Pilgrimage Through Kham: A Medical Mission in Tibet
Be in about be good at in the discussion that protects reform, we often hear a kind of argument: In industrialized country, the expenditure that American medical services is highest, service quality is the poorest. A conclusion is the proportion that holds GDP according to medical services charge; A conclusion is according to health of a few countrymans index is like mean life after, infantile mortality.
But national health just does not depend on medical services. If other society condition commits a crime, the accident also affect mean life. In fact, if eliminate to get hurt,die, american mean life went to the first with respect to the platoon in industrial state home! [note one] additional also somebody points out, american infant mortality is tall because,be certain and phyletic did not get with illegal immigrant proper antenatal nurses. And beautiful state-owned very much teenage mother, raw private parts has weighed light baby. These more ground are social problem. Although be inside medical limits, the smoking number of American go up till 80 time or world highest. The health that this causes is damaged influential still today. And the number slue that the United States overweights, diabetic incidence of a disease is very high also. These say strictly is the problem beyond medical services. So, will evaluate the effectiveness of medical services system with the overall index such as mean life and infantile mortality, the likelihood is oversimplified practice.
Recently, two researcher published guest state university a report, listed gland cancer and mammary cancer once upon a time diagnose the medical services that will compare the United States and other country with cure to serve. [note 2]
Prostate cancer and habits and customs, the concern such as surroundings is not big. If receive inchoate diagnostic services, the opportunity that the patient survives is very great. Of prostate cancer inchoate diagnose the blood test index that basically relies on PSA. And this examines is to be in the United States to be popularized the earliest. Arrive to examine to PSA in the world now open to question still, because be put in quite high false electropositive probability, and although got prostate cancer,also do not deserve services certainly, be opposite especially senile patient. Be in the United States, PSA examines to want to be gotten generally than other country much. For example, 2001 the United States has the male of 50 years old of above of 75% to had accepted PSA at least one times to examine. And be in Canada, this scale is 47.5% , italian scale is 31.4% . And consider to make clear, PSA examines the mortality that can reduce prostate cancer 20% . In fact, the United States diagnosed the prostate carninomatosis philtrum that go out to 25% have produce tumor to transfer 1980. And examine in PSA after gaining ground, have 4% only to 2002 new freshness patient has produced move. Treating a field, the United States takes more active option, most patient accepts operation or radiative services. And other country tends conservative, be in for example Norwegian, only 3% accept active services to the patient of 6% .
Because these are distinguished, the 5 the year‘s harvest of prostate patient of the United States lead remarkable prep above alive other industry country. 2000, 5 years of survival rate of patient of American prostate cancer are 99.3% , and be in Europe is 77.5% . That is to say, the probability that European patient dies is 32 times of American patient! And the mortality of prostate cancer (the number that dies because of this disease in every 100 thousand population) , in 1980 to the United States lags behind at Europe between 1995. But it is after that, american progress is very rapid the prostate cancer mortality that the data 2003 shows the United States is lower than European average 20% .
With prostate cancer likeness, mammary cancer also is easier detect, and the word of inchoate cure survives the opportunity is very tall. Mammary cancer suffers environment and lifestyle effect bigger. But these ab extra elements do not have very big change in nearly a few years. On the remedial effect of mammary cancer, the United States and Europe have similar contrast.
Above is the main content of this report. These data explain, medical services system of the United States is being diagnosed and treat side of these two kinds of cancer to have more comprehensive inchoate diagnostic services and higher surviving rate. And, similar phenomenon is in other cancer and heart disease, considerable also examine arrives in apoplectic cure.
Should point out, these data show medical services system of the United States is more effective certainly. For example, although can raise surviving rate to the active cure of cancer, but its side-effect can reduce life quality. If European country incline to is treated at guarding, not be they adopt active plan without ability certainly, and the likelihood is the choice that they make. This also makes clear, we still need more index ability to reflect the performance of medical services system in the round.
This article did not involve the issue of medical services charge. But it gives us an inspiration: If medical services system of the United States has the tradition that intervenes more actively diagnose and be treated, and if often taking the lead in using new technology, is this one of reasons with high cost of American medical services? If be if, so the freedom that can the effort that limits medical services fee limit people to choose to treat way? And, we are talking about charge to say constantly at 2 o‘clock: Charge of medical services of average per capita is the world highest, and still grow in quickness. But we mention rarely: The medical services expenses of other country also rises in quickness, some is fast even at the United States. [note 3]
Still have the problem of a fair sex. The United States has the person of 10% above to do not have medical services insurance at present. If their healthy state compares difference, show probably on integral statistic do not come out. But the problem that this is sex of fairness of a society apparently. On the other hand, if integral medical services a level and make to rise,the service that certain person enjoys is reduced somewhat (be opposite like what put forward at present " Cadillac class " insurance levy taxes) , this whether fair?
Those who need statement is, I do not think these study those who prove system of American medical services is advantageous. Actually, these study and did not try to evaluate medical services system of the United States in the round, mix about cost especially efficiency. I just want to say, these consider to make clear, evaluating system of a medical services is very complex task.
When we talk about medical services to reform, cannot leave to be opposite now systematic evaluation. And the politician likes to use " understand easily simply " statistical data comes " education " the people. The problem is, the choice of these statistical angle does not not matter, and the way that meeting influence reforms to medical services and result. The discussion of above explains, a few words can not solve evaluate system of a medical services. It is involved a series of value orientaton and terrible balance. At least, the system of medical services that according to present data we hold to very hard to say the United States is reciprocal the first. So, reforming to medical services make decision-making before, we should one pace asks drop back: What is " good " medical services system?
[note one] data sources: I must admit Http://politicalcalculations.blogspot.com/2007/09/natural-life-expectancy-in-united.html I am not to understand among them data completely, because have not little state,eliminate to get hurt the mean life after death was reduced instead.
[note 2] is the report textual see Http://repository.upenn.edu/cgi/viewcontent.cgi? Article=1012&context=psc_working_papers
[note 3] Http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
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