They always say the US has the best health care in the world

Studies have actually been done on this topic - unhealthy lifestyles, health risks and costs to a health care system. It's certainly a topic of interest in countries that do have a universal health care system.

The interesting thing is that, if you're only looking at lifetime medical costs incurred to the health care system, the most expensive patients are nonsmoking, nonobese people.

Here is a link to one recent study.

That study found that although annual health-care costs are highest for obese people earlier in life, and are highest for smokers at older ages, the lifetime costs are highest for the healthy people. Life expectancy from age 20 is reduced by 5 years for obese people and 7 for smokers. The consequence is that healthy people live to incur greater medical expenditure, more than compensating for the earlier excess expenditure related to obesity or smoking.

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All of this is obviously quite apart from the moral question (along the lines of "Do we want people who cannot afford quality health insurance to quietly succumb to their illness?").

The hospital in which the unfortunate woman died was run by the State and it provided free care to the indigent (of which the victim was one) under a government operated and funded program.

Clearly the solution to this problem is the creation of ever more ubiquitous and intrusive government operation of health care facilities and programs !

universal health care government run health care


But you know that of course, george!

I suggest you look into how the Germans and Australians do it. The Australian system would be the easiest for the US to adopt, but the German system is actually better for most.

I assume you have work for a company that will pay your health insurance until you die.

georgeob was a career navy man.

That explains it, he has lifetime government health care paid for by the American tax payer. Thanks CI.

No you are both ill-informed and in the grip of inaccurate prejudgements. Retired military personnel do not normally get access to Military health care facilities. Instead we are covered by a government paid insurance program that has high annual and individual deductables and which purports to pay for only a specified portion of covered expenses. If the individual is also covered by another private or government program such as company-paid benefits or Medicare, then they take precedence and there is virtually no additional benefit to the retiree.

I do have some additional coverage from the VA, based on a combat related injury (high speed ejection), which provides some annual screening and specific treatment of any residual effects of the injury. However the VA hospital is far away and not generally a practical alternative.

However, I am still employed and am covered by a fairly typical company Blue Cross policy for which I pay about 20% of the premiums.

By the way, every American over the age of 65 - even those who didn't spend seven years at sea and 2+ in combat assignments - has lifetime medical care paid for by the U.S. taxpayers through Medicare.

Actually George, if you were covered 100% for health care by my tax money I would be fine with it. I would rather my tax money go to the health of Americans than new roads in Iraq. I hope you will always be comfortably covered, but for myself, the next generation of US children and American businesses - I will vote and fight for a national plan.

I am quite certain OB1 is glad he does not rely on the VA for his health care...

I do know that. However, whether the Universal system is wholly or partly government operated such as those in Canada and the UK or based on government-mandated insurance schemes, the government sets the limits for coverage - particularly for the poor and the indigant - through its budget decisions. That is why these are generally hotly debated political issues in most countries with such systems.

More to the point, however, government-mandated universal health care is not a remedy for the callous indifference and inhumanity illustrated by the incident Gus reported that launched this thread.

But you know that, of course, old europe!

I have always thought that health and lifestyle issues that cost the medical system $$, like smoking cessation products, birth control, condoms, detoxes and rehabs for alcohol and drug-related addictions, diet products, etc., should be provided free if the governments of any country were truly serious about the health and preventative health of their citizens.

Would it not save $$ in the long run?

Sounds nice, but I doubt that it works well. Most of the folks I have encountered who were suffering in the grip of such "lifestyle" issues (drug/alcohol/tobacco addiction) weren't continuing their harmful habits only because no help was available. "Help" isn't usually very successful in the absence of an act of the will of the victim, and, with such a committment , success usually occurs even in the absence of "help". Most state methodone programs for heroin addicts simply involve perpetual substitution of one drug (freely supplied) for another.

I believe the chief benefits of such programs are the palliative to the sensibilities of observers, and employment for those who administer them.

I totally agree Mame. However, Americans love to be "penny wise and pound foolish". The typical insurance coverage for alcohol and drug rehab is less than two weeks. We preach abstinence in our teen sex and STD courses instead of birth control/condoms, and then the conservatives want to reverse the laws on legal abortions and close down family planning centers. We are the descendants of Puritans - Suffering is good, but not as good as the suffering of others.

The only entirely successful government program for the elimination of a widespread addiction that I am aware of occurred in China in the early 1050s.

How did we scoot from health care to addiction, I got lost...

Well, regarding the drug addiction component (although I detest the Cut and Paste):


Vancouver's safe injection site successful: study
Top AIDS researcher suggests Harper government has 'profound bias' against site
Last Updated: Monday, November 20, 2006 | 5:38 PM ET
CBC News

Vancouver's safe injection site is slowing down the spread of HIV and helping drug users quit their habits, a new study finds ?- but an expert suggested that Prime Minister Stephen Harper and his government won't want to hear those results.

The study, which appears Tuesday in the Canadian Medical Association Journal, says the three-year-old Supervised Injection Site in the Downtown Eastside has been a great success.

The injection site, which drew about 5,000 users in its first year of operation, is a place where people can safely go to inject illegal drugs while being supervised by nurses.

"By all criteria, the Vancouver facility has both saved lives and contributed toward the decreased use of illicit drugs and the reduced spread of HIV infection and other blood-borne infections," Mark Wainberg, the director of the McGill University AIDS Centre in Montreal, wrote in a commentary published alongside the study.

The study ?- conducted by Dr. Evan Wood, a professor of epidemiology at the University of British Columbia, and his colleagues ?- found that drug users who visited the site at least once a week were more willing to enter detoxification programs.

The researchers also found that all users in the area, including those with HIV, have been sharing syringes less since the start of the injection site, which is the first of its kind in North America. They have also engaged in other safe injection practices like using sterile water to formulate their drugs and swabbing alcohol on their skin.

Users were less likely to overdose when they used the facility at least once a week, the study found.
Establish more sites, expert urges

Wainberg argued that the injection site should remain open. He said the federal government should be drafting legislation to allow similar facilities to operate elsewhere in the country.

Wainberg criticized the federal Conservative government, singling out Health Minister Tony Clement for cutting a grant that would have allowed further study of the injection site ?- something Clement himself has said is necessary.

"Why would the government on the one hand announce that additional time is needed to study the potential success of the Vancouver safer injecting facility and on the other hand eliminate the funding needed for such evaluations?" wrote Wainberg, who is also a professor of medicine at McGill.

He also cited the Harper government's handling of an extension to the "waiver of law," which allows the site to operate without fear that the users or staff will face criminal charges.

Wainberg pointed out that, in September, Harper's government refused a request to extend the waiver for 3½ more years, only agreeing to let it stay open until the end of 2007.

"One hopes that the current government under Stephen Harper, which has been in office since only February 2006, will be willing to learn and to revisit this issue," Wainberg wrote.

On Tuesday, the health minister said the current project will continue for 18 months and then all of the evidence will be weighed.

"I think it's important to have a diversity of research," Clement told a news conference in Ottawa.
Government accused of 'profound bias'

Meanwhile, one of Canada's foremost AIDS researchers accused the federal government of being against the injection site, saying he doubts Ottawa wants to hear that it has been having a positive effect.

"I think that there is a profound bias in this administration," Dr. Julio Montaner, the director of B.C. Centre for Excellence in HIV/AIDS, told CBC News in an interview tied to the release of the study.

"Unfortunately, no matter how many attempts we have made to have an intelligent and educated discussion about this issue, their principles stand in the way of evidence-based decision making," said Montaner.

"And to me, that's unacceptable."

The injection site is operated by the Vancouver Coastal Health Authority in partnership with the Portland Hotel Society and is funded by the federal and provincial governments.


from:
http://www.cbc.ca/health/story/2006/11/20/injection-study.html

and

Science says safe injection site a success
Dr. Hedy Fry, For The Calgary Herald
Published: Friday, May 30, 2008

Re: "Vancouver's safe injection site contradiction in name and deed: We should focus on the problem as a moral issue," by Susan Martinuk

I would like to clarify some misconceptions expressed by Martinuk in last Friday's column regarding Vancouver's safe-injection site.

Good public policy should be based on objectively researched evidence, and not on subjective morality or ideology.
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Addiction is a medical problem. Extensive medical research has established that over the last 20 years. Effective solutions must therefore be based on good public health principles.

These universally accepted public health principles are: prevention and epidemiology (research and data), harm reduction, treatment and rehabilitation. These principles work together to form a comprehensive, integrated strategy for dealing with public health problems.

Those who exploit the addicted by selling and trafficking in illicit drugs are criminals and should be targeted with effective criminal and law enforcement strategies.

Insite, Vancouver's safe injection site, is a harm reduction project. It is not an original concept. It was patterned on similar, highly successful, harm reduction programs, (sanctioned by the European Parliament) in Switzerland, Germany, Belgium, Portugal and Spain, to name a few, as well as numerous safe injection facilities in Australia.

The project in Vancouver was set up as a clinical trial, to see whether the European and Australian results could be achieved in a North American setting.

The research project was conducted by scientists at UBC and the Centre for Excellence in Clinical Trials for HIV/AIDS.

The protocols followed accepted international scientific standards for clinical research. The chief researcher is Dr. Julio Montaner, a respected clinician and current president of the esteemed Council of the International AIDS Society.

The target population, as in most harm reduction research, was the small but very high-risk IV drug user cohort in Vancouver, who had extremely high overdose mortality rates, peaking at over 200 in the mid-1990s. This group was also at highest risk for HIV and hepatitis C infection, and for frequent hospitalization. They were also the group least likely to seek treatment.

Within six months of the establishment of Insite, the overdose deaths had dropped to zero and remained so among Insite users. Within 18 months, the users of this very resistant group were seeking detox and treatment. There are now 24 beds in the building that provide immediate detox treatment facilities.

Moreover, the rates of illness and hospitalization dropped dramatically, at great savings to the health-care system (Vancouver Coastal Health Authority), and the spread of HIV and hepatitis C was contained in this high risk group.

One of the objectives of the project was also to determine whether public order would be achieved. The Vancouver Police Department's Commander of the drug unit, at the time, Kash Heed (now chief of police for West Vancouver), attests that this is so.

from: http://www.canada.com/calgaryherald/news/story.html?id=75bba6cb-4513-497a-a81a-d34ff42bf900


and just so you don't think I'm biased:

Report Says Vancouver "Safe Injection" Site a Failure

By Gudrun Schultz

VANCOUVER, British Columbia, May 4, 2007 (LifeSiteNews.com) - A Vancouver safe-injection site for drug addicts has not reached the goals that proponents of the facility claim, according to a new study published Wednesday in the Journal of Global Drug Policy and Practice.

The controversial Insite facility, the first of its kind in North America, opened as a pilot project over three years ago in Vancouver?'s notorious Downtown Eastside. Heroin or cocaine addicts are provided with clean needles and allowed to inject themselves with their own heroin or cocaine under a nurse's supervision.

Supporters claim the site reduces overdoses and HIV infection-transfers among injection drug users by preventing them from sharing needles. Crime rates are also said to have dropped in the vicinity of the site.

According to a new study authored by Colin Mangham, director of research with the Drug Prevention Network of Canada, those claims are faulty and ignore research showing the project has failed to reach its goals, the Canadian Press reported May 3.

"[The findings] give an impression the facility is successful, when in fact the research clearly shows a lack of program impact and success," Mangham said.

Studies published in top medical journals, including the Lancet, the British Medical Journal and the New England Journal of Medicine, claim that Insite has produced a reduction in public disorder, crime and overdose deaths. Mangham disputed those findings saying the studies assume that overdoses occurring at the site would have led to deaths if they had happened on the street.

"We do not know if any of the overdoses would have resulted in death outside the side [sic]," Mangham said in his study.

"The number of overdose deaths in Vancouver and the Downtown Eastside has increased since Insite started up. This…at least suggests that in its three years of operation Insite has produced no impact on overdose deaths."

Mangham said a 2005 study published in the American Journal of Infectious Diseases that reported a reduction in needle sharing among addicts using Insite was misleading.

"Only exclusive use of Insite correlates with reduced sharing. If someone uses Insite for all their injections, it goes without saying they would not share needles. Only one in 10 HIV negative participants reported using Insite for all their injections."

As well, Mangham's study attributes a reduction in public disorder and crime in the area to an increase in police presence, saying it was not due to the facility.

Initial reports on the facility claimed the initiative was successful because of the high volume of users--as many as 600 per day. Within a six-month span in the first year of operation there were 107 overdoses reported among 72 "clients" of the facility, the report also acknowledged. As well, the report stated that only 2.3 per cent of addicts using the site contacted a nurse or counselor, saying, "visits to Insite for nursing care or counseling have been uncommon to date."

The Conservative government has extended the program's operation until Dec. 31, 2007, calling for additional research into the success rate of supervised injection sites.

Randy White, president of the Drug Prevention Network of Canada, said Mangham's study could have an impact on the future of the Insite facility.

"There are people in Vancouver and throughout the country who do not agree with the project and would like to see a balancing of the reports and evaluations and I think this is the first time and I think that's good," White said

Prevention and treatment are the best approaches to dealing with substance additions, he said.

Federal Health Minister Tony Clement announced in September 2006 that no further safe injection sites would be established in Canada until the Vancouver review is completed.

See previous LifeSiteNews coverage:

Vancouver "Safe" Drug Injection Site Claims "Success" with 600 Users a Day
http://www.lifesitenews.com/ldn/2004/sep/04092704.html

Vancouver Mayor and MP Libby Davies Pushing for "Harm Reduction" for Crack and Prostitution
http://www.lifesitenews.com/ldn/2004/sep/04092305.html

from: http://www.lifesitenews.com/ldn/2007/may/07050404.html

But that's just regarding drug users. I'm sure many people would be more open to quitting smoking if the cessation products weren't so expensive, and I, for one, would rather provide free condoms and BC if it meant young girls didn't have so many unwanted babies.

Reader's Digest Version:

Stray Cat, three pages ago - "Should universal health care cover smokers?"

Liberal people - "yes"

Conservative people - "no"

Mame - "Governments should help people get over these addictions"

Liberal people - 'yes"

Conservative people - "no"

Re: Abortions and their associated costs in Canada (and this is old - 2001):

Since no level of government has released cost figures for abortion, we can only estimate what the direct costs of abortion are. (These estimates exclude any indirect costs, that is, costs for follow-up procedures for immediate complications and side effects, and longer-term treatments for associated post-abortion problems. See book, Women's Health After Abortion: The Medical and Psychological Evidence . Elizabeth Ring-Cassidy and Ian Gentles. The deVeber Institute for Bioethics and Social Research, 2002.)

We use the figure of $80 million a year, based on an average cost of $800 per abortion for 100,000 abortions. In 2001, the Canadian Institute for Health Information reported 106,418 abortions. They admit that is at least 10% below the actual number of abortions performed because of reporting problems from some provinces and private clinics. So, the $80 million figure is already low for the 2001 year and if past trends continue, the number of abortions has undoubtedly increased in the past two years.

We arrived at the average cost of $800 based on the following numbers published by abortion advocates and in the media. Since hospital abortions constitute roughly two-thirds of all abortions performed in Canada, we used an average of the $500 cost (at the low end) of a clinic abortion and $1000 (again, at the low end) estimate for hospital abortions. We are quite comfortable that the $800 cost per abortion is in fact a very low, conservative estimate of the cost and that the $80 million a year figure is probably an underestimate of how much taxpayers spend on medically unnecessary abortions.

Here are the published estimates of the cost of abortion.

. "The average cost for an early surgical abortion at a private abortion clinic is about $500, while the cost for the same abortion at a hospital can exceed $1000," said Joyce Arthur of Pro-CAN. "Hospitals have bigger bureaucracies and more overhead. Most use general anesthesia for abortions, while clinics use less expensive local anesthesia and conscious sedation. Abortion clinics deliver more 'bang for the buck' than hospitals."

www.prochoiceactionnetwork -canada.org/release-Nov-29-02.html

. Abortions are significantly more expensive in hospitals. An early surgical abortion at a clinic costs between $450 and $550, while the same abortion at a hospital can be estimated at about $900 to $1200.

www.prochoiceactionnetwork -canada.org/release-Nov-29-02.html

. About 500 abortions are performed at Morgentaler's clinic in Fredericton each year. Patients pay between $475 and $725.

. There are about 105,000 abortions in Canada annually, and it is widely believed that more ready access to emergency contraception could cut that number substantially. At $25 (plus another $20 or so for the pharmacist's counselling fee), Plan B is, in crudely economic terms, much more cost-effective than an abortion, which costs upward of $600 (without mentioning the emotional and moral issues related to abortion).

from: http://www.lifecanada.org/html/defunded%20abortion/cost.html

and from 2004:

We use the figure of $80 million a year, based on an average cost of $800 per abortion for 100,000 abortions. In 2004, the Canadian Institute for Health Information reported 100,039 abortions performed in Canada on Canadian women. They admit that is at least 10% below the actual number of abortions performed because of reporting problems from some provinces and private clinics. Also, in 2004 the number of abortions performed in Manitoba clinics went unreported. So, the $80 million figure is already low for the 2004 year.

Since hospital abortions constitute more than half of all abortions performed in Canada, we used an average of the $500 cost (at the low end) of a clinic abortion and $1000 (again, at the low end) estimate for hospital abortions. The $800 cost per abortion is in fact a very conservative estimate and the $80 million a year figure is probably an underestimate of how much taxpayers spend on medically unnecessary abortions.
Some published estimates on the cost of abortion

* "Abortions at clinics are significantly more cost-effective than abortions at hospitals (mostly because hospitals use general anaesthesia (sic) rather than a local anaesthesia (sic)). The average cost for an early surgical abortion at a clinic is about $500, while the cost for the same abortion at a hospital can exceed $1000."

from: http://www.abortionincanada.ca/funding/index.html



I don't know how much birth control pills cost but I suspect it's a lot less than $80M per year!

And not all pregnant single women have abortions, meaning the cost to the 'system' can be a lot more than having an abortion.

GW, thanks for the cliff notes.

Ima drop an opinion and move to the gallery.

If the government says its legal and taxes the hell out of it, the plan ought to cover the victims.

The following stats represents California, but I'm pretty sure it generally speaks for all the states as far as ratio of cost between students and prisoners.


COST PER INMATE IN A CALIFORNIA PRISON

We calculated the annual incarceration costs per inmate for each of the 32 state-run prisons operating during fiscal year 1996-97, as well as a statewide cost per inmate. Our calculation includes all operating and capital costs. We found that annual incarceration costs per inmate vary significantly from one prison to another, depending on each prison's security levels, facility types, and age. Annual costs per inmate for the 32 prisons ranged from $18,562 to $38,554 per year.



EXPENDITURE PER STUDENT IN CALIFORNIA SCHOOLS K - 12

Expenditures per K-12 Pupil in Fall Enrollment for California
Over the Last 10 Years
.........California......Rank.....U.S Average
2005-06 $8,486......29........$9,100
2004-05 $7,935......30........$8,717
2003-04 $7,745......27........$8,340
2002-03 $7,580......26........$8,065



What we're seeing is what taxpayers pay per student vs. per prisoner in California.

It would make more sense to spend $18,562 per student and $8,486 per prisoner.
If we had the foresight to spend on students to succeed at an early age, the incidence of crime should drop automatically.

It's the same with health care; take care of societies health needs first, and the cost should automatically reduce based on prevention and early diagnosis of health problems.

The longer one waits to get health care, the worse the patient's health becomes at much higher cost. Most delays also makes it harder to cure.