity
   1. 7.1 Health care regulatory costs
   2. 7.2 Emergency Medical Treatment and Active Labor Act (EMTALA)
8. 8 Drug efficacy and safety
9. 9 Political issues
   1. 9.1 Prescription drug prices Prescription drug prices in the United States
   2. 9.2 Health care debate Health care reform debate in the United States, Health care reform in the United States
10. 10 See also
11. 11 References
12. 12 Notes
13. 13 Further reading
14. 14 External links

Mrdthree (talk) 22:49, 3 December 2009 (UTC)

I think a new article should be made to handle the details of costs: Healthcare Economics in the United States. Mrdthree (talk) 17:50, 4 December 2009 (UTC)

Header paragraph has too many statistics

As I understand WP policies, the header paragraph or two should be a summary of the article - more like a "heads up" for what is to follow. The key issues should be summarised but the detailed statistics and references should come later down. In summary the header para should be shorter, and enable the reader to navigate to the appropriate section for further explanation. I don't think the article achieves this right now. The reader gets hit with a bewildering array of stats, claims and counter claims in the header paragraphs which are not for that purpose.--Tom (talk) 22:41, 30 November 2008 (UTC)

It's also supposed to summarize the most important points and provide an overview of any significant controversies. It's difficult to do that without including statistics, and impossible to get consensus on what the lead says without including references. EastTN (talk) 22:37, 4 December 2008 (UTC)

It's a good thing statistics are provided. I keep encountering people who question those stats, but they are for the most part Americans who have a fear that Universal Healthcare would mean Soviet Tanks rolling down their streets. Apparently happening in European cities like London.

Nemogbr (talk) 09:28, 4 February 2010 (UTC) --Nemogbr (talk) 09:28, 4 February 2010 (UTC)

The problem is that finances have been poorly addressed. Medicare for older people (me) will be cut, though increasing at a rapid rate anyway and Boomers entering the program apace. The other day, I got back an invoice with the amount for "venipuncture" (blood testing) being $1 for the lab taking the sample. This is too little. There were other charges (and price reductions from the government). At some point, it becomes intolerable for a lab (and other medical servies) to handle older workers. Choice becomes impossible. People who are older and can't travel easily will have to travel further when labs closer by opt out for financial reasons. The current plan will exacerbate, not relief this. Since older Americans, more than younger, voted the "wrong" way, there are certain suspicions to say the least! At my age I don't need a soviet tank to do me in. Poor medical care will do it, just fine, and much more subtly! Student7 (talk) 14:27, 6 February 2010 (UTC)

Discussion badly needs archiving

Theres things from 2005 still here posted. This place needs to be archived badly. I have no idea how, anyone willing to step up? Maybe an admin? 142.192.200.200 (talk) 17:37, 13 March 2010 (UTC)

Repartisioning

It seems to me that much is what is in the introduction is simply misplaced. By that, I mean

#5 Overall system effectiveness compared to other countries
   * 5.1 Less effective

would probably be a better location. At that point, one can go into

   * 5.2 More effective

and add additional information to give balance and due weight. Personally, I would do so, but I need the consensus of others on here. It seems that, once such an action is taken, the introduction would be more concise and less biased, providing a location for competing biases (as I understand, that is appropriate if done in such a way as to give equal and fair treatment to each side).
206.82.65.10 (talk) 20:42, 19 March 2010 (UTC)

Yes. While we are at it, note that there is an article comparing the Canadian system with the American. This is fine and is the title of the article, after all. The title of this one is "Health Care in the US." Therefore the article should confine itself to that and not get carried away with undue pov selective comparison with other countries. Okay to say US stands 125th on somebody's (hopefully npov) list, but pov to pick a particular country (including Canada). Should not be saying US is better than Nigeria or worse than Denmark, for example.Student7 (talk) 00:15, 22 March 2010 (UTC)

Agree This entire article needs to be written subjectively. Explaining HOW health care CURRENTLY works (maybe explaining some changes in a npov way that the bill that passed will make) in the United States. IE: What insurance covers, doesn't cover, how hospitals and physicians work... the only way to do that is to compare how other systems might work but it can be done neutrally without a problem. Netsquall (talk) 19:36, 22 March 2010 (UTC)

Banning cross-state insurances?

There is a whole section in the article claiming "the federal government prohibits the sale of health insurance across state lines". It provides no citations, and as far as I know this is not true. The only reason I am aware of that causes insurance to be different in different states is because the McCarran–Ferguson Act delegates regulation of insurance to the states. States determine what policies are sold in their state, not the federal government. —Preceding unsigned comment added by 75.102.64.76 (talk) 18:45, 23 March 2010 (UTC)

Looks like you're correct. The section was probably put in by someone who doesn't understand American law very well. The actual reason is that states are the plenary sovereigns, which means, as part of their police power to maintain public safety, health, and welfare, that they have plenary power to determine what can and cannot be sold in their state. The Feds could have chosen to invoke preemption as to insurance because of its impact on interstate commerce, but chose not to, and in fact expressly indicated that the states would continue to regulate insurance under McCarran-Ferguson. So it's basically a situation of the default situation obtaining, not the Feds doing anything explicit to ban anything. --Coolcaesar (talk) 19:55, 23 March 2010 (UTC)

AFAIK there's no federal law prohibiting insurance companies from operating across state lines. Presently they're constrained by the need to be licensed in any state in which they operate. States that have insurance companies which hold a monopoly in that state simply have been reluctant to grant new licenses to potential competitors. To change this, the federal government essentially needs to require that insurers licensed in one state can operate across state lines. Legislators from states with insurance monopolies or near-monopolies have tended to resist this legislation. I don't know at the moment what the newly passed health-care legislation has done with this situation. Nonetheless I'm going to strike the questionable statement in the article on the basis of being an unsourced questionable statement per WP:V. ... Kenosis (talk) 17:31, 24 March 2010 (UTC)

Here is one quick summary of the situation prior to passage of the health care bill. I'll be interested to see what the legislation has done. ... Kenosis (talk) 18:24, 24 March 2010 (UTC)

Better patient outcomes

I am assuming that the statement "does not lead to better patient outcomes" always means that with a control group, that group a lived no longer than group b, treated in a different manner.

And not that people in group a died anyway. Because that is a likely outcome of many diseases and the likely destiny of everyone eventually anyway. Sorry to be so naive but the phrase is used quite a bit. Hopefully this means the same to the disparate editors writing this. Student7 (talk) 14:45, 20 February 2010 (UTC)

Good points. Redress of bias issues here must account for comparable and better outcomes (longevity, infant mortality,etc.) in US compared to Europe when controlling for race/ethnicity. Indicates socio-economic, not healthcare sysstemic, issue. Also, better US outcomes in areas like cancer survival, heart disease survival,etc. not discussed. —Preceding unsigned comment added by Umbervox (talk • contribs) 20:46, 7 April 2010 (UTC)

merging of health care prices

Hi, I noticed that we have an old 'merge' request on Health care prices, this is a result of a deletion discussion which seems to have come to the conclusion that it should be removed, but have some of its contents merged here. Hopefully some of the editors here will know what to do with this? I was going to rename it 'health care prices in the united states' but refrained as it may not have enough left? Lee∴V (talk • contribs) 20:03, 28 March 2010 (UTC)

Removed false statement in intro paragraph

In the first paragraph this statement was made:

The United States spends the highest percentage of health care costs on pharmaceuticals in the world.

I looked at the reference where this fact comes from and read this:

Over the past decade, the share of health expenditure spent on pharmaceuticals in the United States increased from 8.6% of total health spending in 1993 to 12.9% in 2003. This remained below the OECD average of 17.7%. In 2003, the United States was the top spender on pharmaceuticals (with 728 USD per capita, adjusted for purchasing power parity), followed by France, Canada and Italy.

Maybe I'm a moron but it sounds to me like the United States spends the largest number of raw dollars on pharmaceuticals but in fact a less than average percent of total health care costs.

Anyway, I reworded this statement to instead say this:

In absolute currency, the United States spends the most on pharmaceuticals per capita in the world. However, the share of expenditure on pharmaceuticals accounted for only 12.9% of total healthcare costs, compared to a world average of 17.7% (2003 figures).

This is truer to the reference than the original wording. Emach 15:47, 1 June 2007 (UTC)

The reference states that the United States spends the most per capita on pharmaceuticals. Not the most in raw dollars, but the most per person. The share of expenditure as part of total healthcare costs is due to our extremely high costs in other areas of health care. It does not change the fact that we spend the most money per person on pharmaceuticals in the world. 24.130.65.211 (talk) 22:39, 25 February 2010 (UTC)

The entire article is extremely biased; should be deleted if not severely revised. It reads like a press release from the Obama Admin. "Uninsured" figures don't take into account those who are uninsured by choice, temporarily, or due to legal status. —Preceding unsigned comment added by Umbervox (talk • contribs) 20:42, 7 April 2010 (UTC)

Okay to change article with solid references. That is what Wikipedia editing is all about. I think the media eventually got away from pretending that the uninsured mostly wanted to be insured and started (correctly IMO) reporting that the government simply wanted to charge that group (most of them healthy young people) for medical care for all the rest. All you would need is a good reference. Student7 (talk) 17:53, 9 April 2010 (UTC)

Obvious bias needs to be cleansed

Obvious bias throughout the introduction means that, in effect, this content is political advocacy for Democrat-party health policy masquerading as an explanation of healthcare in the U.S. I have placed the

header pending a revision that addresses the issue.

It's unfortunate, because the piece does provide solid content on healthcare delivery and payment in the U.S. However, like so many articles in Wikipedia, it's been taken up us a "cause" by political partisans. It quotes every talking point of the U.S. Democratic party and progressive policy-influencers in particular.

For instance, it makes the following claim: "Medical debt is the principal cause of personal bankruptcy in the United States." But here's what the reference article (which is actually a CBS News morning show report that was based on a controversial article from the American Journal of Medicine) actually said: "Early Show national correspondent Hattie Kauffman reports the study says getting sick is a factor in 62 percent of personal bankruptcies -- an increase from just eight percent in 1981." Not the principal cause, but a factor. That's no small distinction, and it's especially noteworthy because it amplifies the misleading nature of the original study, which was prepared and peer-reviewed by researchers who are advocating for single-payer healthcare in the United States. See http://www.politifact.com/truth-o-meter/statements/2009/jun/11/chris-dodd/medical-bankruptcy-study-not-clear-cut/ for problems with the study's conclusions on the relationship between bankruptcy and medical debt.

What's revealing about that example is that it's lifted directly from the narrative of liberals in the U.S. and around the world who are pushing for Democrat-party visions of healthcare reform, along with such dubious claims as the U.S.'s 37th-place finish in WHO's healthcare rankings from 2000. I personally dispute that interpretation, on grounds that will be familiar to those following the healthcare reform debates in the U.S. -- such as the rankings' weighting of healthcare "equity" or "fairness" and its researchers obvious agenda. See http://www.factcheck.org/2009/10/37th-in-health-performance/.

But I'm not arguing that this piece should sing the praises of U.S. healthcare performance. Instead, it should be indifferent. It's an encyclopedia article about healthcare. Statistics about cost and infant mortality and cancer survivability are fair game. Biased conclusions about equality, tainted by political preferences, have no place in the lead and should be moved to a "political" section below.

I'm suggesting a rewrite that handles the macro issues in a balanced way. As it is, this piece is another hijacked cheerleading exercise for a political subset.

It would appear that your repeated use of the partisan phrase "Democrat Party" reveals political biases of your own. —Preceding unsigned comment added by 192.91.147.34 (talk) 06:43, 19 February 2010 (UTC)

Since all is sourced and documented, the "obvious bias" is in the person shouting it. -74.162.151.99 (talk) 21:03, 21 February 2010 (UTC)

I challenge you all to list which pieces in this article are biased, and also focus on suggestions on how to improve the article instead of going on a back and forth 'who is biased and who is not' flame war. Its one thing to flag for neutrality and go on a tirade about the left wing conspiracy going on, its another to give suggestions on what to do about it. On the other hand, its one thing to complain about a 'conservative' reader explaining his concerns about the bias and tone of the article, its another to prove him wrong. Give wp:pov a read, everyone is biased. Its one thing to realize that, and another to do better. Netsquall (talk) 18:56, 12 March 2010 (UTC)

Furthermore to this, I agree with the original poster. There IS bias, it sounds like Barack Obama himself walked into the article and typed out his entire rhetoric for the last year. Factual or not, the introduction to an article needs to be short and concise, it can brush on the 'pros and cons' of U.S health care in general, but any specifics on 'controversy' or such needs to be put in another part of the article and be balanced. I implore an editor who is experienced enough to do this. Netsquall (talk) 19:02, 12 March 2010 (UTC)

The author of this article does not give misleading facts. I find it does leave many other subjects missing (including malpractice lawsuits). This article is a touchy subject that needs many perspectives to be a factual, unbiased, and infomative article.

Davidleejohn (talk) 19:09, 3 June 2010 (UTC)David

The cost of malpractice lawsuits and the effect on medical cost.

I am new to this so I hope my inexperience with Wikipedia does not take away from this point.

Part of the cost for medical care in the United States is related to malpractice lawsuits. I am not saying anything about tort reform but I do believe that this is germane to health care in the United States. Here is one of many resources verifying how much is spent in this area (other sources put the cost near 15%).

http://www.bloomberg.com/apps/news?pid=20601103&sid=az9qxQZNmf0o

From the article.

About 10 percent of the cost of medical services is linked to malpractice lawsuits and more intensive diagnostic testing due to defensive medicine, according to a January 2006 report prepared by PricewaterhouseCoopers LLP for the insurers’ group America’s Health Insurance Plans.

Davidleejohn (talk) 18:46, 3 June 2010 (UTC)David

Comparing "to Europe"

There are several remarks adversely comparing the US system with "Europe." Europe nowdays includes a vast eastern stretch about which we don't know a whole lot. How is the health care system "in Bulgaria" for example. I don't think the editors intended that we all be up to date, nor the quote up to date on Bulgarian health care. This is not a comparison article per se. It would be okay to say, that out of all the systems on earth, the US stands 31st, below every system in Europe except Bulgaria, or whatever. Comparing against all systems may be tolerable for this article.

Note that there is an entire article Comparison of the health care systems in Canada and the United States. If the editors wished, they could have another article comparing the systems of the US and Europe in a fair presentation, not just selectively comparing things which are unfavorable to the US, which tends to be WP:POV and WP:BIAS. Student7 (talk) 12:13, 23 May 2010 (UTC)

I think it is good to compare health care systems from europe, we need to see both the pro's and con's of the situation and see if it is worth bringing health care into our the united states goverment. Josepheidelberg (talk) 06:33, 15 June 2010 (UTC)

Right. That is why a separate article might be interesting. But still beyond the scope of this one. We need to limit scopes of articles to their actual topic and/or make all comparison WP:NPOV, not "evening news" interesting. The latter is non-encyclopedic. Student7 (talk) 18:32, 19 June 2010 (UTC)

Medical products reliable sources

Is the 'post-autistic economic review' a reliable source for an encyclopedia? http://www.paecon.net/PAEReview/issue32/Baker32.htm Mrdthree (talk) 14:43, 26 July 2010 (UTC) - Yes, it is peer reviewed and expresses a variety of scholarly works. —Preceding unsigned comment added by 82.49.196.31 (talk) 10:26, 31 August 2010 (UTC)

Splitting to reduce length.

Wikipedia suggests splitting this content into several sub-pages to reduce its length. I believe that the following sections should get their own pages and only a summary on this page. Health Care Spending, Health Care Payment and System Efficiency and Equity. Thoughts? Haroldham (talk) 19:53, 4 November 2010 (UTC)

I agree, this article is huge Peash (talk) 07:06, 8 November 2010 (UTC)

Discrepancy

The article states "Minorities also have higher rates of cardiovascular disease, HIV/AIDS, and infant mortality than whites." But several minorities have lower infant mortality according to http://www.cdc.gov/nchs/data/databriefs/db09.pdf and http://www.nytimes.com/2009/11/04/health/04infant.html. Fix? 138.67.4.176 (talk) 19:28, 6 November 2010 (UTC)

I'd say use the most recent data Haroldham (talk) 21:29, 6 November 2010 (UTC)

Bankruptcy

The early statement on being the main contributor to bankruptcy is a bit disingenuous for two reasons. 1) The last bill people who have trouble handling money would pay, would be their doctor, out-patient care. You can bet these same people smoke, drink, and play the lottery weekly! 2) It is extremely easy to rack up high bills quickly with the greedy health care system. I had a tiny spur taken off a digit. Time = a few minutes in an out-patient clinic. Cost $10,000! The clinic has to be staffed, cleaned, meet state standards, etc. etc. In the "good old days" it would be done in the same amount of time in the doctors office for $50. So outrageous charges should be higher on the list than they are. And high costs of some tests (which turn out positive or, worse, false negatives, more often than not).

And another thing. People don't often ask about these charges before incurring them, nor do doctors invite curiosity. I had no idea! A person getting a $10,000 bill with no insurance is going to throw it into his trashcan! Sure, it will be at the top of his list when he claims bankruptcy. After he sells his Harley and HDTV to his brother for $5! Student7 (talk) 03:22, 13 November 2010 (UTC)

Private vs public quality

Are there analysis and data that separate publicly and privately paid health care? It seems that the WHO and OECD rankings and such take both as one. 80.50.238.34 (talk) 00:07, 26 December 2010 (UTC)

Not that easy to sort out except by subtracting government costs from total costs. Almost all care has some element of public payment, Medicare being the prime example. Private Hospitals accept Medicaid. Prescription plans assisted by government payout. Student7 (talk) 14:38, 28 December 2010 (UTC)

Affordable Health Care for America Act

The Affordable Health Care for America Act (H.R. 3962) was passed today, and this should expand coverage to more Americans. Shouldn't this information be included? Anon275 (talk) 17:08, 24 December 2009 (UTC)

I think it would be good to have a short summary with a link to the main article for the act, I find it surprisingly neutral Haroldham (talk) 19:31, 28 October 2010 (UTC)

I think the the act should be a sub category in 'health care reform', any thoughts? —Preceding unsigned comment added by Haroldham (talk • contribs) 19:48, 28 October 2010 (UTC)

It should not be added unless it is going to treat the subject in a balanced manner-- increased costs to the already insured, crippling additions to the debt, rationing, and the probability that little to no actual expansion of coverage will take place. Plus the good results, whatever those might possibly be. —Preceding unsigned comment added by Umbervox (talk • contribs) 20:52, 7 April 2010 (UTC)

lol. go call an AM radio station if you want to argue political talking points. —Preceding unsigned comment added by 24.130.112.192 (talk) 21:07, 11 June 2010 (UTC)

The article relies for almost all of its points on articles that are negative-- there is a a large volume of data and articles showing where the US Healthcare excels. Using any views from Harvard or the WHO should be a red flag! This is unbalanced and it is almost impossible to "correct" this whole article dues to the large number of inaccurate data points and biased articles quoted-- yo need to start over and see why the US leads the world on quality care-- I note the Harvard estimate of over 100,000 people dying for lack of care does not take into account the vast waiting lists that are universal in almost all other government run systems. Australia is a disaster in this regard-- too few doctors, nurses, ward closures and long waiting lists. A balanced view should be insisted upon! This is nothing more than socialized medicine propaganda masquerading as facts! Robin Willcourt MD FRANZCOG, Adelaide Australia —Preceding unsigned comment added by 118.210.171.76 (talk) 08:57, 19 September 2010 (UTC)

From reading the wikipedia page on the Patient Protection and Affordable Care Act, it seems that there is nothing about the US government running any health insurance other than Medicare. Haroldham (talk) 19:44, 28 October 2010 (UTC)

- - - I agree the facts in this article associated with the US healthcare system are misleading and highly focused on negative statistics. The US healthcare system has many flaws, however the quality of care and technology available to individuals is unmatched. Whether this article or the healthcare reform act, they both fail to mention that death rates and higher healthcare costs in the US are driven by the fact that the US is the most obese nation on the planet. 75% of Medicare expenses are driven by chronic care conditions, diabetes, hypertension, stroke, all are conditions associated with adults being overweight from overindulgence and not getting a reasonable level of exercise. Frankly, reducing cost in healthcare will only happen when there's an expectation of personal responsiblity and accountability. Gc - - - —Preceding unsigned comment added by 143.112.144.129 (talk) 16:17, 2 February 2011 (UTC)

Very troubled article

I'm trying to move this article towards more of a "just the facts" model. It is seemingly dominated by documentation of the inequities of the U.S. system. While this is certainly something that needs to be covered, it is currently covered excessively. On the other side, the discussion of the other side is mainly from the relatively extreme people over at Cato. There is almost no discussion (I found only one sentence: "An even bigger problem may be that the doctors are paid for procedures instead of results") of the major problem of a fee-for-service model inside a third-party payment system, even though problem has been discussed in the literature for a long, long time, and motivated the push towards health maintenance organizations a while back. II | (t - c) 00:37, 2 February 2011 (UTC)

Obamacare

The payment schedule for Obamacare was eliminated. I presume because that this has not yet been implemented. Obamacare is somewhere else? 3.8% tax on gains, for example.

So how will this article proceed? As the measures are implemented, they will creep back in, one by one? Probably need some kind of plan here. Or limit the article to "before" and "after" and fork one. Student7 (talk) 14:20, 4 February 2011 (UTC)

Certificate of need

Text says that certificate of need requires approval at the state level to prevent monopoly at the local level. This is left up to the states, though. In my area, one hospital has indeed, sewed up the local audience by timing and acquisition. And driven a potential competitor into selling. Both "non-profits."

The flip side is that states don't want hospitals to fail. This is not necessarily all good. A failed hospital could be acquired for less and charge less. A failed hospital in chapter 11 could be reorganized. So there are clearly politics involved on both sides and not necessarily favoring consumers. Student7 (talk) 14:00, 4 February 2011 (UTC)

Doctors paid double in US

I have removed the section titled "Lack of doctors due to limited education" because its citations were unverifiable and the section seemed irrelevant.

Footnote [49]

Footnote [49] is a dead end (i.e. the footnote doesn't link to an article). — Preceding unsigned comment added by Bad2101 (talk • contribs) 21:45, 7 February 2011 (UTC)

Life expectancies

We have taken various projections of US Life expectancy and have from 37 to 52 or so. This looks a bit funny IMO. I don't think they can be made to match because they are often proving different things and represent a rewording of some applicable reference. Maybe we should explain this in the lead? I have never seen that done before and might look even odder. Or be clearer about the year. Doubtless, with different methodologies, we will have some rankings taken in the same year and disagreeing. Anyone with experience on this sort of thing?

Sometimes we get so wrapped up with arguing with each other we forget about the affect on the reader that we are supposedly trying to impress! Student7 (talk) 20:20, 27 February 2011 (UTC)

Health Care Cooperatives, and other service providers

The first paragraph of this article states: "Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector. Health insurance is primarily provided by the private sector, with the exception of programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program, and the Veterans Health Administration." But the article doesn't seem to provide information about the "many separate legal entities". This is uninformative, and leaves me wondering about the status of health care cooperatives, in relation to major corporate providers. A set of examples of the "many separate legal entities" would help, as would a discussion of how they differ from one another. Janice Vian, Ph.D. (talk) 18:56, 6 March 2011 (UTC)

nice comment! you are invited - as everyone is - to find sources about that and add information based on those sources to the article! No need to be passive here.. . Jytdog (talk) 13:52, 28 June 2011 (UTC)

Template talk:Health care reform in the United States#Single payer

Please comment at Template talk:Health care reform in the United States#Single payer if you have an opinion on whether the United States National Health Care Act should be listed alongside the several groups who support it. Dualus (talk) 19:38, 28 October 2011 (UTC)

The first sentence of the last paragraph under the heading "The Uninsured ... does not read well.

"The fiscal impact of uninsurance large enough to affect the availability and quality of local health care services for everyone in the community"

Perhaps it was a "header" — Preceding unsigned comment added by 70.181.130.26 (talk) 20:49, 27 February 2012 (UTC)

NPOV TAG

The NPOV tag is over a year old and is not supported by a clear and specific explanation of which part of the article does not meet NPOV and why. This tag needs to be supported by a sound well reasoned argument or removed.BrandonHoward (talk) 01:21, 9 August 2011 (UTC)

I must say, this article is suspect. My experience working in other countries is that although the US has a messier health insurance system there is generally better access, i.e. expensive medicines can be obtained from multiple sources insurance, public assistance, or drug company assistance, while the single payer systems have rigid cost controls. The article doesn't seem to mention more obvious advantages such a shorter waiting times and higher survivial rates for many kinds of cancers. The article concentrates on soaring costs, which a great deal of is due to expanding technology, i.e. most conditions are treatable nowdays and bio/genetic drugs are very expensive because, duhh, genetic engeneering is expensive.

If a naive person only read this article, and the one on the Cuban system, they might think they would be better off as an HIV or cancer patient in Cuba. Though, the opposite would be true. — Preceding unsigned comment added by 95.222.153.116 (talk) 00:09, 20 March 2012 (UTC)

Needs coherent coverage of prevention

While prevention is mentioned a few times in the article, it really needs more coherent coverage of prevention. (As an area the US health care could do better at, cost savings realized and missed, goals Healthy people, etc.) Zodon (talk) 07:43, 18 March 2012 (UTC)

Auto accidents

Since the US drive more than most countries, I suppose we should say if the US stopped driving, they could save 35,000 "preventable" accidents a year. They don't have that problem in North Korea! Or Tibet! Student7 (talk) 15:34, 9 April 2012 (UTC)

Comparison to "all" countries

This, of course, fails npov, because of the fallacy of the Law of small numbers (a dab, just in case you are looking with a number of applicable articles). Monaco, for example, is inhabited, in large part, by a number of rich old people with impeccable health care which they get, I suppose, somewhere else! How does comparing the United States with Monaco aid understanding anything?

Japan is a large country. And no, I don't have an "official" definition for "large." But large enough that they can have real health problems which they can't solve by traveling next door to Korea or China! Their population, which eats a radically different diet that the US, and is almost totally Asian, lives a couple of years longer than they do in the US. Proving what?

A lot of poppycock lists masquerading as "helpful" to our understanding of the health problems confronting the United States. These are WP:OR lists for this article, I don't care who publishes them! Student7 (talk) 19:15, 15 April 2012 (UTC)

• If you have sources that provides useful, neutral comparisons of the US health outcomes compared to other countries, please provide them and add the references. --KarlB (talk) 19:30, 15 April 2012 (UTC)

Move of lead

Advocates of various positions started using the lead to fight out old battles on health care. Now that it is the Law of the Land, I have moved it to it's own subsection which, in turn, may need reorganization. Footnotes are not supposed to be in the lead. Second, the lead is supposed to be an objective summary of the entire article.— Preceding unsigned comment added by Student7 (talk • contribs) 15:28, 11 January 2013

References