It's a fair point that I hope to address in Part Two. Suicide rates in the US are much higher than almost all comparators, and the lack of access to mental and behavioral healthcare is a pock mark on our system. Not coincidentally, this (along with higher accidental, violent, and drug/alcohol related deaths) contributes to our lower life expectancy. The question is how do we separate the quality of care delivered from the social and political factors that contribute to these results? Should we? Can we? The best care in the world isn't worth much if you can't access it. But when you can, how does that quality of that care stack up?
I think the desire to parse the “quality of care” is defensive. It’s not good. If it was good, the numbers would not be going up. I say this as someone providing that very care.
Would certainly defer to you on the quality of mental healthcare, but as a counterpoint, I would say the quality of Orthopedic care in the US is pretty good compared to other countries. Along those lines, the ability to access MSK care is much better in the US than many other countries we are often unfavorably compared to. For instance, access to joint replacement in Canada, the UK, and Australia is orders of magnitude more restrictive than the US. You could argue (successfully) that this is financially driven -- but I think it's disingenuous to suggest we are the only country that struggles with access. In as much as access reflects quality, it's hard to parse reports such as the Commonwealth Report.
Dr. Shwartz, I understand that we have the best joint replacement procedure in America. However, you fail to acknowledge that if Americans don't have money or health insurance, how are they going to afford this procedure? It is good when people have money and good health insurance. What happens if they lose their employer sponsored health insurance through no fault of their own? Does it mean that they can afford your procedure when they have to make choices between putting food on the table and paying for healthcare? They are going to choose putting food on the table because they know that getting this procedure will bankrupt them and sell their property. Obviously, most of your patients have good health insurance through their employers. How many of them don't have insurance through their employers due to the current system? By the way, we need to move beyond the country's population and size because other countries have learned from America to make their system efficient than ours. I have lived and travelled to other countries and studied their systems. You are too privilege and can't understand people coming from diverse socioeconomic backgrounds. The American healthcare system was built on the backs of slavery. I would recommend you to read Why Doesn’t the United States Have Universal Health Care? The Answer Has Everything to do with Race.
https://afsp.org/story/2021-cdc-suicide-death-data-intensifies-the-call-for-continued-suicide-prevention well it’s clearly money well spent?
It's a fair point that I hope to address in Part Two. Suicide rates in the US are much higher than almost all comparators, and the lack of access to mental and behavioral healthcare is a pock mark on our system. Not coincidentally, this (along with higher accidental, violent, and drug/alcohol related deaths) contributes to our lower life expectancy. The question is how do we separate the quality of care delivered from the social and political factors that contribute to these results? Should we? Can we? The best care in the world isn't worth much if you can't access it. But when you can, how does that quality of that care stack up?
I think the desire to parse the “quality of care” is defensive. It’s not good. If it was good, the numbers would not be going up. I say this as someone providing that very care.
The ability to access care is part of it’s quality. Care you can’t access is about as useful as air you can’t breath.
Would certainly defer to you on the quality of mental healthcare, but as a counterpoint, I would say the quality of Orthopedic care in the US is pretty good compared to other countries. Along those lines, the ability to access MSK care is much better in the US than many other countries we are often unfavorably compared to. For instance, access to joint replacement in Canada, the UK, and Australia is orders of magnitude more restrictive than the US. You could argue (successfully) that this is financially driven -- but I think it's disingenuous to suggest we are the only country that struggles with access. In as much as access reflects quality, it's hard to parse reports such as the Commonwealth Report.
Dr. Shwartz, I understand that we have the best joint replacement procedure in America. However, you fail to acknowledge that if Americans don't have money or health insurance, how are they going to afford this procedure? It is good when people have money and good health insurance. What happens if they lose their employer sponsored health insurance through no fault of their own? Does it mean that they can afford your procedure when they have to make choices between putting food on the table and paying for healthcare? They are going to choose putting food on the table because they know that getting this procedure will bankrupt them and sell their property. Obviously, most of your patients have good health insurance through their employers. How many of them don't have insurance through their employers due to the current system? By the way, we need to move beyond the country's population and size because other countries have learned from America to make their system efficient than ours. I have lived and travelled to other countries and studied their systems. You are too privilege and can't understand people coming from diverse socioeconomic backgrounds. The American healthcare system was built on the backs of slavery. I would recommend you to read Why Doesn’t the United States Have Universal Health Care? The Answer Has Everything to do with Race.
I trained at the best funded ortho dept in Rochester. So makes sense. Mental health is still close to bedlam. https://open.substack.com/pub/thefrontierpsychiatrists/p/psychiatric-restraint-and-its-discontents?utm_source=direct&r=1ct8f&utm_campaign=post&utm_medium=web