masthead-highres

Thursday, October 19, 2006

Huffington Post Beware: A Little Knowledge Is A Dangerous Thing, Part I

David Hogberg says:
Over at the Huffington Post, journalist Blake Fleetwood claims "Poor Little Greece Has Better Health Care than the U.S."

In that blog post, he links to another of his posts, titled "Cuba Has Better Medical Care Than the U.S." That one begins:
Statistics don't lie.
Really? Didn't Mark Twain have something to say about that?

Fleetwood continues:
Figures from the World Health Organization clearly show that The United States lags behind 36 other countries in overall health system performance ranging from infant mortality, to adult mortality, to life expectancy.
First, this simply doesn't pass the smell test. The WHO report (pdf) that Fleetwood refers to puts Colombia, Morocco, Dominica and Costa Rica ahead of the U.S. Do you see Americans running off to those countries (or to Cuba, for that matter) to get treatment from their supposedly superior health care systems? Indeed, the WHO report is a classis example of what happens when bureaucracies are dominated by people who think government knows best. This is evidenced by the fact that the report states that in health care, "government remains the prime mover," and its "key role is one of oversight and trusteeship -- to follow the advice of 'row less and steer more.'"

We further learn that markets ration health care
by price, which means that who gets what goods and services depends not only on how much those goods and services are valued by people, but on who has the means to buy them. Priorities are not set by anyone but emerge from the play of the market. As indicated, this is almost the worst possible way to determine who gets which health services.
But back to Fleetwood. In his first blog post he explains why the U.S. health care system is inferior:
One of the main indices of the success of a nation or its government is the state of health of its citizens. Life expectancy is the most verifiable statistic to determine this. Considering the U.S.'s dismal health care performance, this should be a major election issue. But it is not.
Sorry, but the research doesn't bear out that life expectancy is "the most verifiable statistic to determine" the quality of a health care system. Indeed, it is one of the worst. As I explained in a recent policy analysis, numerous studies have shown that life expectancy is determined by factors such as GDP per capita, literacy rate and sanitation. Measures like health care expenditures or physicians per capita have no effect. (For an explanation of why the U.S. has lower life expectancy than other industrialized nations, see the policy analysis.)

As for the other statistic mentioned, infant mortality, it is also largely useless. It is measured far to inconsistently across nations to be of any value. Switzerland, for instance, doesn't count any infant born under 30 centimeters, thereby eliminating some of the most at risk infants from its infant mortality numbers. Belgium and France, for instance, exclude any infant born prior to 26 weeks. Ultimately, life expectancy and infant mortality tell us next to nothing about the quality of a health care system.

When we look at areas where (1) the health care system can actually have an impact, and (2) the data is collected consistently, we find that the U.S. exceeds other nations.

Fleetwood clearly loves single-payer systems, and touts Canada as one nation that has longer-life expectancy than the U.S. Yet, a recent article in the journal Circulation found that the mortality post-heart attack was higher in Canada than the U.S. The researchers attributed this to the fact that we do more angioplasties and bypass surgeries than Canada. (Word to the wise: we also do more angioplasties and bypass surgeries than any other nation on Earth, so if you have heart problems, the U.S. is where you want to be.)

We can also look at another single-payer system, that of Great Britain, where most of the hospitals are government-run. How do we compare? It's not even close. A 2003 study in the British Journal of Surgery found that the mortality rate after most major surgeries in British hospitals was four times higher than in American hospitals.

Unfortunately, using statistics that tell us next to nothing about a health care system is not the only problem in Fleetwood's blog posts. I'll address other problems in a second blog post.
Go here to read David's second post in this series.

Posted by Amy Ridenour at 12:03 AM

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