ARC's 1st Law: As a "progressive" online discussion grows longer, the probability of a nefarious reference to Karl Rove approaches one

Wednesday, August 22, 2007

Healthcare

Wow... has it been a week since I've posted? And with all of the "Rove is leaving kerfluffle?" It seems that I've broken the cardinal mandate of blogging, which is to post something at least 1x a day. I guess I'll have to regroup with my co-conspirators and discuss the fate of this blog...

Anyway, saw this article by John Stossel and thought it was post-worthy:

Why the U.S. Ranks Low on WHO's Health-Care Study
By John Stossel
Wednesday, August 22, 2007

The New York Times recently declared "the disturbing truth ... that ... the United States is a laggard not a leader in providing good medical care."

As usual, the Times editors get it wrong.

They find evidence in a 2000 World Health Organization (WHO) rating of 191 nations and a Commonwealth Fund study of wealthy nations published last May.

In the WHO rankings, the United States finished 37th, behind nations like Morocco, Cyprus and Costa Rica. Finishing first and second were France and Italy. Michael Moore makes much of this in his movie "Sicko."

The Commonwealth Fund looked at Australia, Canada, Germany, New Zealand, the United Kingdom and the United States -- and ranked the U.S. last or next to last on all but one criterion.

So the verdict is in. The vaunted U.S. medical system is one of the worst.

But there's less to these studies than meets the eye. They measure something other than quality of medical care. So saying that the U.S. finished behind those other countries is misleading.

First let's acknowledge that the U.S. medical system has serious problems. But the problems stem from departures from free-market principles. The system is riddled with tax manipulation, costly insurance mandates and bureaucratic interference. Most important, six out of seven health-care dollars are spent by third parties, which means that most consumers exercise no cost-consciousness. As Milton Friedman always pointed out, no one spends other people's money as carefully as he spends his own.

Very true... ask someone what a trip to their Primary Care Physician (PCP) costs them and they'll give you the co-pay. Ask them what the total bill is and they'll blink their eyes and give you the same look I get from my dog when he's confused by a strange sound (looks like this dog).

Stossel doesn't even mention the problems of having your health care tied to your employment, further hiding not only costs, but your actual income.
Even with all that, it strains credulity to hear that the U.S. ranks far from the top. Sick people come to the United States for treatment. When was the last time you heard of someone leaving this country to get medical care? The last famous case I can remember is Rock Hudson, who went to France in the 1980s to seek treatment for AIDS.

So what's wrong with the WHO and Commonwealth Fund studies? Let me count the ways.

The WHO judged a country's quality of health on life expectancy. But that's a lousy measure of a health-care system. Many things that cause premature death have nothing do with medical care. We have far more fatal transportation accidents than other countries. That's not a health-care problem.

Similarly, our homicide rate is 10 times higher than in the U.K., eight times higher than in France, and five times greater than in Canada.

When you adjust for these "fatal injury" rates, U.S. life expectancy is actually higher than in nearly every other industrialized nation.

Ahh, the "progressives" will jump in here about gun control.
Diet and lack of exercise also bring down average life expectancy.

Nanny-staters like faux-righty Mayor Bloomberg would love to help us with that, John. Obviously, education and smart choices are the right solution...
Another reason the U.S. didn't score high in the WHO rankings is that we are less socialistic than other nations. What has that got to do with the quality of health care? For the authors of the study, it's crucial. The WHO judged countries not on the absolute quality of health care, but on how "fairly" health care of any quality is "distributed." The problem here is obvious. By that criterion, a country with high-quality care overall but "unequal distribution" would rank below a country with lower quality care but equal distribution.

It's when this so-called "fairness," a highly subjective standard, is factored in that the U.S. scores go south.

The U.S. ranking is influenced heavily by the number of people -- 45 million -- without medical insurance. As I reported in previous columns, our government aggravates that problem by making insurance artificially expensive with, for example, mandates for coverage that many people would not choose and forbidding us to buy policies from companies in another state.

The prohibition on policies from companies in another state is a relic and should be abolished. It also prohibits nationwide associations of small business from establishing health care plans which could provide coverage for the millions of people working in lower paying jobs who do not have coverage today.
Even with these interventions, the 45 million figure is misleading. Thirty-seven percent of that group live in households making more than $50,000 a year, says the U.S. Census Bureau. Nineteen percent are in households making more than $75,000 a year;

Wait a minute... of the 45 million uninsured, 25.2 million (56%) make over $50,000 per year? And these are the people that need me to pay higher taxes and suffer lower quality of care? I'm sorry, but you can't fix stupid. Of course, they're not stupid. They're opting for no coverage, betting that they won't get seriously ill.
20 percent are not citizens, and 33 percent are eligible for existing government programs but are not enrolled.

WAIT!!! We just pointed out that 25.2 million (56%) of the 45 million are not in poor households, well into the middle class, who chose not to be covered. We now find out that 33% of the 45 million (or an additional 14.85 million) could get coverage through a government program, but either decide not to or aren't aware that they're eligible. That means that of the 45 million uninsured, 40 million have access to health care but are not choosing to get coverage. And the remaining 20 percent (5 million) are not even citizens of this country...

Where's the problem again?
For all its problems, the U.S. ranks at the top for quality of care and innovation, including development of life-saving drugs. It "falters" only when the criterion is proximity to socialized medicine.

Meanwhile, the Dems and "progressives" are tripping all over each other to propose the surest way to wreck the most advanced medical treatments in the world.

And in Canada, probably ranked as one of the best healthcare systems in the world, a woman was put on a 10 month waiting list - for the delivery of her baby. Ultimately had to fly to some backwater outpost in Montana where, as Mark Steyn puts it:
Well, you can't expect a G7 economy of only 30 million people to be able to offer the same level of neonatal ICU coverage as a town of 50,000 in remote rural Montana. And let's face it, there's nothing an expectant mom likes more than 300 miles in a bumpy twin prop over the Rockies.

I'm sure Michael Moore is aware of the problems of socialized medicine. He just doesn't care.

***UPDATE***
CafeHayek is also covering this excellent article

Your Co-Conspirator,
ARC: St Wendeler