DG Breast cancer incidence cannot be the same thing as breast cancer survival , can it? Incidence is how often it is found in the population.In Japan it is found in about 9 per 100,000 , in Greece about 17, in Britain, the US , France and others about 21 and so on.The Icelanders find it in nearly 40. That suggests some genetic factor at work.(Alternatively the percentage getting it is the same the world over but the Icelanders about five times better at detecting it than the Japanese are )

You're right. Apparently, I wasn't thinking.

quote:

Originally posted by DorianGreyed:
You're right. Apparently, I wasn't thinking.

Well, it's difficult. The problem I have is in my words 'like for like'. It's not easy, even possible,to check that what is shown in one set of stats is exactly comparable with another set.For example we can't always say whether the percentage is of all the people in a country who have the condition or of those who are treated for it or whether the percentage in each set is of all people presenting with a cancer which is at the same stage.

The one thing that is clear is that survival rates have improved throughout the advanced countries over the past twenty years and are continuing to increase very rapidly .

Another thing that's clear is that a country where you may have to decide which of your fingers you can have saved because you can't afford the cost of saving them all [one of Michael Moore's instances, so I take it with a pinch of salt:do tell us that such a thing is impossible] or where you may wait while your doctor telephones your insurers to discover whether they'll pay ,before coming back to say whether you'll have to find the money or go without may not have caught up with other countries yet

quote:

...do tell us that such a thing is impossible...

There's a comment here to that effect, but the site has 'a clearly predetermined political agenda', to borrow a phrase, and (call me cynical) is Dr. Condit a real person? There's no particular reason for us to expect a surgeon to have accurate grammar too, but...

'As a hand surgeon who treats many traumatic injuries, Moore's portrayal of a patient who amputated his middle fingertip captured my interest. He depicted this uninsured man as required to pay $23,000 to have his finger "saved." Moore lost considerable credibility here. Most hand surgeons would never consider micro-surgically replanting this table saw injury at the finger nail base. Rather, this unfortunate injury would have been comfortably and safely treated -- without reattachment of the severed bit of finger -- in an office procedure room for $1,000 or less.'

There's a very strange objection to the accuracy of the anecdote here:

'He makes a similar mistake with the film's opening anecdote, about an uninsured Oregon man, identified only as "Rick," who accidentally sawed off the tips of two fingers.

"The hospital gave him a choice: Reattach the middle finger for $60,000 or do the ring finger for $12,000," Moore says in the narration. "Being a hopeless romantic, Rick chose the ring finger for the bargain price of 12 grand. The top of his middle finger now enjoys its new home in an Oregon landfill."

It's a compelling story, but Moore over-embellished it with his bogus setup as a "choice" offered by the hospital. No, it wasn't. "Rick" couldn't afford $72,000 in surgery, so he chose to have just one finger reattached.

Then there's the colorful "landfill" line. Sorry, but Oregon's strict laws on medical waste disposal require incineration of body parts, including fingertips.'

Oh, well, that's alright then. It wasn't a "choice", it's just that he couldn't afford it.

It makes me feel a little better, though, to learn we're talking about tips of fingers here.

"Is Dr Condit a real person"? Yes. He's a hand surgeon in Grand Rapids.He has written for the trade magazine too.

One of the comments beneath the piece talks of preventative medicine being better than cure. Cuba, here we come !

It says here that he works at the 'Michigan Hand Center' - on a page dated 2003. But the Michigan Hand Center doesn't list him as one of their physicians. (Maybe he was fired for offering $1000 procedures right there on his desk, using the stapler and some sticky tape?)

He's in the Yellow Pages, anyway. Most hits on his name, though, seem to lead to copies of that article above.

quote:

The U.S. ranking is influenced heavily by the number of people -- 45 million -- without medical insurance.

'The number of Americans lacking health insurance rose by nearly 8.6 million to 47 million from 2000 to 2006, with children and workers from every income level losing coverage, a new report said on Thursday.

The increase was "driven primarily by the continued erosion in employer-provided health insurance," said the report by the Washington, D.C.-based Economic Policy Institute.' 47 mln Americans lack health insurance

A footnote to that Giuliani comment -

'...when asked if the campaign would continue to use the figure, a Giuliani spokeswoman said, "Yes, we will."' It's George Bush with brains

Oh, yes, and...

'...So Giuliani's case for the superiority of our "free market" health care system goes something like this: While on health insurance provided by New York state, he was treated, using a surgery developed by Europeans, for prostate cancer, a disease that most commonly afflicts those covered by the federal government's single-payer health care system. Take that, Europe/national health insurance.' Ezra Klein

Scientific American published an article " Hospitals and Superbugs: Go in sick...Get sicker" on 18th October this year.

Key points:

MRSA [a drug resistant strain of staphyloccus] causes 94,000 invasive infections each year in the USA, resulting in almost 19,000 deaths."The majority of these cases appear to be healthcare acquired": Elizabeth Bancroft, medical epidemiologist, Los Angeles County Department of Public Health.

Every year nearly 100,000 people die of infections they developed in US hospitals and healthcare facilities

1.7 million people contract hospital infections annually in the US

"Close to 70 per cent of infections in intensive care units are MRSA" Fred Tenover,CDC's National Center for Infectious Diseases Office of Antimicrobial Resistance.

" The vast majority of all hospital infections are preventable " says Elizabeth Bancroft [supra]. In the past " the mantra was that hospital infections are inevitable" but the attitude is changing.

The incidence of such infections is far lower in e.g. Denmark and the Netherlands [which have healthcare which is open to everyone, of course.That doesn't compare to the American system]

A law has been proposed which would require all hospitals nationally to report the incidence of such infections and would offer monetary incentives to reduce them.Since 2003 some 19 states have required hospitals to publicly report infection rates.One commentator complains that presently there is an incentive for hospitals not to be frank.

MRSA has been a big issue in Britain. It has received massive publicity: healthcare is always a very important matter of public interest in Britain.If nothing else, votes depend on it .Britain has one fifth of the population of the USA.The incidence of MRSA is,nonetheless,seemingly pro rata smaller than in the US. The last figures were for 2005 when there were 1,629 deaths where MRSA was cited as the underlying cause (compared to the 19,000 deaths in the US): note that that figure is 78 per cent of all cases where MRSA was mentioned on the death certificate. It was present, but not certified as the underlying cause, in 22 per cent of cases.The government has committed itself to ensuring a halving of the incidence within a year.

We also have another 'superbug' called clostridium difficile. "C Diff" accounted for deaths in 55 per cent of the 3,807 cases in which it was mentioned on the death certificate in 2005.My ignorance of such matters does not permit me to say whether "c.diff'is being described in different terms as one of the 'superbugs' in the Scientific American article.It is known in North America.


Scientific American

The MRSA and C diff. figures cited for Britain came from:

MSRA

C diff

How big in the media has this question of superbugs in US hospitals been in the US?