This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
Depends on what you mean. With respect to differences in the trainee experience, not as well as I'd like. Well enough to answer the question of "how do I get a good doctor in X country?" No.
For the question at hand, plenty. INCOMING RANT.
TLDR- No the U.S. has EASILY the best healthcare system in the world.
You'll note that for the most part the people who say we (the U.S.) have a deficient healthcare system are the same ones making all kinds of other claims we (as in the average Mottizen) have immense concern about.
If you can afford it (which is admittedly a big if) the U.S. still offers the best healthcare in the world. We often see people throw out outcome measures but they tend to be misleading. The U.S. is stuffed with obesity and other comorbid conditions and ....other forms of intractable problems that naturally lead to bad outcomes. Those same people would do worse elsewhere.
If you already have a rare genetic disease, an incurable condition, cancer, or DM2, CHF, and COPD - you'll get the best care here, should you be able to afford it. You may be more likely to end up with problems here, but you'll get better treatment.
That's because we are rich as fuck and have tons of resources and a huge chunk of global research is done here. Doctors also get paid more than elsewhere which means we drain everyone else's doctors and researchers, likewise we also work more than elsewhere which means more experience and faster care. Our training is also the best, often to a comical degree (which makes sense - we suffer through those hours and people are motivated by the pay). That's the carrot that goes along with the sticks I was whining about.
Wait times are a big difference with Canada, you may complain about waiting two-three months to see a neurologist in the U.S. but you'll wait two-three years north of the border.
Medical tourism does have a role, especially if you don't have unlimited money, but it's very easy to get grossly deficient care, end up with "customer service" care, or other problems (see: BBL complications). If you know the one hospital in Mexico or India that actually has good care that might turn out well, but it's still an actuarial game - if you have complications from anesthesia you are way more likely to die abroad, for example.
Also watch out for things like rationing and end of life care differences.
Other stuff adds some complexity here, as the U.S. does have some problems and while some European practice guidelines are inferior to our some are probably superior or more beneficial to such and such population of patients.
These tend to be very specific things though that don't alter the main point.
Scott would probably say something about the FDA, approval processes, cost disease and so on. Yeah people die because we take awhile to approve stuff but as far as I can tell we also make certain kinds of mistakes less frequently. It's complicated and individual patients can fall in or out of favor of those trends but ultimately it's likely the better structural approach.
Does that answer the question?
Yes, thank you for the detailed reply
More options
Context Copy link
More options
Context Copy link