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What Happens In Europe?
When you look at the central core of drugs available to medicine, there's little difference between one country and the next. Everyone uses the same antidepressants, erectile dysfunction and pain-killing drugs. The names may change. Obviously, sometimes the brand name translates into something unfortunate in other languages. But there can also be some quite dramatic differences in the way the drugs are used. In this, Europe is one of the leading groups of countries when it comes to medical practice. Within the federal structure and the member states, there are groups of experts who adopt an evidence-based approach to the practice of medicine. If there's no evidence a treatment is effective, the advisory bodies positively recommend doctors find a different way of treating the problem. Why is this?
Europe depends on a socialist approach to healthcare. All the states fund the care services out of tax revenue. This is not to deny the role of private insurance companies. Anyone who wants something better than the state provides, buys a policy that will provide it. So, since most people receive treatment without having to pay ...
... for it, the states are interested in controlling costs. The tax payers do not want to feel their money is being used without good reason. So all drugs, medical devices and other treatments are vetted. Only those that pass the tests are paid for by out of state funds. A policyholder can ask his or her insurance company to pay, but that's a private matter. The result is that treatment strategies are standardized across Europe, using only those drugs and devices where the evidence clearly shows they are effective.
In the US, this approach is rejected. Our doctors are free to prescribe whatever drugs they like whether on or off-label. They can recommend procedures and treatments where there's not a shred of evidence they will produce good results. This is one of the reasons why healthcare spending is out of control in the US. Insurance companies simply pay out on the treatments billed by the doctors. When the money in the insurance finds runs low, they increase the premium rates. At some point, individual states and the federal government must come to grips with this problem and, truth be told, the European model is the best alternative. If the insurance companies only paid out for treatments where there's clear evidence of their effectiveness, we would all benefit.
When it comes to painkillers, the range of drugs is the same in Europe and the US but they prescribe a tiny percentage of the quantity we consume. This is not to say there are physical differences, that the European are stronger or feel less pain. It reflects a different approach where they are taught how to live using fewer drugs. The European doctors think this gives their patients a better quality of life and saves the state money. This is not to say people in pain do not take drugs. Ultram is a staple drug in all European countries. But its use is more tightly controlled and people are encouraged to do without unless the level of pain genuinely becomes unbearable. So yes to Ultram but only when it's absolutely necessary.
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