The Government is merely a servant -- merely a temporary servant; it cannot be its prerogative to determine what is right and what is wrong, and decide who is a patriot and who isn't. Its function is to obey orders, not originate them. - Mark Twain

Healthcare Myths: II. This Place Stinks

by Hal_10000

Part II of my series on healthcare myths is up, this time tackling the myth that America’s healthcare system has a poor performance record.  It’s a really long post, so I’ll give you the edited highlights.

Traditionally, there are two measure of healthcare quality — lifespan and infant mortality. They’re useful and liked because they are relatively easy to measure and compare. The surest sign of civilization’s march has been people living longer and babies surviving. Moreover, they’re good general population indicators. Rich people don’t live to be 300 or have 70 healthy babies, so they won’t skew the statistics.

The argument that the US’s healthcare system lags is based largely on these two measures. But they both have problems.

There’s a deluge of fact on violence, obesity and drug abuse.  My conclusion:

We live four years shorter than Japanese people — and we’re ten times as likely to be obese — not overweight, obese. We live two fewer years than our European and Canadian peers — with obesity rates that are 1.5-3 times as high.

And really, that’s what it comes down to. We are a nation filled with fat, accident-prone, gun-toting, drug-abusing, alcohol-swilling couch potatoes. The only nation in our peer group that comes anywhere close to us in self-destruction is the UK. Their wonderful socialized medical care system has bought them a whole seven extra months of life — and at the expense of increasing attempts by the UK government to control people’s lifestyles.

I next tackle infant mortality:

It is highly likely that our slightly higher infant mortality rate is again reflective of our lifestyle and not our healthcare system. Considering that the glorious UK issued a scathing report on their maternity wards, I wouldn’t be holding them up as a way to keep babies from dying.

And I finally get into a less useless measure of healthcare quality, the WHO’s responsiveness index—essentially a measure of customer satisfaction that can account for the much greater challenges our healthcare system faces.  We rank #1 in the world.  And it isn’t even close:

The #2 nation on the list is Switzerland. They’re at 7.4. The difference between the US [8.1] and Switzerland is as yawning a chasm as the difference between Switzerland and Finland (ranked #19). Moore’s Cuba, by the way, ranks a cozy 115th.

Here’s a graph of the WHO’s measure of per capita spending against health.  That point way off on the right?  That’s us.

What you’ll see is very interesting — a rapid rise in healthcare responsiveness at low levels of spending and then a leveling off at about $500 per capita to a straight line that represents the developed world. The more each country spends, the better its healthcare responsiveness. The US lies right along that line, but way further along it that anyone else.

I’ve left out the ugly details of my arguments but they’re available on my site.  The short story is that the people using infant mortality and lifespan figures to argue that our healthcare system stinks have simply not done their homework.  They haven’t looked at the raw numbers; they haven’t looked at the confounding factors; they are, in some cases, comparing us to nations that are a tiny fraction of our size.

I’m not going to sit here and argue that our system is perfect by any means.  There are millions who get poor care—although the worst care comes from hospitals dependent upon Medicaid and Medicare.  And we are paying a lot of money for this.  But the argument that our system’s overall health performance is a disgrace simply doesn’t hold water.

That is, unless you want to blame the doctors for our drug use, our alcohol use, our obesity, our laziness, our car accidents, our shootings and our teen pregnancy.  Knowing how Democrats think, that’s probably the case.

Comments

Posted by on 03/05/09 at 10:19 PM from

It’s funny that this gem of a post comes immediately following WVR’s pathetic attempt at addressing health care.

Posted by on 03/06/09 at 12:07 AM from

Everyone wants to come to America when they are sick, Americans don’t think “Shit!  I need to go to overseas for surgery” unless that happens to be where the specialist is that is doing experimental procedures…

Posted by on 03/06/09 at 05:16 AM from

One of the major flaws of the infant mortality rate is what’s considered infant mortality.  If the newborn dies in the womb, or at moment of birth, it’s not considered an ‘infant mortality’.  If you do what we in the states have a habit of doing, with performing extreme medical procedures to save every baby, ones that would have just been ‘born dead’, end up dying later.  So what’s better, stilborns, or a higher than average infant mortality rate?

Posted by on 03/06/09 at 06:13 AM from

“Shit!  I need to go to overseas for surgery”

Actually, some Americans go overseas for procedures because they are cheaper.

It’s funny that this gem of a post comes immediately following WVR’s pathetic attempt at addressing health care.

Really, zoomzoom?

I love you Hal, but this is a rank piece of hyperbole given the behavior of Republicans during the Bush era:

That is, unless you want to blame the doctors for our drug use, our alcohol use, our obesity, our laziness, our car accidents, our shootings and our teen pregnancy.  Knowing how Democrats think, that’s probably the case.

No one thinks like this and if WVR had said the same thing about Republicans, it would have been called out as pithy ...

Posted by InsipiD on 03/06/09 at 07:36 AM from

I love you Hal, but this is a rank piece of hyperbole given the behavior of Republicans during the Bush era:

I’ll agree with that.  I was never a big fan of how much Bush acted like a Democrat, even as they treated him like Public Enemy #1.

Posted by Hal_10000 on 03/06/09 at 08:03 AM from

Yeah, that probably was a cheap shot on my part.  However, when you spend a lot of time in healthcare debate circles, you do hear a lot—mostly from people supporting socialized medicine—about how doctors should be doing more to address these things.  Specifically:

1) The AMA and other organizations want doctors to report injured women as potential domestic abuse victims.

2) The government of the UK has been trying to enforce lifestyle changes through the healthcare system.

3) There is a lot of talk about how doctors won’t do enough to encourage good habits so people run up big medical bills.

4) I seem to recall one of the gun lobbies wanted doctors to inquire about gun ownership.

And so on.  There are a lot of people—and while there are many Republicans, they are predominantly Democrats—who see our national healthcare system as a way to create social change and encourage (force) healthy behavior on the populace.

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