Health Care Parallels Education

I was listening today to a Fresh Air interview from a couple of weeks ago on the reasons for the high cost of health care:

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Highly informative and thought provoking. One thing that struck me was the discussion about how we don’t pay primary care physicians enough and that specialists make a majority of the dollars. This is not earth shattering news, but it I was reminded of a similar problem in higher education. Specialization is highly valued where as general studies and thinking/life skills are not, despite the fact that it’s these more general abilities and knowledge that determine how successful you are in your chosen trade (specialized or not). Same thing in medical care: it’s not the specialists who have the most impact on your health and mortality, it’s the general, preventative things you do (or do not) that have the biggest impact. And who should be looking after us on this front if not our primary care physicians?

  • Excellent comparison. As a bonafide General Practioner, I would much prefer being compared to my first grade reading teacher than my college food chemisry professor.

  • Merlin Flugum

    Note to Rafe:Imaging does give accurate picture of cholesterol builup in most veins and arteries. However, imaging often fails to show cholesterol buildup in tiny blood vessels near the heart or in the numerous tiny blood vessels in one’s brain, according to a young woman (a physician) who spoke at a heart health seminar in Minneapolis last year.Hmmmmm. HMMMM!! Statin drugs work much better than exercise and diet alone in 97 percent of the population while 3 percent are not helped, according to her.I opted for a drug prescribed by my doctor. Cost: $5 at walgreens or $4 at Walmart for once a day monthly supply thanks to Texas Presidents Lyndon Johnson (Medicare) and George W Bush (drug bill). Thank you fellow taxpayers, as well. Result of generic drug Simvastatin: cholesterol readings down markedly, despite only slight improvement in exercise and diet. Hope both right and left wingers can set aside their mutual hatred for one another long enough to help the President and the Congress move the ball downfield on health care for all. I took a health care plan of my own to Washington DC in 1994 – the best plan ever, in my humble opinion. Literally delivered it to every office in the Capitol one hot August day – 545 offices! It sunk like a stone. Why? It accomplished two things. It got rid of the unnecessary health insurance industry – and it remained capitalist in nature. No one was interested.Both parties are well-served by the continued chaos on this issue – as on many other issues. So goes life and death in America. Stay tuned.

    • rafefurst

      Merlin, check out the Wikipedia entry for statins where it says:

      An independent analysis has been done to compare atorvastatin, pravastatin and simvastatin, based on their effectiveness against placebos. It found that, at commonly prescribed doses, there are no statistically significant differences in reducing cardiovascular morbidity and mortality.

      So while you may be reducing your numbers, you are probably just wasting your money if what you care about is living longer. And if you at all rely on the statins instead of changing your true risk factors (nutrition and exercise), then you are doing worse than wasting your money.

      • rafefurst

        Oops, I just realized I mistook “differences in reducing” for “reducing”….

        • rafefurst

          Can someone provide clinical evidence that statins reduce mortality?

  • Alex Golubev

    at the risk of being labeled an idealist again – this reminds me of drunks looking for their keys where the light is. just because general practices are more ambiguous doesn’t mean they’re less important. predictability driving focus is like the tail waggin the dog at times.

  • I am European so from my point of view the question about government run health care is something I/we Europeans think of almost as a human right; it should be free, it should be available to each and all
    and not be determined by a patients wallet. Granted I know, and hopefully many of my Euro trash friends know that this is not the most efficient in the world. That yes we do have endless waiting for operations, patients aren’t given the full care they need, it is absolutely not without it’s faults, and yes it can be more expensive in many cases. (More on this later).

    It has taken me some time to understand the American culture since I am sort of new to this country. But in my humble view it seems like this whole argument is rooted in the American culture. The American culture is basically against anything run by local or federal government. That alone something as seriously as health care. So the argument against government run health care touches a deep belief and fundamental view of many, that this it not something the government can, or should run.

    I can honestly say that I do understand the Republicans whom is seriously against government run health care, cause I can relate to their culture. Let me be more precise so you understand this cultural cliff between America and Europe by explaining it in reverse: Europeans will never adopt an American style health care system cause it’s our fundamental view that it should be free for all.

    So, even though I am on the side of free health care I truly and honestly understand both sides of this argument.

    However arguments are…. well arguments based upon political views and self interest opinions. I would like to throw in some numbers cause I have a strong feeling that most of the Americans whom are against government run health care have never been outside America and hence have never experienced or seen the inside of a government run hospital. ( A recent study stated that less than 15% of Americans currently hold a passport.)

    I am Danish and the numbers from The Economist 2007 edition of World in figures is this compared to America:


    Denmark America
    % of GDP used on Health care 9.00% 15.20%
    Hospital beds per 1,000 pop 3.3 4.0
    Doctors pr 1,000 pop 2.5 2.9

    In Denmark we have free universal health care, we have free dental care until the age of 18. And yet we only spend 9% of GDP on this? And yet America spends 15.2% and still have roughly 50 million uninsured? Salaries for doctors and nurses are much lower in Denmark cause to our high income taxes, but surely all this money can’t only be due to higher/lower salaries?

    Again I would like to stress out that the free health care in Denmark has faults, ain’t perfect and you have to wait for some operations.

    But the mathematical formula here seems to say that if America got free health care it would apparently only cost 9% of GDP instead of the current 15.2% and at the same time get more doctors and more hospital beds.

    I know this is not true…but the numbers does seem odd. I mean where does all that money go? Anyone with more insight more wisdom than me…please give me your 2 cents here. Cause something doesn’t add up.

    *(Numbers are from The Economist 2007 edition of World in figures)

  • Sorry for the numbers box, or lack of it, this blog wont let me set it up nicely in excel.