Ever Wonder How We in the U.S. Could Be So SICK, When We Spend So Much Money On Health Care?

[McCamy Taylor]

Light up, America! If you are a heavy smoker, you can now get a lottery ticket that will give you a one in five chance of beating your first lung cancer! Whoopee! I'll smoke to that!




The United States ranks at the bottom of industrialized nations when it comes to measures of health, such as infant mortality (ours is high) and life expectancy (ours is low). However, we spend twice as much per person on health care as any other country in the world. And that includes Canada and France.

A study released by the National Cancer Institute explains how this is possible. The National Lung Screening Trial studied 53,000 heavy smokers and former heavy smokers over the age of 55 for 20 months. Half got annual chest x-rays---already shown to have no effect in decreasing deaths from lung cancer. Half got CT scans each year. The CT scan group ended up with 20% fewer lung cancer deaths.

http://www.cancer.gov/newscenter/pressreleases/NLSTresultsRelease

Eureka! Exclaims the New York Times. Now you can smoke your unfiltered Camels---and get a lottery ticket that gives you a one in five change of beating the (first) lung cancer that you will get from smoking.

The findings represent an enormous advance in cancer detection that could potentially save thousands of lives annually, although at considerable expenseThe findings represent an enormous advance in cancer detection that could potentially save thousands of lives annually, although at considerable expense.

http://www.nytimes.com/2010/11/05/health/research/05cancer.html

Just how expensive will all those CT scans for heavy smokers be? Almost 20% ( 43 million) Americans smoke. That number is the same when you just consider middle aged Americans, too—the ones considered in the NLST study.

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5745a2.htm

According to the U.S. Census there are around 40 million Americans who fall into the age range of 55-74—and this is the fastest growing demographic group in the country. So, if 20% of these folks smoke or used to smoke, that means 8 million CT scans a year. At $300 each, that means $2.4 billion a year spent on medical tests to catch one in ten cancers when they can be treated. Not so bad, until you consider that a “positive” CT scan does not necessarily mean cancer. Lots of people will go through unnecessary---and much more expensive and risky---testing, such as bronchoscopy and biopsy to prove that the little blip on their CT scan was not cancer. That will raise the expense of this medical “breakthrough” considerably.

It gets even worse if you consider the effect on the individual smoker. Now that there is a (slim) chance that smoking induced lung cancer can be caught in time, smokers will lose a powerful disincentive to smoke. If the new medical standard becomes a CT scan every year for smokers, then some smokers who might have quit because of fear of cancer will decide to keep puffing away---even though 80% of them destined to get cancer will still die. Why would Americans bet their lives on those kinds of odds? Because we all love to play the lottery. It is easy to convince ourselves that we will be among the lucky 20%.

Keep in mind that cancer is not the main way that smoking kills. Heart disease is the number on killer in the country, and smoking causes heart disease. The net result of this kind of “medical breakthrough” could actually be more premature deaths from heart attacks, emphysema, stroke and non-lung cancers associated with smoking (head and neck tumors, for example), if smokers decide to continue puffing away, secure in the knowledge that they now have a 20% chance of beating lung cancer.

The solution to all this lung cancer death---and the way to cut our rates of heart disease, other lung disease and stroke---is public health policy designed to keep people from smoking in the first place and encourage those who do smoke to stop before their addiction injures their health. However, prevention is a four letter word in America, where the medical industrial complex gets rich applying expensive---and often ineffective---Band-aids to treat diseases that could have been prevented in the first place at little to no cost.

[mcollins]

1. Our lifestyle. nt

[Zenlitened]

2. Do we spend twice as much on health CARE, or on health INSURANCE?

In other words, are health insurance premiums included in the tally of health spending?

:shrug:

[The Wielding Truth]

3. That is why we must enforce that at least 80% be spent directly on healthcare.

[truedelphi]

9. It is the insurance premium costs that really boost

The overall cost of our "healthcare."

And also, we just have a really stupid system in place. If someone you know has diabetes, and theyrun out of or lose their insulin supply, the local ER will write them a prescription for that drug at two Am - but the pharmacy doesn't open till 9 Am.

So the person might still be in trouble. Whereas in Europe, the pharmacy is attached to the hospital or clinic that offers ER services, so the person picks up the insulin before they get driven home.

And right now, we have an epidemic of Hepatitis. Yet no major HMO in California screens for it. I have a friend whose spouse told the doctors that his skin was deep bronze in color, and yet even with that information, they failed to do any tests to see if he had Hep.

He only found out he had hepatitis when volunteering blood for blood donation drive. As the blood bank screened his blood, found the disease and dropped him a letter explaining his condition.

Yet the HMO he went to had run $ 4,000 worth of testing!

[sabrina 1]

4. The real reason is our for-profit system.

Other countries with a national health care system, have no incentive to push for expensive tests and drugs.

Interesting that they chose only smoking as a reason for the expense of our health care system though.

This article doesn't even begin to address the problem the question asks.

Healthcare in most civilized countries is a right, not a for-profit commodity.

Take profit OUT of healtcare, that is the way to cut costs.

I really get sick of these kind of articles that do not address the real problems with American's for-profit system but are transparently focused on an agenda.

And that is another reason why we will not fix the real problems. The wrong focus, and everyone with an agenda, jumping on the bandwagon.

America needs to grow up.

[txlibdem]

8. +1, transparently focused on an agenda

I think we can all agree that smoking is bad, bad, bad. Tsk, tsk, tsk. But focusing on that as anything other than a small fraction of the problems with our health and our health "care" system is demagoguery of the highest order.

Let's get real. We spend twice as much as Europeans yet the health outcomes for Americans are far worse no matter how you measure it. The profits drained out of the system are enormous and that is the only thing that needs to change. The health system in Cuba beats us for longevity, child mortality and about 12 other metrics. The Cuban government cares more about its citizens than our great, wonderful Capitalist-controlled politicians?!?

Remove the for-profit motive and we will have the best health care system in the world. 95% of insurance premiums should be mandated to be paid out in health care or be returned to the customers.

[Kalyke]

5. UM.... no.

We're unhealthy because we're fat, we don't exercise, we eat crap food and - the biggie - we don't have as much access to preventative health care screenings and health care, in general.

People in Europe smoke as much, if not more, than we do and they are healthier and live longer.

I'm glad you want to advocate to others to quit smoking, but it isn't the No.1 cause of our ills.

FWIW, lung cancer is rising DESPITE the fact that millions quit smoking every year... because we're fat, we don't exercise, we eat crap food and we don't have access to health care.

http://www.ncbi.nlm.nih.gov/pubmed/285289

http://www.journaloftheoretics.com/Editorials/Vol-1/e1-4.htm

[JDPriestly]

11. If you are obese and smoke and are over 50, watch out.

If cancer doesn't get you, diabetes could.

Health care is affordable in other industrialized countries -- for people of all ages.

Prenatal, infant and pediatric care establish the foundation of a person's health for life.

European healthcare in the vital early years is far superior to ours.

Every mother, I repeat, every mother who wants it gets regular checkups during pregnancy.

Babies receive regular check-ups and timely immunizations. Health care problems in infants are diagnosed, taken seriously and treated carefully.

American pregnant women, babies and children get the healthcare that they can afford. And many of them cannot afford much.

That's the difference.

[StandingInLeftField]

6. I'm just wondering where I can get one of those $300 CT scans!

My daughter's scans (for a congenital heart condition with no insurance coverage) average about $1100 per scan. Mabye different price for lungs?

[RC]

7. We don't spend that much on health care.

We pay a lot for our health insurance, true. But most of that money (30% to 40%) does not go for our health care. It goes for obscene profits, bonuses, "Overhead", business trips, Meetings in world class resorts, everything except our health care. We are talking Billions with a capitol 'B' here, not going for our health care.

We need Single Payer Universal Health Care.

[area51]

12. +1

Each day, 273 people die due to lack of health care in the U.S.; that's 100,000 deaths per year.

We need single-payer health care, not a welfare bailout for the serial-killer insurance agencies.

We don't need the GingrichCare of mandated, unregulated, for-profit insurance that is still too expensive, only pays parts of medical bills, denies claims, bankrupts and kills people.

Republinazi '93 plan:

"Subtitle F: Universal Coverage - Requires each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005."

"We will never have real reform until people's health stops being treated as a financial opportunity for corporations."

"Any proposal that sticks with our current dependence on for-profit private insurers ... will not be sustainable. And the new law will not get us to universal coverage ...." -- T.R. Reid, The Healing of America

[RC]

13. We are on the same page.

http://www.timws.com/

[madrchsod]

10. my mother died from my fathers second hand smoke....

[Jeneral2885]

14. No well not according to the UNDP

United States life expectancy at birth--79.6 and overall HDI 4th in the world

http://hdr.undp.org/en/media/HDR_2010_EN_Tables.pdf

[Taitertots]

15. Just show a picture of an insurance executive's mansion

Why do we pay so much and get so little? Because the excess is going somewhere, and it sure isn't to preventative medicine, research, or infrastructure improvements.

[AngryAmish]

16. It is the hoarders and wreckers.