ATTN: foreigners RE: USA

[Epinephrine]

How am I completely ignorant? If we want to get into personal experience with health care I can hold my own as well. I've volunteered for hospitals for 4 years, my mother is a doctor, and my uncle is the manager of a Kaiser hospital in San Francisco. From speaking with them and my own observations I'm pretty sure I know what the fuck I'm talking about. I'm not sure why you think what we're saying is so different - I could agree with 80% of that fat post you just made.

Of course it costs more because it's privatized - that was my argument for why it's better. It's fucking capitalism. I'm not saying that your doctors are bad by any means at all; I was saying that the best trained doctors stay in the states where they make more money. If you want proof of that refer to Face and TK's discussion of CFL vs. NFL players.

Needless amputations do occur, do you not read the news? Hell, they happen in America sometimes - just not to the extent as in other countries. I was mainly talking about countries like Mexico and some parts of Eastern Europe where health care is good but isn't comparable to America or even Canada's.

I'm quite familiar with how the health care system works and I can assure you my uncle has his gripes with the insurance-run way of things being in charge of a giant hospital but that's just the way things fucking are if you want to attract the best people. I mean this is, at its base, an argument for free-market capitalism and for some reason you think I'm saying Canada has piece of shit doctors.

when you just randomly say stuff like countries which are not America have more amputations and have flubb doctors it shows your ignorance. Sure you may have been talking about crack doctors in mexico... or darfur. But that's a completely straw man argument. The fact is, other first world countries that are not america, don;t have tons of needless amputations and flubb doctors. Americans spending so much doesn't have much bearing on it.

Just because your mom is a doctor doesn't mean you actually know things. I don't understand how america's health care system is the 'best' when with basically any health indicator you can get, americans fare badly compared to most other first world countries, AND they spend much more money per capita.

Then there's how the system works in the first place. It is very hard to be a doctor in America unless you trained in America and are American. Trust me, I've looked into it. It is very hard to train in America unless you're american due to lack of spots. Thus, you retain a lot of American doctors... woowee. Doesn't mean they are the best doctors or the smartest doctors by any standard.

For sure top research doctors can be professors at medical schools and enter the country that way, but they will dedicate most of their time to reserach, and not directly in healthcare. Since research benefits everyone in the world, it doesn't necessarily make American health care superior.

Generally each country retains the doctors they;ve trained except for poor third world nations, whose best healthcare people are poached by all english speaking countries in the first world (thus not necessarily giving america any advantage )

What does this mean? Since standards are somewhat international, there's basically only a few ways to treat things... the fact is most first world countries practice medicine in very similar ways. We use the exact same procedures and equiptment that they do in America.

The difference is... our doctors offices and hospitals don't look as nice. They are physically uglier because of lack of cash. Our machines may not be the absolute newest... but then why do you need a top of the line machine to measure blood pressure anyway?> Most critical systems we have are basically just as good, and this is consistant in many countries.

Finally there's the economic argument. Just because doctors can earn more in America doesn't mean the best doctors are there! Because it is hard to get in in the first place, many are ineligable. Because people like staying home and not moving to a foreign country, they won't go. Because amazingly doctors don't do it all for the money, many won't go. Becasue many people don't like the American lifestyle they won';t go. Besides a LOT of doctors, unlike say lawyers come from modest backgrounds. Being able to make $300,000/year in Canada is good enough... they don't need to make 400k per year while being away from all their friends and family(yes the differences may not be that big for MOST doctors).

I agree that for some very special things such as cosmetic plastic surgery and invitro fertilization america has the best in the world... but for almost everything else, it would be hard to find a real difference, except that y'all pay much more for healthcare.

[genocidal]

when you just randomly say stuff like countries which are not America have more amputations and have flubb doctors it shows your ignorance. Sure you may have been talking about crack doctors in mexico... or darfur. But that's a completely straw man argument. The fact is, other first world countries that are not america, don;t have tons of needless amputations and flubb doctors. Americans spending so much doesn't have much bearing on it.

No, I'm talking about all countries. It's not a straw man when I'm comparing us to other countries.Evidence for Germany. Why do you think that income has no bearing on the quality of health care? Why do you think that the best and brightest doctors come to America?

Just because your mom is a doctor doesn't mean you actually know things. I don't understand how america's health care system is the 'best' when with basically any health indicator you can get, americans fare badly compared to most other first world countries, AND they spend much more money per capita.

She's a doctor, I've been involved in the health care system to a degree, and my uncle is the guy in charge. I do actually know things and what I'm talking about; you're just too emotional with your nationalism to see what I'm saying. What are you talking about we fare badly? Can you prove this somehow? Again, because of brain drain, we're attracting smart people from all over the world to go to our medical schools.

Then there's how the system works in the first place. It is very hard to be a doctor in America unless you trained in America and are American. Trust me, I've looked into it. It is very hard to train in America unless you're american due to lack of spots. Thus, you retain a lot of American doctors... woowee. Doesn't mean they are the best doctors or the smartest doctors by any standard.

It's not that hard to be a doctor without an American degree. Granted, it is harder, but I know plenty of people who went to Puerto Rican, Mexican, and other countries' medical schools and practice in the States. We get a HUGE number of Indians, Asians, etc. coming into America to go to our medical schools. Again, I would know this better than you. Probably the reason you think it's so hard is because you're not smart enough yourself to get into the American medical school system - I don't know.

For sure top research doctors can be professors at medical schools and enter the country that way, but they will dedicate most of their time to reserach, and not directly in healthcare. Since research benefits everyone in the world, it doesn't necessarily make American health care superior.

Generally each country retains the doctors they;ve trained except for poor third world nations, whose best healthcare people are poached by all english speaking countries in the first world (thus not necessarily giving america any advantage )

That may be true, but when we get international students coming to America to be trained they 99% of the time stay here because they can make more money. And they are here in the first place because they work hard and are intelligent. My university has a medical school and I have friends in it; so again, I do know what I'm talking about. Ask any other American on these boards. There are a huge number of international students at any university.

What does this mean? Since standards are somewhat international, there's basically only a few ways to treat things... the fact is most first world countries practice medicine in very similar ways. We use the exact same procedures and equiptment that they do in America.

The difference is... our doctors offices and hospitals don't look as nice. They are physically uglier because of lack of cash. Our machines may not be the absolute newest... but then why do you need a top of the line machine to measure blood pressure anyway?> Most critical systems we have are basically just as good, and this is consistant in many countries.

We're on the same page here. Perhaps it may not matter for blood pressures but the fact that we have newer, better technology and better trained doctors means the health care will be that much better. Whether or not you think it's negligible is your own opinion. I doubt you've ever lived in America and almost surely have never been in a hospital.

Finally there's the economic argument. Just because doctors can earn more in America doesn't mean the best doctors are there! Because it is hard to get in in the first place, many are ineligable. Because people like staying home and not moving to a foreign country, they won't go. Because amazingly doctors don't do it all for the money, many won't go. Becasue many people don't like the American lifestyle they won';t go. Besides a LOT of doctors, unlike say lawyers come from modest backgrounds. Being able to make $300,000/year in Canada is good enough... they don't need to make 400k per year while being away from all their friends and family(yes the differences may not be that big for MOST doctors).

I agree that for some very special things such as cosmetic plastic surgery and invitro fertilization america has the best in the world... but for almost everything else, it would be hard to find a real difference, except that y'all pay much more for healthcare.

Why make $300,000 in Canada (giving up like 40% of that for your socialized medicine) when you can make $2,000,000 in America and keep 84% of it? It might be "good enough" but when the offer is in your lap (as it is with the doctors just out of medical schools like Johns Hopkins, Harvard, Cornell, etc.) you're going to take the fat check and fast food.

As for what America is superior on, why don't you do some research. How many leading cancer institutes of the world are in Canada? How many in America? How about AIDS research? How about hepatitis research? How about heart disease research? Just because plastic surgery is what you see on American television doesn't mean it dominates and trumps all other forms of health care.

[Epinephrine]

No, I'm talking about all countries. It's not a straw man when I'm comparing us to other countries.Evidence for Germany. Why do you think that income has no bearing on the quality of health care? Why do you think that the best and brightest doctors come to America?

The best and brighest doctors also go to other countries too. I don't see why you think America has a lock on the best and brightest.

She's a doctor, I've been involved in the health care system to a degree, and my uncle is the guy in charge. I do actually know things and what I'm talking about; you're just too emotional with your nationalism to see what I'm saying. What are you talking about we fare badly? Can you prove this somehow? Again, because of brain drain, we're attracting smart people from all over the world to go to our medical schools.

That's nice. Too bad i'm not debating with your mom or your uncle. I'm debating with you. My dad took economics in unversity, does that make me an expert? Hardly. And no, volunteering in a hospital isn't 'working in healthcare' LOL.

I'm not being blinded by my nationalism. If I had more time I'd do the literature searches for the requested articles. Needless to say, I've read a lot of research that shows that America flatly spends 2x as much per capita on health care than any other country. Meanwhile, you can go to the CIA factbook and look up yourself at your country's life expectancy, child mortality, AIDS infection rate and so on, and tell me it's really that much better.

It's not that hard to be a doctor without an American degree. Granted, it is harder, but I know plenty of people who went to Puerto Rican, Mexican, and other countries' medical schools and practice in the States. We get a HUGE number of Indians, Asians, etc. coming into America to go to our medical schools. Again, I would know this better than you. Probably the reason you think it's so hard is because you're not smart enough yourself to get into the American medical school system - I don't know.

Actually it IS very hard to be a doctor in America without an American degree. It is very hard to be a doctor in America without being AMERICAN. Most international medical students and residents go back to their home countries after they train, because it is very hard to get into America (or any other first world country for that matter) because doctor's assocations have a virtual lock on who they let in the country. They purposefully make it HARD to get into the country because it takes away business and because of the issue of standards.

There are a number of immigration issues that you must do in order to be a doctor in America. Basically for immigrants to go in, you have to service an underserviced area where they need to have put up an ad for 1 year and found no other suitable candidate before they can let you in. Even then, you can only stay for 2 years and then you have to go home. It's the law. It's easier for mexican illegals to get into the country than doctors.

And yes i'm quite aware at the number of minorities in medicine, it's the same in Canada and Britian and any other English-speaking country as well.

That may be true, but when we get international students coming to America to be trained they 99% of the time stay here because they can make more money. And they are here in the first place because they work hard and are intelligent. My university has a medical school and I have friends in it; so again, I do know what I'm talking about. Ask any other American on these boards. There are a huge number of international students at any university.

No a lot of them go home afterwards because they HAVE to. And there isn't that many international spots in American medical schools... trust me.

We're on the same page here. Perhaps it may not matter for blood pressures but the fact that we have newer, better technology and better trained doctors means the health care will be that much better. Whether or not you think it's negligible is your own opinion. I doubt you've ever lived in America and almost surely have never been in a hospital.

First of all, I don't see why America has on the whole better trained doctors. It's much easier to get into more than 1/2 of American medical schools than it is Canadian medical schools, just looking at the requirements needed to get in (GPA, MCAT scores, etc). As a whole the standards in Canadian medical schools and residency programs are actually a lot higher because there are so few schools, thus it is easier to enforce the standards. There are a lot of really bad programs in the US that I would never want to subject myself to, which is why I'm not even going to bother applying to American residency programs.

Secondly, the idea that better technology = better health care is a misnomer. For almost everything, it really doesn't matter if you have the best newest thing. The old thing works just as good or almost just as good and has very few differences. That's like saying you need to buy a Intel Core Duo 2 to be good at Warcraft or something. It's nice to have, but not necessary in many cases. For things which ARE necessary (i.e. newest model heart stent), I can assure you other countries have this stuff if the research says it's actually better.

Why make $300,000 in Canada (giving up like 40% of that for your socialized medicine) when you can make $2,000,000 in America and keep 84% of it? It might be "good enough" but when the offer is in your lap (as it is with the doctors just out of medical schools like Johns Hopkins, Harvard, Cornell, etc.) you're going to take the fat check and fast food.

You're living in a dream world if you think the average doctor makes $2 million in America or that the tax rate is 16%. I have no idea how you made that number up. Perhaps it's to justify your CFL vs. NFL analogy, which has nothing to do with healthcare. You don't make that much more in America. Considering you also have to hire extra secretaries to manage all the billing and pay higher insurance rates, you end up making not that much more. Also since doctors are self-employed for the most part, they pay their own healthcare expenses (insurance) which is free in Canada... another large cost to bear. Besides, many doctors in Canada that I've worked with actually DID train in famous US centers, but they choose to stay in Canada afterwards because... they LIKE Canada.

And I must reiterate. You are just completely wrong if you think that just because people can make a bit more money, they are willing to leave their friends and family and homes to live in America. Doctors are well off everywhere, so it's not like they are poor if they stay in their home countries. Lifestyle is a VERY BIG deal in medicine these days. Sure there will always be those that will move to America to get paid more, but a great majority don't care at all past a certain point. Not everyone is as moneygrubbing as your mother I guess?

As for what America is superior on, why don't you do some research. How many leading cancer institutes of the world are in Canada? How many in America? How about AIDS research? How about hepatitis research? How about heart disease research? Just because plastic surgery is what you see on American television doesn't mean it dominates and trumps all other forms of health care.

Having better reserach thus making America better is as I've said a complete misnomer. Canada has excellent health research as well and some of the best researchers in the world live here, but then that's not the point. Scientific research once published is free for the entire world. Everyone benefits from research, so just because America has a lot of researchers, doens't mean that America has beter medicine. It just means they reseached it first, and other people will use it too! And no, it's not like the entirety of America benefits first, then other countries, but explaining how medical research works is another thing altogether.

My plastic surgery thing isn't a red herring. If you're doing complex facial plastic surgery there certainly is a talent to it, and only certain people can do it well. Since the payoffs are MUCH bigger in the USA for this particular thing (as opposed to say... being almost anything else), they will probably go there.

Finally, I have to say the idea that 'more money = better doctors' and 'better doctors = better healthcare' is a really bad argument. The fact is, any competently trained doctor will be able to do their job pretty much just as good as another. You are simply unaware of the major things that a doctor will deal with in a day. Almost all of it is routine, thus almost all people who have concerns will be treated just as well.

It may be hard for you to understand, but once you are an expert, you are an expert. Even for top surgeons, it's not like they are born perfect, it's all practice and has nothing to do with how much money they make. There is not very much undeniable talent involved as long as you pass a certain baseline of competency and knowledge.

Just because one doctor went to Harvard and another went somewhere else, doesn't mean that Harvard doctor suddenly can cure you better. It simply does not work that way. That's what standards of care are for. It's not like the TV show House where suddenly all American doctors can recognize dieseases no one else can... it simply isn't like that. To think that is ignorant.

[Epinephrine]

I admit that obviously some doctors are more competent than others, but this rarely has anything to do with how much money they make or even what school they went to, but in fact has to do with their own dedication to their patients in ensuring their patients are better served. In fact everyone in the real world knows this, which is why not every department in the world is run by a Hopkins/Harvard grad.

In the end stuff like one hospital having a stricter policy on handwashing than another probably makes a bigger difference in outcomes than anything else. There are so many different determinants of health that having the 'newest technology' or 'most expensive doctors' aren't what matters.

For most people out there, they will never develop any super rare diesease that no one else can treat but the one world-famous center out there. For most people out there, even if they do develop this, they won't be able to afford to go there, American or otherwise even if it's because it's on the other side of the country.

The fact is, a private system ensures that everyone can charge more... but it doesn't ensure that quality goes up. Training in America isn't vastly different than elsewhere. The testing isn't better (we write the US standardized tests at my medical school anyway). The level of competentcy isn't especially higher by any standard. This is also true with the newest equiptment, or the newest drugs. Not always the best, and I think the whole escapade with Vioxx has at least shown the general public some of that.

Paying more for healthcare just means you pay more. It means HMOs take a huge amount of middlemen money that just doesn't exist in other places. It means that they can charge higher fees for equivalent services because... hey why not. It means that when everyone is out there knowing they can make a profit or a quick buck, the temptation is that much higher to be in fact a bad doctor and do unnecessary tests (yes Americans go through more expensive and useless tests than anyone) or unnecessary procedures just because you can. Is this really better healthcare?



To end off. I do admit that America has some of the best doctors in the world. Then again, Canada does too. And I'm sure China does too. It's also true that America has the best reserach out there too, and this benefits everyone. It's also true that there is more new technology as well. But in the end, thanks to the fact that everyone is out there making a quick buck, thanks to the fact that HMOs exist at all... Americans end up spending more on healthcare than anyone else on the planet. And your health insurance costs far outweigh the potential taxes of a public system for something which really isn't better at all for the vast majority of people, and actually much worse for the 40 million or so uninsured Americans out there.

[Mantra-Slider]

nm, wont go there!

[genocidal]

To end off. I do admit that America has some of the best doctors in the world. Then again, Canada does too. And I'm sure China does too. It's also true that America has the best reserach out there too, and this benefits everyone. It's also true that there is more new technology as well. But in the end, thanks to the fact that everyone is out there making a quick buck, thanks to the fact that HMOs exist at all... Americans end up spending more on healthcare than anyone else on the planet. And your health insurance costs far outweigh the potential taxes of a public system for something which really isn't better at all for the vast majority of people, and actually much worse for the 40 million or so uninsured Americans out there.

I think we agree more often than not. This isn't even relevant to the discussion of this thread and I'm sick of arguing it so I'm done.

[Blood]

My vote will never change anything ever in any situation ever ever. It takes a lot of effort to vote, and I never will. It is worthless, and therefore not worth my time.

Ideals and principles can be for the other fools who think they're making a difference.

Democracy is dandy I guess, but deluding yourself into thinking an individual voter can bring about change is silly.

Even if I felt my vote counted or even if it actually did, I still wouldn't have voted because no candidate in my lifetime has appealed to me, and I think voting for the guy you hate the least is stupid and bad because it encourages a two and only two party system.

Are you serious? I mean.. are you? Democracy doesn't work properly if people do not vote and are not active politically.

[DoTheFandango]

When my school concert band went to Canada we were yelled at by Torontoians calling us Bush Lovers and War Mongerers. What's up with that?

[ConcreteSchlyrd]

Because Canada has jackasses just like the US. Just like every other country on the planet.

[Cops]

When my school concert band went to Canada we were yelled at by Torontoians calling us Bush Lovers and War Mongerers. What's up with that?

you must have met scott, he's a dick

[Reaver]

I'm not talking about being a prick Face, it's the Americanization. I'll not bother to search this, but I'll throw it out: Americans on these very forums has fronted their country more than any other people. Like the 9/11 thread where something that happened in America is to be forced on every subspace player. (Yes, what happened sucked, but what happened would never have been blowed this far out if it had happened in any other country (happened count: 4 including this)). And this, that so many Americans thinks and behaves that everyone give the fuck about anything American event, product, movie, whatever. That is the thing that is annoying me the most.

Then we have the entire global police thingy and war on terrorism. Which I don't even care to get bothered about, because I can just sit around and wank, and that shit will never touch me. And I can't do anything about it either, except devoting my life to changing it, which I don't feel like.

I'm not going to bother to edit my entire post for this, so I'll just add it here:
I don't hate America, or Americans. What I dislike (as previously said) is the constant propaganda. I enjoy alot of American things, like Marlboro, Bud, and some good bands, but the second you throw an American flag on those products and/or add some sort of ultra pro-America slogans/pictures/etc I'll stop using it in a heartbeat and start hating it.

While I'm slightly sympathetic to your situation, saying you can just sit around and 'wank' and never be affected by terrorist attacks is just blatant ignorance. Trust me, there are plenty of American's that aren't interested in pushing our problems or our pride into anyone else's face but there are enough outspoken individuals that make it seem like alot of us are that way.