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American Healthcare Rant 2: Die Harder
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Darqcyde



Joined: 11 Jul 2006
Posts: 10660
Location: A false vacuum abiding in ignorance.

PostPosted: Mon May 31, 2010 9:58 pm    Post subject: Reply with quote

Catel wrote:
Health national expense (in % of GNP):
-France: 11%
-USA: 16%

Infant mortality:
-France: 4,2 ‰
-USA: 6,3 ‰

Life expectancy:
-France: 80.7 years
-USA: 78.2 years

(OECD and UNO datas)

A private health care system is more expensive and less efficient. Q.E.D. Cool

Obviously these numbers were fabricated by anarchist commie loving socialist terrorist who seek only to destroy the American dream Rolling Eyes
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Yorick



Joined: 11 Jul 2006
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Location: In the undersnow

PostPosted: Mon May 31, 2010 11:23 pm    Post subject: Reply with quote

Darqcyde wrote:
Catel wrote:
Health national expense (in % of GNP):
-France: 11%
-USA: 16%

Infant mortality:
-France: 4,2 ‰
-USA: 6,3 ‰

Life expectancy:
-France: 80.7 years
-USA: 78.2 years

(OECD and UNO datas)

A private health care system is more expensive and less efficient. Q.E.D. Cool

Obviously these numbers were fabricated by anarchist commie loving socialist terrorist who seek only to destroy the American dream Rolling Eyes

these percentages are hard to quantify. do these nations have equal GDP and population? (I don't believe they do, therefore the percentages aren't very useful)
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CTrees



Joined: 21 Jul 2006
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PostPosted: Tue Jun 01, 2010 1:27 am    Post subject: Reply with quote

France actually has a lower per capita GPD (by about eight percent), which makes the percentage expense more impressive. Comparing indicators like infant mortality rate and life expectancy to health spending, though, is really hard to make meaningful without all other factors being equal. Since the demographics and subcultures of the countries are very different, and things like diet are radically different between those two countries...
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andrew



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PostPosted: Tue Jun 01, 2010 2:05 am    Post subject: Reply with quote

Health expense percentage data is almost completely meaningless without detailed frequency counts of reported illnesses, hospitalizations, etc., along with similar reports on treatments.
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Dro



Joined: 10 Jul 2006
Posts: 3869

PostPosted: Tue Jun 01, 2010 4:53 am    Post subject: Reply with quote

That could also set up false comparisons. What if one health care system (hypothetically) tended to treat disease symptoms instead of offering robust preventative care and chronic disease management, as a second hypothetical system might? We would count up the cases of diabetic amputations and exclaim, "Well, that is why the first system is so much more expensive!"
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reasonablymad



Joined: 03 Apr 2007
Posts: 6783

PostPosted: Tue Jun 01, 2010 5:03 am    Post subject: Reply with quote

but the french women are so beautiful.
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andrew



Joined: 13 Jul 2006
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PostPosted: Tue Jun 01, 2010 5:28 am    Post subject: Reply with quote

Dro wrote:
That could also set up false comparisons. What if one health care system (hypothetically) tended to treat disease symptoms instead of offering robust preventative care and chronic disease management, as a second hypothetical system might? We would count up the cases of diabetic amputations and exclaim, "Well, that is why the first system is so much more expensive!"

Well, yes, I was assuming it would be obvious from the "etc." that my response wasn't in any way an exhaustive list of the things we would need data on in order to make the quoted percentages meaningful. If it wasn't clear, I'll do my best to spell it o--well, no, fuck that.
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Sam



Joined: 09 Jul 2006
Posts: 9674

PostPosted: Tue Jun 01, 2010 5:35 am    Post subject: Reply with quote

okay thank you for yet again dipping a toe in
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reasonablymad



Joined: 03 Apr 2007
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PostPosted: Tue Jun 01, 2010 5:35 am    Post subject: Reply with quote

... french women are beautiful?
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Dro



Joined: 10 Jul 2006
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PostPosted: Tue Jun 01, 2010 6:00 am    Post subject: Reply with quote

andrew wrote:
Dro wrote:
That could also set up false comparisons. What if one health care system (hypothetically) tended to treat disease symptoms instead of offering robust preventative care and chronic disease management, as a second hypothetical system might? We would count up the cases of diabetic amputations and exclaim, "Well, that is why the first system is so much more expensive!"

Well, yes, I was assuming it would be obvious from the "etc." that my response wasn't in any way an exhaustive list of the things we would need data on in order to make the quoted percentages meaningful. If it wasn't clear, I'll do my best to spell it o--well, no, fuck that.


Ohhhkay. Sorry for trying to think of ways that some of the data might have pitfalls and not couching it in a way to make it clear I wasn't all out attacking the suggestion of gathering data.
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Catel



Joined: 16 Nov 2009
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Location: France

PostPosted: Tue Jun 01, 2010 9:49 am    Post subject: Reply with quote

reasonablymad wrote:
... french women are beautiful?

Danielle Darrieux is still alive and shooting movies. If it's not a point for French health system ! Very Happy
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Michael



Joined: 09 Jul 2006
Posts: 10749

PostPosted: Tue Jun 01, 2010 6:03 pm    Post subject: Reply with quote

Guys I've been here now for 2 weeks and none of you seem to be sick. This healthcare thing was obviously a waste of money.

Unless you were all very very sick in which case it worked wonderfully.
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ShadowCell



Joined: 03 Aug 2008
Posts: 6184
Location: California

PostPosted: Tue Jun 01, 2010 6:09 pm    Post subject: Reply with quote

Actually, sick Americans look strikingly similar to healthy Europeans.

We have a steady diet of FREEDOM
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Catel



Joined: 16 Nov 2009
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Location: France

PostPosted: Wed Jun 02, 2010 7:32 am    Post subject: Reply with quote

When America goes achoo, the world goes snirfl.
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Darqcyde



Joined: 11 Jul 2006
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Location: A false vacuum abiding in ignorance.

PostPosted: Wed Feb 01, 2012 6:57 am    Post subject: Reply with quote

Are hospitals helping to create a new super bug? Seems that way. Gotta love how bacteria can share and swap genetic code.

Antibiotic-Resistant Bacteria Found in 37 U.S. States
By Jason Koebler | U.S.News & World Report LP – 9 hrs ago
Quote:
Half a world away, doctors in India are fighting outbreaks of bacterial infections that are resistant to more than 15 types of antibiotics. But closer to home, a similarly scary bug is making the rounds in intensive care and other long-term units of American hospitals.

In at least 37 states, Washington, D.C., and Puerto Rico, doctors have identified bacteria, including E. coli, that produce Klebsiella pneumoniae carbapenemase, or KPC--an enzyme that makes bacteria resistant to most known treatments. It's much more prevalent in America than bacteria that produce NDM-1, the enzyme that has Indian doctors "hell scared," and, according to Alexander Kallen, a medical officer at the Centers for Disease Control in Atlanta, the final outcome isn't much different: superbacteria that are hard to kill.

"It's got a slightly different structure than [NDM-1]," he says of KPC. "But the bottom line is they're two different ways to produce bacteria that are resistant to a wide range of antibiotics."

That's bad news for infected patients--the mortality rate for patients infected with KPC-producing bacteria has been estimated to be as high as 50 percent. Doctors are advised to do their best to keep the bacteria from spreading, which explains why the problem is most prevalent in hospitals and other close-quarter medical units. Infected patients are often isolated. KPC has been seen in a wide range of bacteria, including E. coli, Salmonella, and K. pneumonia, which often affects hospitalized patients.

These superbugs are resistant to nearly every weapon doctors can throw at them, including carbapenems, a class of antibiotic that the CDC calls the "last line of defense" against infections that are resistant to other types of antibiotics. There are a couple antibiotics that have been shown to kill these superbugs, but often at great risk to patients. In fact, the FDA has associated the use of these effective antibiotics with an "increased risk of death" in patients with pneumonia.

That leaves many doctors scratching their heads. KPC-bacteria often grow on medical equipment such as catheters and ventilators, so doctors can sometimes remove that equipment or perform surgery to try to eliminate the infection from a patient's body. CDC researchers, including Kallen, say that hospitals who haven't been vigilant about isolating patients with KPC-producing bacteria may have missed their chance. According to a paper co-authored by Kallen released last year, "failure to recognize CRE infections when they first occur in a facility has resulted in a missed opportunity to intervene before these organisms are transmitted more widely."

The good news is that, at least for now, KPC-producing bacteria generally only infects people who already have compromised immune systems. "It can move into the wider community," says Kallen, "but we haven't seen much of that yet."


And this is supported by a horrifyingly scary paper:

Quote:
Abstract and Introduction

Abstract

Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria are a group of emerging highly drug-resistant Gram-negative bacilli causing infections associated with significant morbidity and mortality. Once confined to outbreaks in the northeastern United States (US), they have spread throughout the US and most of the world. KPCs are an important mechanism of resistance for an increasingly wide range of Gram-negative bacteria and are no longer limited to K pneumoniae. KPC-producing bacteria are often misidentified by routine microbiological susceptibility testing and incorrectly reported as sensitive to carbapenems; however, resistance to the carbapenem antibiotic ertapenem is common and a better indicator of the presence of KPCs. Carbapenem antibiotics are generally not effective against KPC-producing organisms. The best therapeutic approach to KPC-producing organisms has yet to be defined; however, common treatments based on in vitro susceptibility testing are the polymyxins, tigecycline, and less frequently, aminoglycoside antibiotics. The purpose of this review is to identify the various challenges that KPC-producing bacteria present to clinicians. These include the need for special techniques for microbiological detection, the potential for nosocomial transmission, and therapeutic challenges related to limited, relatively unproven antimicrobial treatment options.

Introduction

Infections caused by bacteria-producing Klebsiella pneumoniae carbapenemases (KPCs) are becoming an increasingly significant problem worldwide since the first detection of these enzymes greater than a decade ago.[1] Although KPCs do not represent the first or the sole mechanism of carbapenem resistance, they are remarkable because they are often not detected by routine susceptibility screening and possess an exceptional potential for dissemination. In addition to the infection control challenges that have arisen, infections caused by these organisms present clinicians with serious treatment challenges, due to limited antibiotic options.

Efforts are under way to address these varied clinical challenges and have concentrated on enhanced infection control practices, better screening methods, determination of optimal usage of existing antibiotics, and development of novel antimicrobials.


With an equally scary conclusion:
Quote:
Summary

After initial outbreaks in the northeastern United States, KPC-producing bacteria have emerged in multiple species of Gram-negative bacteria across the world. They have created significant clinical challenges for clinicians because they are not consistently identified by routine screening methods and are highly drug-resistant, resulting in delays in effective treatment and a high rate of clinical failures. Effective antibiotics are limited to polymyxins, tigecycline, and occasionally aminoglycosides. Hospitals must prepare so that they can identify these organisms early and institute enhanced infection control efforts when necessary. Clinical microbiology laboratories need to recognize the signature of ertapenem resistance as a marker for KPC-producing bacteria, and should alert physicians to assume cross resistance to all carbapenems when it is present. Furthermore, clinicians need to appreciate that KPC-production can occur in many Gram-negative bacilli and become familiar with the limited effective antibiotics against KPC-producing bacteria as the frequency of KPC-producing bacteria is expected to continue to increase.

Full Paper: http://www.medscape.com/viewarticle/735068
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