tag:blogger.com,1999:blog-7772182113499451603.post2197679096030824116..comments2024-03-27T10:50:53.692-05:00Comments on Real Psychiatry: The Charlie Gard Case - Why Political Rhetoric Can Never Be Ignored...George Dawson, MD, DFAPAhttp://www.blogger.com/profile/03474899831557543486noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-7772182113499451603.post-16631463223354264462017-08-24T13:20:30.190-05:002017-08-24T13:20:30.190-05:00Good points - but I think the real reason why the ...Good points - but I think the real reason why the US system looks so bad is the cost side rather than the mortality side (point #4 above and the Himmelstein Woolhandler graph in this post: http://real-psychiatry.blogspot.com/2017/08/why-there-are-no-bipartisan-solutions.html<br />There is not that much difference between dying at 78 or 80 - but the minimum of $2,000 cost difference for no added benefit is a clear problem.<br /><br />Some of the problems you mention have considerable overlap with public health issues and health care infrastructure. You can argue that the opioid epidemic is a clear cause of excess mortality but the increased access to opioids that cause this came about directly from a health care system that is business focused and that has cut both addiction and psychiatric care to the minimum.<br /><br />Health care cannot be removed from political context. How can physicians advocate for adequate public health members when as a profession they have bee marginalized to the point that they can't do adequate research on gun violence or even ask patients about firearm access (temporarily I think in Florida).<br /><br />I think a graph like that is useful in considering all of those aspects of health care and certainly the runaway costs and lack of efficiency. And you are right plots of diet, obesity, and infant mortality would be similar.George Dawson, MD, DFAPAhttps://www.blogger.com/profile/03474899831557543486noreply@blogger.comtag:blogger.com,1999:blog-7772182113499451603.post-48754033266529216762017-08-24T12:34:15.912-05:002017-08-24T12:34:15.912-05:00Psychiatry resident here - I'd just like to re...Psychiatry resident here - I'd just like to register the caveat that graphs like these, while highlighting the inefficiencies of the U.S. medical budget, often don't adjust actual *outcome* measurements for higher rates of violent/catastrophic death of otherwise healthy people in the U.S. [more mileage per day spent in personal motor vehicles, more access to firearms, world's highest rate of opioid usage, etc.], with violent deaths tending to affect younger citizens and so drastically skewing estimations of life expectancy to the left.<br /><br />This isn't to say that we don't have other, independent problems with access to healthcare, infant mortality, adverse diet and lifestyle trends, an industry-sponsored opioid epidemic, and a profiteering health-insurance sector. Still, I'd like to see graphs like these at least adjust for catastrophic deaths of young, healthy people. Otherwise, I think disingenuous [if well-meaning] interpretation of the implications. Anonymousnoreply@blogger.com