Talk:Healthcare in the United States/Archive 3

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Archive 1 Archive 2 Archive 3

Way to Long-winded

In my opinion it is not that the article is too long but that it is written more as a narrative rather than a presentation of data. Take the key section of data: Spending and answer two basic questions: "How much money does the US spend on healthcare?" "How much of US spending on healthcare comes from taxation and how much from obligatory health insurance?" These figures should be givem in the same way as in all other articles I've seen, as a total amount and as a percentage. But to answer these sort of basic questions needs an analysis of the text with no guarantee that after this exercise it will be found that the figures are actually even there. LookingGlass (talk) 07:27, 15 June 2012 (UTC)

Perhaps true. Like most controversial articles, editors have required WP:RS for entries. While this may result in a relatively error-free article, it may not answer everyone's questions. And answering those by compiling figures (for example), may be construed as WP:SYNTH.
What do you suggest? Student7 (talk) 13:51, 20 June 2012 (UTC)
Take massive doses of WP:SUMMARY, spin off a dozen sub-articles, and call me in the morning. —Cupco 06:07, 26 September 2012 (UTC)

Second Sentence Of This Piece Is Nonsensical

The second sentence makes no sense. I would rewrite it, but I do not have any way of knowing what they intended to say. The sentence should be eliminated and replaced with something that makes sense. Here it is: "Health insurance is now primarily provided by the government in the public sector, with 60-65% ... of healthcare provision and spending coming from programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program, and the Veterans Health Administration." How is health insurance today "primarily provided by the government in the public sector[?]" What are they trying to say? Obviously in the public sector, if by that you mean for government employees (do they mean that?), the government provides the funding for the employees' health insurance, because they are government jobs. But government employees do not use Medicaid, because few government jobs pay that little and carry no insurance. And they do not use the other programs mentioned, except sometimes from their status not related to their government job. But if employees currently have a good job with a government entity, they use that insurance generally, even if they would otherwise qualify for one of the programs mentioned. So this is false if this is what the writer was trying to say. Obviously 100%, not 60% or 65% as this says, of public sector healthcare spending is funded by the government, i.e. the public sector! So this cannot be what they meant! There is no interpretation of the meaning of this that is logically true. This sentence is gobbledygook. 65.8.187.9 (talk) 14:02, 30 June 2012 (UTC)

I changed that to "Health insurance for public sector employees is primarily provided by the government. 60-65% of healthcare provision and spending comes from programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program, and the Veterans Health Administration." That clarified the first part and broke up an obvious run-on sentence. I hope it helped. —Cupco 06:20, 26 September 2012 (UTC)

How much of Obamacare has been integrated?

Since it seems like virtually every provision of the Patient Protection and Affordable Care Act takes effect at a different calendar date, does anyone know whether this article is up to date concerning its provisions at present? If nobody familiar with the article answers in a week or so, I'll try to go through them all and check. —Cupco 06:13, 26 September 2012 (UTC)

Private payment statement unsupported by provided reference

Citation #57 is used to support the assertion that US is one of only three OECD countries where private provision accounts for >10% of health care spend - however the provided source indicates that there are numerous countries that exceed this ratio. I suggest perhaps they were using another threshold or included the wrong source? — Preceding unsigned comment added by 82.211.73.34 (talk) 15:35, 9 October 2012 (UTC)

Provider Reimbursement

I've found I have several issues with all sections discussing provider reimbursement:

"Low reimbursement rates for Medicare and Medicaid have increased cost-shifting pressures on hospitals and doctors, who charge higher rates for the same services to private payers, which eventually affects health insurance rates.[170]"

This caught my eye as well as:

"The report noted that providers and insurers negotiate privately, and therefore the prices can vary between providers and insurers for the same services, and it found that the variation in prices did not vary based on quality of care but rather on market leverage."

Then later it discusses the inability of smaller practices to negotiate higher rates.

So what's left is providers being forced to accept rates that don't pay the overhead costs to even remain open. So we've adapted and shifted to do what we can. At the same time provider reimbursement has been virtually stalled since 2005. Inflation however has not been stalled, so as we watch the same amount come in more needs to go out to pay the bills. This has left providers to change their staffing and treatment paradigms in hopes to mitigate cost.

In other words, providers have already suffered a huge loss from the stall of rate increases, yet everywhere I turn all that can be heard is that provider charges are out of control. To tell the truth how much providers are paid by the insurance companies is what is really out of the their control. This is pushing the providers to worry more about quantity than quality, thus creating a system of abuse and poor care to stay out of the red.

Also the part about cost-shifting. If you are a contracted provider for and insurance company you cannot charge the patient above and beyond their insurers determination of patient responsibility. Because of this we are very limited in the ways that we may be able shift the cost to the patient. These limited ways are "No Show" or "Cancellation" charge or supplies. The only other way to effectively limit the extra expense if a paradigm shift. Such as increasing the quantity of of treatments while limiting the amount of time for each treatment. This is seen when a physician gets paid for spending 15-25 minutes with the patient. In the past they had been seeing 3 patients an hour for 20 minutes each. Well if they drop 5 minutes from each patient they can see now 4 in an hour rather than 3, creating another unit of billable time. The end product being a lower quality of care, while not effectively lowering cost to the insurance company. In fact it may have the reverse effect since a whole new claim is more money than the 3 or 4 dollars they saved from their reduction. — Preceding unsigned comment added by 174.61.143.207 (talk) 20:03, 13 December 2012 (UTC)

Steven Brill's article about healthcare in the US

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/ — Preceding unsigned comment added by 89.139.39.245 (talk) 22:36, 28 February 2013 (UTC)

Forked "Payment" and "Spending" sections

I moved the "Payment" and "Spending" sections into a new article, [[Health care spending in the United States]. I did this for reasons including these:

  1. This article was longer than guidelines recommend. It had a prose size of 132k. By WP:LENGTH, articles over 40k may be split and articles over 100k should be split. The sections I removed were 45k.
  2. Health care spending is a topic relevant to many other articles, and other articles should link directly to this and not to the health care article in general.
  3. The topic of financing health care splits cleaning from the rest of the health care article, as people interested in other aspects of health care may not need to read about financing.

Thoughts? Blue Rasberry (talk) 13:04, 24 March 2013 (UTC)

Neutrality

The lead appears to be written by supporters of the "Affordable Care Act", and IMHO fails to meet WP:NEU. I will tag the article accordingly, and hope that it is written in a more neutral way as not to make it appear that the U.S. healthcare system is the worse thing out there. --RightCowLeftCoast (talk) 06:47, 14 February 2014 (UTC)

Link to previous talk page discussion Talk:Health care in the United States/Archive 2#Articles needs to be NPOVed.
--RightCowLeftCoast (talk) 06:48, 14 February 2014 (UTC)
So much of the content of the intro gives statistics that are related to the subject of this article, but are not directly about the subject. The article subject is health care in the U.S. not the health demographics of those who reside in the geographical U.S. --RightCowLeftCoast (talk) 07:11, 14 February 2014 (UTC)

Call for alternative statistics

Mortality is definitely one of the parameters for casually comparing health care, but hardly definitive. I argue that the US has one of the best health care systems in the world, BUT, American life style choices remain one of the worst, supported by WP:RS. Obesity, contributing to diabetes, sex leading to STDs, HIV, and AIDs, and (BTW) low weight babies, smoking leading to COPD, etc. None of these can be significantly lowered by "better health care" per se. These will persist under Obamacare, and will not change until Americans make smarter choices.

Other statistics, besides mortality, should be used as well. Student7 (talk) 15:28, 11 January 2013 (UTC)

  • Please provide sources sharing the statistics you would like to be used. Blue Rasberry (talk) 21:36, 8 March 2013 (UTC)
And please spare us the soapbox.Jytdog (talk) 22:20, 8 March 2013 (UTC)

I agree with the comments above. The article, as written now, taken as a whole, has a lefty, Europe is better slant. That's an argument, not a fact. Americans don't live as long as some countries, primarily because we have more teen pregnancy, resulting in more infant mortality. Secondarily, we are fat. Neither of those things is the result of ineffectiveness of our medical delivery system. Once an American is diagnosed with heart disease, cancer, etc., his survival is much better than anywhere else. How is this reflected in the article. Quoting international bodies that evaluate "quality of healthcare system" does nothing to address the biases of those bodies. It's fine to quote them, but how about also citing some of the actual facts I allude to. — Preceding unsigned comment added by 98.220.81.200 (talk) 17:38, 27 January 2014 (UTC)

Thats just it. You said it yourself. Once they are diagnosed. But since preventative care is not emphasized as much in the US as it is in other countries... Said diagnosis is generally much later. Your POV has almost a righty slant. How hard is it to accept that most other countries spend LESS and get better results? Or does the WHOLE rest of the world have a "lefty/liberal bias"?

Abalu (talk) 03:13, 15 April 2014 (UTC)Abalu

Actually that's not true. The US has much higher screening rates than other developed nations do, and Americans generally have much easier access to pharmaceutical drugs. VictorD7 (talk) 20:29, 24 January 2015 (UTC)

Serious problems; article needs substantial revising

As other editors have noted, this article mostly reads like a one sided propaganda pamphlet written by a committee of people who didn't speak to each other or plan anything. The page is a mess. It's a random accumulation of political talking points, not a true encyclopedia article and needs to be heavily rewritten and restructured. The goal should be to describe the basic layout of US healthcare, not crusade via soapbox for changes to it. Salient political debates merit coverage but such coverage should be neutral, clear, and accurate, and should probably be located near the bottom of the article. As has been pointed out elsewhere here, the topic is "health care", not health. Large segments conflating the two should be accompanied with appropriate disclaimers, and shouldn't be heavily emphasized in the article to begin with.

The current lede is bloated and should be heavily streamlined so that it briefly describes the most basic summary of US healthcare. The monstrosity's current body leads off with a section simply titled "Statistics", which serves as a hodgepodge of political talking points and "facts" not transparently attributed to people and groups with documented agendas. I've seen no other nation's healthcare article start off with such a section. The entire section should be deleted and whatever points are deemed critical to describing the political debate should be transferred to some kind of new "Political debate" section near the bottom of the page. Much of the material throughout the rest of the body is appropriate but the article is laced with repetitive factoids that should be deleted or consolidated. More material describing the actual process of American healthcare should probably be added. VictorD7 (talk) 22:52, 30 April 2015 (UTC)

Biased parts

The way the healthcare in USA is portrayed in this article is biased. For example, a statement from introduction: "Of 17 high-income countries studied by the National Institutes of Health in 2013, the United States had the highest or near-highest prevalence of infant mortality, heart and lung disease, sexually transmitted infections, adolescent pregnancies, injuries, homicides, and disability."

Issues like injuries, homicides and sexually transmitted infections cannot be atributed to the system of healthcare or can be atributed at most a little. Similarily with life expectancy - it is influenced by many factors, like racial diversification of different societies, obesity etc. You can even wonder about things like heart or lung disease - social factors can influence this, e.g. obesity can influence level of heart diseases. On the other hand, there are indicators at which USA performs well, e.g. some of mentioned on this site http://en.wikipedia.org/wiki/List_of_countries_by_quality_of_health_care. An objective article wouldn't mention issues like life expectancy, that cannot be fully atributed to healthcare system, or would mention them with the reservation I mentioned. At the same time it would also mention that at some indicators USA performs well. Article focuses too much on negative aspects. — Preceding unsigned comment added by 83.26.211.220 (talk) 23:32, 29 June 2014 (UTC)

Would it help to separate out an article about Health in the USA, as opposed to Health Care?Rathfelder (talk) 11:11, 5 May 2015 (UTC)
No, we don't need another article that portrays the U.S. in a negative light. We already have way too many articles that do that already, not to mention, they are extremely biased, one sided, and opinioned as well, most of which that indirectly sends a false and untrue message that the "country is failing in every aspect". Please, not a another one that attacks the country with negative opinions. We need to maintain more well balanced articles for a encyclopedia that is supposed to be fair and neutral for all.2601:647:4601:4634:A8EE:29FE:5863:6FC3 (talk) 07:24, 5 November 2015 (UTC)
If you perceive the facts as negative it might be because they are. There may be better sources out there, but you can't argue fact with opinion. CFCF 💌 📧 00:09, 8 November 2015 (UTC) 
The so called "facts" you are referring to are actually opinions written apparently without any kind of credible sources. Therefore they are not facts, but actually opinions. I am not sure where you got that conclusion from, perhaps from one of the unreliable and opinioned articles themselves? 2601:647:4601:4634:A8EE:29FE:5863:6FC3 (talk) 01:12, 22 November 2015 (UTC)
There is no need for a website like Wikipedia to bash the healthcare of the United States, and the opinionated statements in regards to the subject have been basically been repeated in a verbatim or near verbatim manner in nearly all of the articles that relate or even make a hint to healthcare. It is way too excessive and if some of the negativity is actually fact based and not biased, then we only need an article or two at most to mention it briefly without getting too carried away with the criticisms. In this way, the article will be neutral and health care bashing will come to an end, all while provide its readers with an informational source for an important topic. I appreciate your kind consideration so that this issue can be resolved in a constructive manner and that the articles in question can be revised in such manner. 2601:647:4601:4634:A8EE:29FE:5863:6FC3 (talk) 01:31, 22 November 2015 (UTC)
Calling each article that paints the American health care system in a negative light biased is very questionable. There is no limit to how many articles we should include these statements in, and frankly each health care system will receive criticism, and there is quite a lot to critique the American system of – not in the least that it bears a cost per capita twice that of other OECD-countries. CFCF 💌 📧 08:55, 22 November 2015 (UTC) 
It is also very questionable that you are even bashing the health care system right here on this talk page, not to mention that you are off topic as well. And also, I am not saying that the American healthcare is perfect and I welcome constructive and balanced analysis of such system, but it needs to be controlled properly. Far too often, the criticisms of a given subject go overboard with some turning into mere complaints that are illogical and fail to consider America's unique position as a nation of immigrants that can skew the health costs higher, due to the diverse health needs of such people. Maybe its time that we get another administrator or neutral person on this site to help us out with this problem. 2601:647:4601:4634:D455:1D6A:4C07:B030 (talk) 21:03, 22 November 2015 (UTC)
No, it's time you provide sources for your make-belief statements. You're forgetting about Australia, New Zealand, Canada, etc. CFCF 💌 📧 21:04, 22 November 2015 (UTC)
Its time that you stop attacking other users and calling their statements "make believe" for no reason. I have notified an administrator to get this issue resolved. 2601:647:4601:4634:D455:1D6A:4C07:B030 (talk) 21:16, 22 November 2015 (UTC)

FWIW - Thank you *very much* for inviting me to comment on the issue - yes - *entirely* agree with *all* the relevant comments made by "User:CFCF" above - hope this helps in some way - in any case - Enjoy! :) Drbogdan (talk) 22:08, 22 November 2015 (UTC)

That's good! :) :) - Even if you agree with CFCF completely. We need balanced input from a wide range of users so that the awareness can be raised on this neutrality issue. 2601:647:4601:4634:D455:1D6A:4C07:B030 (talk) 22:18, 22 November 2015 (UTC)
Team Hello, I am a DRN volunteer, and I found many references that cast a positive light on US health care system. I feel that a judicious use of these would improve the neutrality of this article. As per Jonas and Kovner, the number of individuals under medical coverage has gone up, forms of delivry have proliferated, and quality of health care has gone up due to improvements of incentives and education[1]. As per James A. Morone, as many important matters regarding health care reforms are beyond the reach of states, experimentation, innovation and talent has been pushed to state levels[2]. OK, maybe my understanding is not complete and maybe there is better material to be quoted from these sources, but I am sure if we work together we can make this article more neutral. I think the problem with this article is that not many neutral editors have been able to work on it--Wikishagnik (talk) 08:52, 29 November 2015 (UTC)

References

  1. ^ James R. Knickman, PhD; Anthony R. Kovner, PhD (8 April 2015). Jonas and Kovner's Health Care Delivery in the United States, 11th Edition. Springer Publishing Company. pp. 13–. ISBN 978-0-8261-2527-9.
  2. ^ James A. Morone (1994). The Politics of Health Care Reform: Lessons from the Past, Prospects for the Future. Duke University Press. pp. 6–. ISBN 0-8223-1489-4.
I agree with the statement above. Perhaps we can now determine the manner in which the new citations and revisions can occur not just within the article mentioned, but to ensure that some of the other articles that are tied to this one are equally objective and neutral as well. Some notable ones I found that could use some cleanup are Health systems by country, Health system, Single-payer health care, and Publicly funded health care. 2601:647:4601:4634:A8D3:C40:D286:B3E2 (talk) 06:54, 1 December 2015 (UTC)
Just start by suggesting some, and make sure to abide by the different sourcing guidelines WP:RS, WP:MEDRS, WP:SCIRS, when applicable. Also make sure not to violate WP:OR, WP:SYNTH etc. CFCF 💌 📧 07:18, 1 December 2015 (UTC)
How about the balanced news sources such as the NY Times, CNN, and from other encyclopedia websites as well? I think searching there would certainly be a good start. 2601:647:4601:4634:D455:1D6A:4C07:B030 (talk) 05:25, 2 December 2015 (UTC)

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Impartiality of introduction

The introduction paragraph has been edited multiple times to address/undo edits regarding impartiality. This sentance in particular has been removed/added: "Despite being among the top world economic powers, the US remains the sole industrialized nation in the world without universal health care coverage" I think the language "despite" and "remains the sole ... without" is a judgement on the state of healthcare in the US, rather than reporting a mere fact. I added the sentence "The United States does not have a universal healthcare program (e.g., at least some individuals do not have health insurance or coverage), unlike some comparable nations." This has numerous advantages. First, it is primarily a fact. Second, it elaborates on what it means to not have universal healthcare. Finally, it maintains the point that the US is unlike comparable nations, without appearing biased toward "universal coverage". — Preceding unsigned comment added by Gdcwd5 (talk • contribs) 21:48, 3 January 2019 (UTC)

Trimming, not adding

Nihil novi (talk · contribs), I appreciate your interest in this article, but truth be told I don't see your latest edit as particularly necessary [1] - this article is already information overload and needs to be trimmed down to WP:SUMMARY. Thoughts? II | (t - c) 08:15, 1 May 2019 (UTC)

I think the cited passage from the London Review of Books provides some interesting perspectives, on U.S. health-related institutions, that are likely to be overlooked in U.S. publications.
Thanks.
Nihil novi (talk) 08:45, 1 May 2019 (UTC)

New article on ableism in US health care

Hello! My name is Sanchu and I'm a student in the Poverty, Justice, and Human Capabilities course at Rice University. I am considering writing a new page on ableism in US health care. This page would be a parent article for that. You can see my user page for more detail: https://en.wikipedia.org/wiki/User:Sraghuvir. Let me know if you have any suggestions or comments! Sraghuvir (talk) 13:33, 12 September 2019 (UTC) Sraghuvir

State Healthcare Programs

Why is there no mention of state-level healthcare programs in this article? For example Masshealth. In fact there is no aggregate information source for state level healthcare programs anywhere I can find on the web?? Strange huh Gnostc (talk) 22:44, 28 August 2020 (UTC)

Probably because very few people are obsessed enough with Medicaid insurance programs and other similar state-level programs to be able to write informed generalizations about them in the aggregate. The diversity of American healthcare law is mind-boggling. The differences between states when it comes to hospitals (in terms of the laws regulating how they are founded and operated) are so vast that John Horty had to invent a computer database in the 1950s just to keep track of them. The Ohio State Bar Association was then inspired by Horty's database to create their own database for Ohio law, which evolved into LexisNexis. (The amazing thing is that Horty is still practicing hospital law today.) --Coolcaesar (talk) 05:52, 29 August 2020 (UTC)

Error rate in medical billing found to be 45%-80%

I'm not sure how or where to include this but seems important, here are a few sources, there are many more available but this isn't my area at all so unsure which are acceptable

Thanks

John Cummings (talk) 22:15, 16 February 2021 (UTC)

@John Cummings: I see that you are a bewildered European visiting America to share a 10 year old article. Mostly local people are in regional articles like this one, which is why no one thinks the issue that you raise is too strange.
I have looked at sorting United States health payment in wiki and it is not easy. Here are articles which describe the American system.
I support anyone else jumping into this issue. Yes it is important and interesting but also a challenge to untangle. Blue Rasberry (talk) 01:39, 17 February 2021 (UTC)

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Chemistry

Significance of usa in field of medicine 219.91.202.81 (talk) 04:27, 4 January 2023 (UTC)

ER Healthcare

Working in a hospital, an ER is a big part of the facility. I would like to add a section for ER Healthcare in the United States into this topic. I am still researching sources for this, but I think it would be a good addition to this page. I can find sources for budgets of the er, and different topics that have been discussed in this article. QueenTwig (talk) 19:24, 9 February 2023 (UTC)

Great Idea! CirclePulse (talk) 00:38, 15 April 2023 (UTC)

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