SiCKO: a realidade não é um filme

Julho 20, 2007

SiCKO: a realidade não é um filme

Arquivado como: Comentário, Diversos, Internacional — BZ @ 12:53 am

Baseando-se no “documentário” intitulado SiCKO, Daniel Oliveira escreveu o seguinte no semanário Expresso (meus destaques):

A qualidade do sistema de saúde americano, quase exclusivamente garantido por seguradoras, põe os Estados Unidos no humilhante 37º lugar do «ranking» da Organização Mundial de Saúde. Os dez primeiros são quase todos europeus. Segure-se: Portugal está em 12º.

Via LvMI, um post de Stefan Karlsson:

Myth: “Despite its higher costs, the World Health Organizations ranking show that the American health care system ranks only number 37 in quality”.

Fact: No, it doesn’t show that at all. The ranking is actually only to a small extent a ranking of health care quality. If you check its details it measures mostly other things. What is being measured is mostly things like a population’s health level (why this is not a good indicator of health care quality see below) and to what extent financing and treatment is in accordance with the WHO’s socialist ideals. That socialist systems are better in accordance with socialist ideals is hardly surprising and is definitely not a valid indicator of health care quality. The only one of their indicators which measures quality is “level of responsiveness” which is based on patient satisfaction and how quickly and efficient the system works. And in this category the American health care system is….number one!

Neste indicador Portugal fica-se pelo 38º lugar…

Quanto à exclusividade das seguradoras no sistema de saúde americano, Karlsson - além de referir um estudo de 2004 em que o financiamento público representa 45% dos custos de saúde americanos - sugere um artigo na Economist:

So is America’s health system really red in tooth and claw? Hardly, according to a growing body of academic evidence. As a result of interference at the federal and state levels, health care is one of America’s most heavily regulated industries. Indeed, its muddled approach to health-care regulation may act as a massive drag on the American economy—what one expert has called “a $169 billion hidden tax”.

Daniel Oliveira acaba por concluir assim:

Da próxima vez que alguém, para defender a privatização do serviço público de saúde, lhe falar de liberdade de escolha e de qualidade dos serviços veja este filme. O europeu gasta menos e pode escolher entre o privado e o público. O americano gasta mais para poder escolher entre as seguradoras e coisa nenhuma. E mesmo assim terá de negociar a sua vida.

Talvez o que o Expresso paga por artigos desta qualidade possibilite ao Daniel Oliveira “escolher entre o privado e o público”. O nível de impostos impede, porém, a maioria dos portugueses de tomar tais decisões a respeito dos cuidados médicos a receber.

PS: Três anos atrás eu fui um dos que falei sobre liberdade de escolha. Fi-lo a propósito dum post de João Tilly (”SNS: como se deixa morrer um homem por falta de assistência”). Preferia nunca ter tido a necessidade de escrever sobre o assunto.

20 Comentários »

[...] SiCKO: a realidade não é um filme. [...]

Pingback por blogue atlântico » Blog Archive » SiCKO e as ficções de Daniel Oliveira — Julho 20, 2007 @ 1:03 am
«Talvez o que o Expresso paga por artigos desta qualidade possibilite ao Daniel Oliveira “escolher entre o privado e o público”. O nível de impostos impede, porém, a maioria dos portugueses de tomar tais decisões a respeito dos cuidados médicos a receber.»

Pode ser que sim. Mas podendo não ter escolha, têm direito a cuidados médicos. Coisa que não se passa nos EUA. Não deixa de ser curioso que esboce este argumento…

Comentário por Jam — Julho 20, 2007 @ 1:31 am
“Mas podendo não ter escolha, têm direito a cuidados médicos.”

Se não morrerem na lista de espera e/ou por não terem acesso aos meios disponíveis nos EUA…

Comentário por André Azevedo Alves — Julho 20, 2007 @ 1:53 am
Ainda não percebeu. Estava-me a referir a quem não tem acesso a meios, porque não estão (para eles) disponíveis nos EUA.

Comentário por Jam — Julho 20, 2007 @ 2:43 am
Com a repetição de algumas falsidades (propositadas ou derivadas da falta de investigação), o DO procura estabelecer uma nova verdade que se adapte ao seu programa. Se a realidade não serve, crai-se uma outra, paralela.
Post muito oportuno, BZ.

Comentário por LA — Julho 20, 2007 @ 8:56 am
“Mas podendo não ter escolha, têm direito a cuidados médicos. Coisa que não se passa nos EUA.”

Caro Jam, vejo que ainda não teve a oportunidade de ler o post de Stefan Karlsson que acima linkei. Um pequeno excerto:

“Everyone in America over the age of 65 is covered by the Medicare program and low income earners below the age of 65 can get their health care paid by the Medicaid program. And besides, one can always simply go to an emergency room and demand care there since federal law prohibits hospitals from denying people care there, a possibility which has created some problems in the border regions to Mexico since illegal immigrants have been very good at taking advantage of this.”

Comentário por BZ — Julho 20, 2007 @ 10:02 am
http://www.msnbc.msn.com/id/18674951/

http://www.commonwealthfund.org/newsroom/newsroom_show.htm?doc_id=362992

Comentário por José M. Sousa — Julho 20, 2007 @ 11:11 am
Value for money

Jul 18th 2007
From Economist.com

AMERICA spends more on health than any other rich country—total public and private expenditure amounted to a huge 15.3% of GDP in 2005, according to the OECD’s annual health report published on Wednesday July 18th.

This is well above the 30-country OECD average of 9%.

South Korea spends least, at 6%. But, higher spending won’t necessarily mean a longer life.

It may seem like hair-splitting to quibble over a few years, but life expectancy in most other rich countries is higher than America’s 77.8 years.

For instance, Japan spends 8% of GDP on health and has a life expectancy of 82.

Gráfico: http://www.economist.com/research/articlesBySubject/displaystory.cfm?subjectid=7933596&story_id=9502420

Comentário por Alvarinho — Julho 20, 2007 @ 12:00 pm
One of the little discussed issues with private health insurance discussed is the cost it adds to businesses in the US. Countries with state health care allow businesses to pocket that expense directly, or add a supplementary insurance option for things that are not covered via universal coverage. In Soviet Cannuckistan, my employer offers medical benefits of pharmaceuticals and dental care. All my other needs are met by the universal medical care. And those costs are a fraction of the cost of complete health care. How much does a business save when they don’t have to foot the bill the government could and probably should? You may not like this source, but the facts are strong:

” There are many factors that determine a country’s competitiveness. While taxation does play a role, it is no more or less important than the price of utilities, the cost of housing, the availability and skills of the local labour force, access to markets and customers and suppliers, and even crime rates.

Moving to the top of this long list, especially in the United States, are the exorbitant costs associated with providing health coverage to employees – a fact that corporate leaders will readily admit to these days.

Consider the auto industry. Did you know that U.S. automakers spend more money on health insurance each year than they do on steel?

In 1988, Chrysler’s CEO Lee Iacocca reported that each car his company produced in the U.S. cost $700 in health benefits alone, while the same car produced in Canada by Chrysler cost only $233 in health benefits.

The situation hasn’t changed much since then. In 2005, General Motors of Canada’s CEO Michael Grimaldi reported that each U.S.-produced car cost $1,500 in health benefits, compared to less than $500 in Canada. And in 2006, the Conference Board of Canada reported that in the U.S., health care and pensions add between $1,400 and $1,800 to the price of each vehicle – a major reason Toyota cited for building its newest plant in Ontario.

The carmakers aren’t the only ones bearing the burden. Wal-Mart’s annual bill for health benefits is $1.5 billion, even though fewer than half of the company’s 1.3 million U.S. employees are actually insured.

The Globe and Mail’s Andre Picard recently quoted a survey by the Kaiser Foundation which reveals that average employee health premiums in the U.S. now amount to $10,880 a year – more than the gross earnings of minimumwage workers. On average, employees with benefits pay $3,718 of that total, with employers picking up the balance. Believe it or not, one of the top advocates for public health care in the U.S. is Howard Schultz, the chairman of Starbucks. He has been outspoken about the “moral responsibility” of businesses to provide health coverage. But he also knows that this is one of the best ways for companies like his to retain employees. Given that 45 million people in the U.S. have no health coverage whatsoever, even a low-paid job slinging coffee is desirable if it includes health benefits.

But it’s not just large corporations that are paying the health costs of their employees. According to the same Kaiser Foundation study, 98 per cent of all U.S. firms with over 200 employees offered health benefits in 2006, but so did 60 per cent of smaller firms. And while larger companies might be able to absorb mounting health care costs, the impact on small businesses can be crushing.”

Link http://www.canadians.org/publications/CP/2007/spring/healthcare.html

Comentário por Alvarinho — Julho 20, 2007 @ 12:04 pm
Para aqueles que dizem que o SNS é espectacular :Ver esta sondagem do Correio da Manhã . É tão bom tão bom que ninguêm gosta dele. é caso para dizer: que tenha muita saude e que não tenha o azar de ficar doente para não para ao sns

Comentário por menino mau — Julho 20, 2007 @ 12:05 pm
The Waiting Game
By Paul Krugman
The New York Times

Monday 16 July 2007

Being without health insurance is no big deal. Just ask President Bush. “I mean, people have access to health care in America,” he said last week. “After all, you just go to an emergency room.”

This is what you might call callousness with consequences. The White House has announced that Mr. Bush will veto a bipartisan plan that would extend health insurance, and with it such essentials as regular checkups and preventive medical care, to an estimated 4.1 million currently uninsured children. After all, it’s not as if those kids really need insurance - they can just go to emergency rooms, right?

O.K., it’s not news that Mr. Bush has no empathy for people less fortunate than himself. But his willful ignorance here is part of a larger picture: by and large, opponents of universal health care paint a glowing portrait of the American system that bears as little resemblance to reality as the scare stories they tell about health care in France, Britain, and Canada.

The claim that the uninsured can get all the care they need in emergency rooms is just the beginning. Beyond that is the myth that Americans who are lucky enough to have insurance never face long waits for medical care.

Actually, the persistence of that myth puzzles me. I can understand how people like Mr. Bush or Fred Thompson, who declared recently that “the poorest Americans are getting far better service” than Canadians or the British, can wave away the desperation of uninsured Americans, who are often poor and voiceless. But how can they get away with pretending that insured Americans always get prompt care, when most of us can testify otherwise?

A recent article in Business Week put it bluntly: “In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems.”

A cross-national survey conducted by the Commonwealth Fund found that America ranks near the bottom among advanced countries in terms of how hard it is to get medical attention on short notice (although Canada was slightly worse), and that America is the worst place in the advanced world if you need care after hours or on a weekend.

We look better when it comes to seeing a specialist or receiving elective surgery. But Germany outperforms us even on those measures - and I suspect that France, which wasn’t included in the study, matches Germany’s performance.

Besides, not all medical delays are created equal. In Canada and Britain, delays are caused by doctors trying to devote limited medical resources to the most urgent cases. In the United States, they’re often caused by insurance companies trying to save money.

This can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. “It was only later,” writes Mr. Kleiman on his blog, “that I discovered why the insurance company was stalling; I had an option, which I didn’t know I had, to avoid all the approvals by going to ‘Tier II,’ which would have meant higher co-payments.”

He adds, “I don’t know how many people my insurance company waited to death that year, but I’m certain the number wasn’t zero.”

To be fair, Mr. Kleiman is only surmising that his insurance company risked his life in an attempt to get him to pay more of his treatment costs. But there’s no question that some Americans who seemingly have good insurance nonetheless die because insurers are trying to hold down their “medical losses” - the industry term for actually having to pay for care.

On the other hand, it’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding - end of story. The alleged virtues of private insurance have nothing to do with it.

The bottom line is that the opponents of universal health care appear to have run out of honest arguments. All they have left are fantasies: horror fiction about health care in other countries, and fairy tales about health care here in America.

link http://www.truthout.org/docs_2006/071607F.shtml

Comentário por Alvarinho — Julho 20, 2007 @ 12:05 pm
Esta argumentação é ridicula! E as pessoas que morrem por não terem seguro de saúde tb devem achar o sistema o “number one” ou será ninguém lhes perguntou! O acesso à saúde deve ser livre e universal!

Comentário por Nuno — Julho 20, 2007 @ 12:33 pm
Deve ser por isso que há tanta gente a emigrar dos states para a europa.

Comentário por noddy — Julho 20, 2007 @ 1:15 pm
ai sim noddy? espantoso! não será antes o contrário?

Comentário por menino mau — Julho 20, 2007 @ 1:52 pm
Julgo quer era ironia…

Penso que se diva olhar para as taxas de sobrevivència para operações, listas de espera, avanços tecnológicos, e taxas de sobrevivência para doenças como cancro.

Comentário por lucklucky — Julho 20, 2007 @ 5:04 pm
deveria…

Comentário por lucklucky — Julho 20, 2007 @ 5:06 pm
«And besides, one can always simply go to an emergency room and demand care there since federal law prohibits hospitals from denying people care »

Caro BZ, só colocou em negrito parte da citação… mas isso refere clara e exclusivamente os casos de urgências médicas. São esses os únicos casos? Uma pessoa com cancro precisa de cuidados em E.R.’s?

Comentário por Jam — Julho 20, 2007 @ 8:20 pm
Mais uma vez, Daniel Oliveira mete-se por áreas de que não percebe rigorosamente nada. Quando as pessoas falam, sem perceber nada do que falam, dá nisto.

O exemplo Americano da saúde não é o melhor, pois gastam em 2007, cerca de 17% do PIB em saúde. Óbviamente que os que não têm seguro, são mais mal atendidos…….mas, são atendidos!

Por cá, com o tal 12º lugar, atribuído pela OMS, cerca de 1.000.000 de portugueses não têm Médico de Família, e o nível de satisfação global dos doentes é muito baixo.

Mas, é preciso saber-se da “coisa”, para se escrever…….por isso, é que não compro o Espesso há 3 anos!

Comentário por Jose — Julho 20, 2007 @ 10:03 pm
Por acaso alguém me sabe dizer se no 17% do PIB gastos com saúde está a investigação?

Comentário por Estetoscópio — Julho 20, 2007 @ 11:22 pm
“Penso que se diva olhar para as taxas de sobrevivència para operações”

Ao contrário de itens como a taxa de sobrevivencia para cancros, a taxa de sobrevivencia para operações é um mau item, já que ignora os que não são operados.

Comentário por Miguel Madeira — Julho 21, 2007 @ 2:31 am