The public healthcare here in Spain has an endemic problem of ever reducing budgets, and it's so saturated (because of that) that most people that can also get private healthcare. When politicians touch that is to reduce the budget even further.
Yet people think that the main problems in Spain are other things... damn the propaganda machine.
Spain's public healthcare expenditure was:
38.552 €bn in 2002, and
66.678 €bn in 2016 (latest official year),
On other hand while population was
41.31 m in 2002, and
46.48 m in 2016,
In my opinion, healthcare expenditure is out of control. But that is a completely different debate.
I don't know about Spain, but at least in Sweden there's an argument that the increase in privatization in the health care sector has resulted in higher costs (and thus higher government expenditure) without matching improvement in heath care outcomes.
Raw expenditure tells us nothing about whether or not it has been privatised, too. Often the privatised services are more expensive - after all, they have to pay dividends.
2. CPI won't change a the bottom line take-away. Feel free to run the numbers.
Sure, but what percentage of that government expenditure is going to private health care providers? And how has that number changed over time?
The transference to the private sector in 2002 (thousands of Euros): 25017
In 2010 (the highest of the serie): 81997
In 2016: 54913
I didn't say the "rampant privatization" thing, but, as you can see, the spending more than doubled. Should we take into account the inflation here or not?
GDP per capita is, I think, important as an answer to your opinion of "expenditure is out of control" by the way.
>>"I'm not here for armchair politics."
Good to know, but until where I can see, we were discussing numbers not politics.
EDIT: I keep reading and that data is not right. The number are low, but I can't make sense of the tables. It would take a while to understand it. The good news is the data is there.
Page 9 is central administrative costs, and then, if we put your private expenditure figure into perspective: in 2010 (highest of the series) private costs were €82m vs €69,000m total healthcare costs in 2010. That is a 0.12%
38.552 €bn * 1.04^(2016-2002)
As far as I've seen, privatisation seems to normally lead to increases in government expenditure: the US has the highest per capita federal health budgets in the world (and Switzerland, in second place, is far behind)
€1191.25 per capita in 2002.
€1434.55 per capita in 2016.
Also, quite bold calling propaganda a report from United Nations analyzing population health. What do other problems the country has have to do with the people health?
Maybe your comment contains some propaganda too.
Propaganda is what is done in Spain to make people look at fake problems instead of the real ones.
I don't think this report is propaganda.
What I am saying is that besides the intention of the article (which is Bloomberg giving UN results) these are facts.
Seeing this facts stated might help others and it does not mean stop fighting for other causes in the country.
No, I do not mean what you are saying.
I was talking about what is on the newspapers these days on here:
* Next general elections (on April)
* "Minor" cases of corruption (relative to others in either money amount or the person affected)
* Football (Soccer for the people from USA)
* "Famous" people (only famous because they appear on media as "famous")
* Bad migrants
What is not talked about is:
* Mayor cases of corruption
* Dismantling of the public sector (before it was in big steps, now it is in small ones)
* Housing bubble (again)
* Low salaries
* Bad support to small entreperneurs
* The reasons why there are more migrants and what to do
On the other hand, and repeating myself: I do not attribute any political intention to the article at all. How many more times do I have to deny it? You not letting go of this act like some bad actors when doing clumsy manipulation of debates.
Besides that, sun light is very healthy, we see all the time articles about vitamin D, I think the way of living of Italians and Spanish of being more in the outside because the good weather might influence too, hard to know for sure.
In fact, moving to NYC I was struck by how I still saw people smoking because of how infrequent it was elsewhere
Nowadays it's generally not cool anymore, it's seen as a vice and people will sdmit so when they ask if it's okay.
I also noticed that one big factor that actually worked in discouraging teens from even starting is the "uncool" image built around smoking.
Unfortunately it look like the coolness factor is moving to electronic cigarettes and there's not much data to discourage the use yet.
> To access the Bloomberg 2019 Healthiest Country Index data set for all nations, click HERE.
The "click here" link is for terminal subscribers only so I guess Quint might not have been able to resolve it properly.
Cuba has a longer life expectancy than US.
As a European, I'd say there's something wrong with US approach to health: people living under a dictatorship in a poor country have better health than Americans.
> well-known issue with cross-country comparisons of infant mortality is possible reporting differences for infants born near the threshold of viability. Extremely preterm births recorded as a live birth in some places may be considered miscarriages or stillbirths in other countries (Golding 2001; Graafmans et al. 2001; Sachs et al. 1995; Wegman 1996). Since survival before 22 weeks or under 500 grams is very rare, categorizing these births as live births would inflate reported infant mortality rates (which are reported as a share of live births).
I’ve even seen the claim healthcare is super good outside the United stares. Although it costs more, the US had a top notch system for medical care. They can see a doctor in minutes, get open heart surgery, and go home for <$8000 within a week, with a high chance of survival. The only requirement is insurance, which the vast majority of people have. It’s the insurance part that gets people upset, the health care is not.
Further, Longer life expectancy means little by itself doesn’t mean much. What if a group is predisposed to disease via their genetics? Is that country not counting deaths of children, are the mothers less likely to carry to term, etc? Even if you controlled for everything, you’d also need good records are kept (something I doubt on Cuba).
My point is a lot of time this data is so fuzzy, it’s meaningless. Give me 100 stats and I can mess with the weights until Spain is #1 or #50 easily in healthcare. There needs to be lots of care to make solid claims and I don’t think that was done here, I think they wanted viewership.
Personally, and this is my intuition talking, I think that the most important fact is primary care.
If you need open heart surgery you probably would be better (marginally) in the States than Cube (assuming you can afford it), but what really makes a difference is to get diagnosed in the early states of a illness or, for old people, constant follow up by a doctor.
Interesting, it seems that both Italy and Spain have primary care totally public, that means, the doctors work for the National Health System. It would be interesting to check if this the case for the other top countries in the list.
Physical activity is also far higher. Again, this may be a result of relative poverty. But walking or taking public transport to work just happens to also be healthy.
Interestingly, these are factors somewhat shared across Cuba, Spain and Italy, even though there is no similar economic pressure in those countries.
On the other side of the divide, I live in Germany. We have universal insurance that is functionally equivalent to government-run healthcare (I, and everyone else, can visit a GP any time without paying). Yet outcomes here, and in Britain and Canada, are closer to the US.
There are also private insurances. They offer flat rates (not indexed to income) and are attractive to high earners and some young people.
See, that's one of the problems I have with the American system right there. Why do you have to pay for life-saving surgery when you already have insurance? That's absurd.
This doesn't appear to be any different in the US, though -- people die often in the US from either waiting to get enough money for copays or from having their treatment be rejected by their insurance enough times until they die.
$8000 for lift saving treatment is nothing really. I can go to the doctor for $20 - $40. However, if I need open heart surgery, $8k is fair.
In Ireland, Canada, etc you have to wait months to get treatment. People die on the list to get treatment. That’s my issue with that setup. I agree the US healthcare can be improved. However, don’t let the propaganda fool you (that’s for political campaigns), it’s expensive and we all want to fix that, but it’s very effective.
Also: nobody does on any waiting lists in Ireland or Canada. Or, more accurately: There may sometimes be waits for elective procedures, and people may get hit by busses while on such a list. But there’s no causality. The only waiting lists where people die are for organ transplants, as in most any country.
This just does not compute. If you have a health concern, YOU NEED TO GO TO THE DOCTORS.
Trying to scare people away from visiting a doctors until it is bad-enough that their fear for their health overpowers their fear for their wallet is just sadistic madness. Utter utter madness.
No this doesn't seem fair to me at all. No one should have to pay so much out of their pocket for a life saving operation.
A "one-off" treatment such as this is one thing, but the co-pay system really breaks down for the individual once you start talking chronic conditions that require regular treatments for life.
In that case your insurance company may start to see you as a liability and raise the co-pay until treatment is no longer econically viable for the patient.
However, the vast majority of people do not have access to $8000.
This is the same in any developed country (i.e. you can see a doctor if you pay), except that in addition to that most non-US developed countries also have the safety net of cradle-to-grave government run health care system.
This means if you dont have $8000 you can also get heart surgery and dont die.
Ideally with free & universal healthcare, you dont even get to the stage where you need emergency surgery in the first place. i.e. you'll be diagnosed and treated ahead of time when its not an emergency yet.
I've used both public and private in the UK. The benefit for the private health care is you generally get to pick when & where your appointment is (vs public when you are often told when & where your appointment will be and you need to change your schedule to get there on time ... although you do have some leeway in picking your clinic), and the places you go to do it are generally nicer places to be (decor, surroundings etc). If you need something truly urgently, the public system will generally get you seen as quickly as private. If its not urgent, then the public system has longer waiting times (because the truly urgent cases are getting seen first). Typically the equipment & treatments available in public clinics/hospitals is as-good or even better than the private clinics, and all the surgeons and doctors often do both public and private work.
tl;dr - Money generally just buys you convenience and nicer waiting rooms in non-US countries. The level of care is about the same IME.
I once worked with someone doing stats for a UN program. They used to say that the two most reliable statistics, in any country, are life expectancy and the murder rate. Because it’s quite hard to systematically hide murders or change the age in death certificates. In the Western Hemisphere, you can get a pretty good estimate just by taking a stroll of any cemetery.
Having been to Cuba, I can also assure you that despite all its shortcomings, starvation just isn’t a thing. Unless you’re allergic to rice and/or chicken. I even got to experience the health system (yeay climbing). And while „bare bones“ was the motto of the day, all the essential parts seemed to be working quite well.
I personally would rather prefer live an average life in Cuba than in the US (and I visited both).
Meanwhile, Cuba actually has a very high number of doctors per capita.
1994 - https://www.independent.co.uk/news/world/millions-of-cubans-...
2012 - https://www.poverties.org/blog/poverty-in-cuba
Apparently, it has improved since then - but that’s because international aid was sent, aka food.
I literally just bought 20lbs of pork for $20 and 20lbs of rice and 10lbs of beans for another $20. You can beg and easily make more than $20 a day.
But even then the US gives out food coupons and there are tons of soup kitchens.
And before anyone gets to the argument about why they're in that situation, it often is cyclical. Go read up on trauma and trauma informed care (you can start with ACE scores).
 Counseling, court appearances, etc...