Chart 2: US has better access to health tech than world

By Tim Andrews
Americans for Tax Reform,
Article here

US has nearly double CT scanners (left) and MRI machines per person aqs compared to the rest of the world.

More details below..
One of the One of the arguments against socializing medicine is how, through usurping the price mechanism, it will invariably lead to rationing. Whilst the most common example of this is that of waiting lists, an alternate example worth looking at would be on the amount of high end medical technology availiable, and benchmarking the number of units per capita with other similar counties. If the U.S has significant higher numbers of such machines, then it could indicate that rationing has occured in other nations, leading to a suboptimum outcome. Data is most readily availiable for Computed Tomography (CT) Scanners and Magnetic Resonance Imaging (MRI) machines: As can be seen, the U.S has has almost double the per capita distribution of OECD Scanners as the OECD median (14.8 to 34 per million people). Next let us look at MRI machines, perhaps an even stronger indicater, due to their relative cost and shorter time since invention: Here the difference is even more stark. Not only does the U.S have almost almost 4 times as many MRI machines per capita as the OECD median (26.5 to 7.1 per million), it also has more than any other country. From this data, an argumant can definatly be made that the socialization of medicine may lead to a decrease in the supply of high-end medical technologies.
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Posted by at 05:59 | Posted in Measure 37 | 39 Comments |Email This Post Email This Post |Print This Post Print This Post
  • dartagnan

    US also has more unnecessary use of these expensive machines than other countries, which is one reason we spend more on health care than any other country. Why do we have so many CT and MRI scanners? Because they’re money-makers for the clinics that have them — which in many cases are owned by the same doctors who order the tests. And of course the more tests they order, the more money they make. The other day I went in to a clinic with lower abdominal pain and they wanted to do a CT scan (cost approx. $500) to see if I had diverticulitis — although I had no other symptoms that would point to diverticulitis. I told them I wasn’t going to spend $500 on a CT scan because I had a bellyache and if it wasn’t better in a couple of days I’d come back. It got better and I saved $500. But a more naive or worried patient might well have gone for it.

    In many cases, these CT and MRI scans are scams.

    • eagle eye

      I might have skipped the scan too. (I’d guess they probably were defending themselves against a possible malpractice suit, not trying to rip you off.)

      But I’m curious. If you didn’t want to spend money on a scan, what exactly did you have in mind getting at the clinic for your bellyache? A tickle from the doctor? A pack of roll-aids? Why did you go to the clinic at all? Why didn’t you just wait a couple of days?

      • Rupert in Springfield

        >Why did you go to the clinic at all?

        Great point, if you have a belly ache that you are willing to wait a couple of days to see if it gets better, what is the point of going to the doctor at all?

      • dartagnan

        Because the pain was severe, it was of a kind I hadn’t had before, and there are diagnostic procedures short of a CT scan that can be performed to rule out various problems — for example, urinalysis, stool analysis to detect blood in the feces (possibly indicating internal bleeding), blood tests to determine if infection (such as a kidney infection) is present, and a physical examination by the doctor which involves, among other things, palpation to see if the kidneys or liver are enlarged and/or tender. All these things were done and nothing was found that might point to diverticulitis; nonetheless the doctor tried to talk me into a CT scan (which would have been done at the clinic’s own lab).

        • eagle eye

          Given what you’ve described, and if the scan was only $500, I would have gone for it in a second, especially given the possible complications of diverticulitis, which could cost a fortune, even your life.

          And if I really mistrusted my physician’s motives that much, I would find another doctor.

          • dartagnan

            “Given what you’ve described, and if the scan was only $500, I would have gone for it in a second,”

            I bet you would. But I’m still here, ain’t I, despite not having a CT scan?

            Look, I KNEW I didn’t have diverticulitis because I know the symptoms of diverticulitis and I didn’t have any of them. (If I had I would have INSISTED on a CT scan, believe me.) The only symptom was lower abdominal pain, which can be caused by a great many things. I was more worried about a possible kidney or bladder problem; the urinalysis and other tests ruled that out.

            People get a lot of aches and pains, few of which are serious, almost all of which go away on their own and for many of which the cause can’t be identified. Part of the reason our health care costs are so high is that we’ve become a nation of hypochondriacs, running in for a CT scan for every bellyache and an MRI for every backache. And too many members of the medical profession encourage this. For one thing, as somebody said, it can be protection against malpractice suits. For another, it can be a substitute for spending enough time with a patient to make an accurate diagnosis. And finally, IT MAKES A TON OF MONEY for the clinics that do the tests and the doctors who own the clinics.

            For a picture of how this scam works, I recommend you check out an excellent New Yorker story that appeared several weeks ago: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?yrail

          • eagle eye

            Again, if I thought I was being scammed, I’d find another doctor instead of posting my self-diagnosis for what you said was “severe [abdominal] pain”. No wonder you have a bellyache!

            By the way: did you ever find out what caused this severe pain? I would want to.

            As for life expectancy: you ask why America lags. I have my suspicions why, but I’ve never seen any serious analysis of it. Kind of astounding, when you think about it.

            Another thing: if you want someone who will spend a lot of time with you, might think about seeing a naturopath.

          • dartagnan

            “By the way: did you ever find out what caused this severe pain? I would want to.”

            No, and if it doesn’t recur I won’t worry about it. It was gone within 24 hours. I had just gotten back from a vacation in Hawaii; maybe I ate a bad papaya or something.

            Do you go and get a full diagnostic workup, including CT scans and MRIs, every time you have a pain? You’re a physician’s dream.

          • eagle eye

            I haven’t had a severe abdominal pain in about 40 years, so no. I may not be a physician’s dream, but you sound like a pain to me!

          • v person

            I suspect our problem with life expectancy relative to other wealthy nations is that we have by far the highest poverty rate, so our overall number is dragged down by our much higher percet of poor people, who are less healthy and do not live as long. It may have les to do with treatment and more to do with unheaklthy life styles. Thus raising our life expectency would require reducing poverty, I suspect that if you compared life expectency across income levels with say France, we would be about equal.

          • eagle eye

            You say you “suspect”. That is my point about the lack of serious analysis of the life expectancy phenomenon.

            Here’s my suspicion: a serious analysis would bring too many politically incorrect things to view. Krauthammer this morning points out that Asian women in America have a life expectancy of 87, while black men are at 69. The longest-lived whites are in low-income northern Plains states. You’d probably find that a lot of it has to do with murder, drugs, and especially obesity. Probably lack of exercise too. Many of the same things that go into poor American educational performance — things that nobody, including the committed left and right, wants to talk about.

          • v person

            I should be commited.

          • eagle eye

            I only read the article in the New York Times (not a very reliable news source, in my view), not the original journal article.

            But it’s telling that the only mention of race is this: “Race may also be a factor.”

            When everyone with a brain knows it’s a major factor, perhaps the main factor. (See what Krauthammer says about Asian women and black men.)

            You can trot out all the bromides about liberals “reducing poverty”. The bit about not knowing what conservatives want is a mite disingenuous. (I’d say that conservatives want to reduce poverty through a strong market economy, and liberals are constantly producing poverty through the undermining of the economy and most especially through the undermining of personal responsibility. Hint: the NY Times article mentions both AIDS and homicide, as I recall.)

            But again: it’s largely about race and also lower class behavior. I have no idea how to get the black illegitimacy rate back down now that our welfare programs have gotten it up to 70%. I have no idea how to keep the country from being overrun with impoverished Mexican peasants. I have no idea how to get the obese white hogs in Oregon to stop gorging themselves.

            I doubt, however, that it has much to do with the medical system.

          • v person

            I have no brain.

          • Anonymous

            I’ll overlook the typical leftist slander — basically, “we aren’t Eurosocialists because we are racists.” I have to laugh at that, given that Europe’s racial crimes during the time of the welfare state are, oh, something like 100 times ours. But this is the kind of race-baiting that I’ve come to expect from the liberals, especially the academic leftists.

            You say:

            “I look north and across the pond and see nations with 1/10th our crime rate and prison populations, longer life spans, better health at 1/2 the cost, and so forth.”

            But you don’t have to look to Canada or Europe. (If you look to Europe, be sure to exclude the Balkans, Russia, northern Ireland. And make sure you start history after 1945.) But Just look at the Dakotas.

            For a low murder rate, just come to Oregon.

          • dartagnan

            “I have no idea how to get the obese white hogs in Oregon to stop gorging themselves.”

            Interestingly, despite all the concern about obesity in America, our death rate from heart disease has been steadily going DOWN for about the last 20 years. I’d guess it has a lot to do with the decline in cigarette smoking and probably, to a lesser extent, to the use of cholesterol-lowering drugs.

  • Isoconetic

    Just because you have more machines dosen’t seem to me to be a good way to justify that you have a “better” system in one way or another. It’s like If I were a foreign country and had 10 legions of submarines for warfare at my disposal and I was wanting to destroy the problems of my country, but yet I don’t have a clue if the countries that I’m defending against have a strong air presence or if they are even armed with nukes for all I know. It’s the same kind of approach I see in the U.S. towards medicine. If we just buy more machines it will make it better is the thing that they see. Kind of like the whole idea of the jobs in this country anymore, if we just buy more computers and have one person with a “high-end” thinking computer we can put those people out of their job and save the country money. It’s a loose-loose situation at best.

  • dartagnan

    This is another classic case of conservatives taking evidence that points to one of the defects of our health care system and trying to make it look like a virtue. If it’s such an advantage to have more of this expensive hardware than any other country, why does America lag behind other countries in so many measures of health, including life expectancy?

    Is there any evidence that people in France or Germany or Italy or any of those other countries are not getting needed CT scans and MRIs because they don’t have enough machines? No, there is not. All this data shows is that the US has a ridiculously, unnecessarily high number of these scanners — and the reason we have so many is that they are PROFITABLE.

    Meanwhile, because he’s reimbursed on a per-patient basis, your physician spends an average of 12 minutes with you in an office visit — a completely inadequate amount of time to make an accurate diagnosis. What you get instead is a guess, a bottle of pills to treat the symptom and instructions to come back in a couple of weeks if the symptom doesn’t get better. If physicians were able to spend enough time with patients to listen to them,adequately examine them and make accurate diagnoses, it would save more lives than all this high-tech junk.

  • John in Oregon

    dartagnan as I said in a earlier post you did exhibit an informed health care purchasing decision. You consulted with your attending and concluded the CT scan was not necessary. Although I did note you were abrupt in your rejection.

    I was going to leave it at that until I put 2 and 2 together. You listed a series of symptoms that you felt were negative. I assume your attending asked you about those.

    Later I realized that those are what are called silent symptoms. That is symptoms that are often recognized only after the diagnosis. I wonder if your attending hadn’t wanted to rule out an unlikely but dangerous possibility.

    That disease is colon cancer for which CT scan would be a preferred diagnostic. If you have had one of those unnecessary Colonoscopies then you shouldn’t have much to worry about.

    In any case best of luck on your decision.

  • http://www.medicalnegligenceireland.com medical negilegence ireland

    One of the major handicaps when claiming compensation for medical negligence in Ireland is the time that is available to compile and present a case in court before it becomes “time-barred”. The Statute of Limitations allows for two years from the “date of knowledge” of medical negligence in which to make a claim for medical negligence in Ireland. However, gaining access to case notes and medical records can take many months. In addition to this, the medical expert most relevant to your case may not be immediately available, protracting the length of time a case for medical negligence takes to compile.

  • http://www.medical-negligence-ireland.com medical negligence ireland

    Medical negligence occurs when a health care professional has failed to act in accordance with a practice accepted in Ireland as proper by a responsible body of skilled medical practitioners. If you are suffered in any medical negligence cases you should take a help from the medical attorney.They provide a great help and settlement for your compensation claims .

  • http://www.killiansaid.blogspot.com K.

    We already have rationing by employment and income. The high number of MRI and CT scanners isn’t necessarily a good thing, as they are grossly overused. Essentially, a purchased MRI is a fully scheduled MRI.

  • http://www.killiansaid.blogspot.com K.

    The number of machines is meaningful only if they can be shown to improve outcomes. Given how far we lag behind other wealthy nations in virtually every measurable outcome, the high number of MRI and CT scanners does us no good whatsoever. It does contribute to our costs — the highest in the world — though.

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