The OP equates life expectancy with the best health care. This is flawed logic. I would not want to be sick in some of those high ranking countries. Some of them, I wouldn't mind.
Some countries have a severe shortage of certain types of sub-specialists.
Some countries are good at giving you a free annual check-up but lousy in other areas.
Some countries have fewer obese people so their life expectancy is longer.
Most countries are much more efficient as far as not having lawyers increase the costs of healthcare. In some countries, only drunkeness is punished and honest mistakes and overlooking something results in additional medical care at no extra cost but no lawyers. Whether you like or dislike it, that's some countries answers to the legal problem.
The topic of the thread is "Do those who Parrot the Claim that US has Best Health Care believe in their own BS"?
Can I put you down for a "yes"?
Quote:
Originally Posted by 797-3
The OP equates life expectancy with the best health care. This is flawed logic. I would not want to be sick in some of those high ranking countries. Some of them, I wouldn't mind.
Actually, the OP does not equate anything. The US is ranked by independent organizations against other countries' performance according to objective, respected, internationally agreed measures, of which life expectancy is just one (albeit an important one that really says something about how well a nation as a whole is doing and for those who actually stop to think that health care should actually have a positive outcome for patients, not just for the unaccountable corporations running their "health care" franchise).
Quote:
Originally Posted by 797-3
Some countries have a severe shortage of certain types of sub-specialists.
Some countries are good at giving you a free annual check-up but lousy in other areas.
Some countries have fewer obese people so their life expectancy is longer.
And one country in particular is lousy at providing incentives for potential doctors who want to help people and become a primary care physician to become the kind of doctors that really promote wellness and could move America higher on the league list. Instead, it makes medicine something for the money obsessed who all want to become specialists where the big bucks are, stepping on patients all the way to the top.
It is fascinating to hear the claim parroted that "life expectancy and other measures don't count because Americans are fat and unhealthy slobs".
Perhaps a bit of the reason behind this is because Americans suffer from a "treat the symptoms, not the problem" health care system with all the wrong incentives that doesn't educate citizens. Have a cholesterol problem? Don't change your diet, take a pill! It is much more profitable for the system and the patient gets to indulge his "there really is a free lunch" fantasy.
Quote:
Originally Posted by 797-3
Most countries are much more efficient as far as not having lawyers increase the costs of healthcare. In some countries, only drunkeness is punished and honest mistakes and overlooking something results in additional medical care at no extra cost but no lawyers. Whether you like or dislike it, that's some countries answers to the legal problem.
Interesting that the legal canard is brought up again. I agree with you that the legal system is also broke, but you are barking up the wrong tree here. Doing a search just on FT will show you how insignificant this is in the scheme of things.
Quote:
Originally Posted by PhlyingRPh
I must admit, I have never placed any of the items you listed above universal healthcare in my personal hierarchy of people's rights. It's an interesting thought, in that if one the goals of universal healthcare is to build a truly preventative health environment, it is hard to be truly preventive when people are eating foods loaded with high fructose corn syrup and carbs, as well as canned meats and vegetables.
It is however important to remember that the HFCS is a direct result of America's still very active and funded Soviet-style, big government, agriculture programs which had the philosophy at their core of ensuring that political security for those in power would be ensured because Americans would always have "cheap food". They were thinking in terms of cheap=inexpensive. The result has become of course cheap=very poor quality and nutritious value but in very shiny packages.
The billions of taxpayer money that are paid to Iowans to become "welfare queen" farmers of government subsidized corn to be converted into taxpayer subsidized, gooey high fructose corn syrup added to just about anything to feed the teat of fat, unhealthy Americans who aren't educated about what they put in their mouth 24/7 are a key cornerstone of today's American (anti-) health care system.
Why is Kristof blaming poor health statistics (life expectancy, infant mortality, transplant success) exclusively on our health care system? Does our national inclination to be fat, sedentary and gluttonous not play a very substantial role? Also, lack of reasonable health care access for millions of people is a very serious problem, but it does not bear on the quality of care the system provides for those with access.
... medical insurance in practice is very different from other forms of insurance in that people expect to make regular claims. It's because of that perverse sense of expectation that people come to such a faulty conclusion about the quality of "insurance" which most people treat as a subsidy instead.
It is telling that you consider that individuals "making regular claims" for timely, preventative, regular, disaster-preventing, wellness promoting, cost saving, rational health care provided reliably and conveniently at affordable rates is a "perverse expectation."
I suppose that expecting that clean water will come out of your tap, or that the garbage will be collected or that the street will be mended are all also "perverse expectations" of "the socialist types"?
I agree with your fundamental assumption that medical insurance in practice (and I would say when done right also philosophy) is very different from other forms of insurance. That difference is the reason why those national health insurance systems that are leaving the nation America and her increasingly unhealthy, overpaying, short-lived, restricted from or even excluded from proper care, dying in droves from preventable deaths citizens in the dust:
The recognition that expecting the square peg of a poorly regulated private insurance market system into the round hole of what makes effective and efficient health care provision a success is a "perverse expectation".
Social Security works because it is social insurance not private for profit speculation.
Medicare works because it is social insurance not private for profit marketing shell games.
The health insurance markets and national health services of those countries whose citizens are spending much less to get the same or much more than Americans while treating all citizens as equally valuable, all have a social insurance element with the simple but elegant truth at their core: that the best risk pool for a nation is the entire nation and that insurance works best when it is organized to do everything it can to provide health care instead of everything in its power to deny it.
Quote:
Originally Posted by Plato90s
Medicare, like the rest of the Great Society programs which LBJ passed, was a wealth transfer program.
If you want to see a real example of a wealth transfer program, you don't have to look any further than the voodoo economics introduced by Ronnie "Medicare will turn us into Communists" Reagan which were justified to remove taxation from the rich and starve the government of funding.
If the goal was to bring America's government and economy "of the people, to the people" to its knees (so aptly illustrated by the canary in the coalmine California with its Dr. Kevorkian Prop 13 measures) while creating the largest income inequality and highest concentration of the nation's wealth into just a few hands since before the Great Depression, then there can be no greater success of a wealth transfer program imaginable. It had the added benefit of taking away Pell Grants so that the poor would not get a college education, reducing "wasted money" on social security payments to the widows of veterans, etc.
Why is Kristof blaming poor health statistics (life expectancy, infant mortality, transplant success) exclusively on our health care system? Does our national inclination to be fat, sedentary and gluttonous not play a very substantial role? Also, lack of reasonable health care access for millions of people is a very serious problem, but it does not bear on the quality of care the system provides for those with access.
Pretty weak argument, I think.
I suppose it depends on what you are trying to defend, or rationalize or fight for.
If one is trying to fight for "my own good thing" of having positioned oneself into being on the right side of the health care apartheid line and enjoying great private health insurance made possible by placing a hidden tax on the products your company and industry sells to those who can't afford insurance and by the US government also sheltering this substantial portion of your income from income taxes, then it makes sense to fight for the status quo and to say "the hell with the 40.000 who die unnecessarily per year and the 40 million who have no access to speak of at all. I got mine and it is all because of my own efforts and am dependent on no one else. Screw them."
If you are trying to rationalize the poor performance of the American private insurance market and privatized health care, that spends dramatically more while providing dramatically less and creating huge windfall profits for executives and shareholders, then it makes sense to search for a scapegoat and blame another factor such as "fat, sedentary, gluttony".
If you are trying to fight for the long lives of healthy Americans, and defend the long term Competitive Advantage of the American Nation, then it makes sense not to look for someone to blame or to sacrifice abstract scapegoats, but to actually examine reality and think about addressing root causes rather than fighting symptoms and playing the blame game.
Whose interests are you advocating?
Last edited by Klm is Dead - Long Live KLM; Nov 6, 09 at 3:40 am.
Reason: sp.
Programs: NW silver, Spirit Somebody; DL, CO, UA once gold now dirt. AA & US for magazines.
Posts: 6,002
Quote:
Originally Posted by Plato90s
As noted elsewhere, medical insurance in practice is very different from other forms of insurance in that people expect to make regular claims. It's because of that perverse sense of expectation that people come to such a faulty conclusion about the quality of "insurance" which most people treat as a subsidy instead.
Uh, no. The basic fact is that any claims costs paid by insurance companies reduce profits by the same amount (i.e. drop straight to the bottom line), and that's the way they look at it and treat it. They won't say on camera something ridiculous like that they expect no claims, but the actions speak louder. Sometimes profit and people directly collide and often you have to make a choice. And yes, they'll deny claims knowing full well they may have a fight on their hands that they may ultimately lose, but the bet there is that you'll tire of it or die.
We can quarrel over details, but I think a big change in the political debate this time vs. 1993 or earlier is the additional experience and awareness many people have over insurance companies and their practices. The right can try to bat down "Sicko" all they want, but more people today know someone personally who had a bad experience (in my case, a 60-year-old cancelled after 20 years of exorbitant rates). That kind of second-hand or first-hand familiarity is much harder to fight.
Quote:
That's in addition to the outright falsehood you claimed. The vast majority of medical care provided are things which MOST people can afford.
The ultra expensive care is the exception, not the rule as falsely represented by advocates.
Depends how you count. There would certainly be more office visits than major operations, but which one's the stronger cost driver? If we average $12,000 a person in health care spending and the check-ups are $150x2, what's causing the other $11,700? People fear the bankrupting emergency. The uninsured and underinsured don't get the check-ups and have economic disincentives there that need to be removed, but the cost problems are a lot bigger and more complex than fighting with employees over who pays for preventive care and from where. As it stands we're penny-wise and pound-foolish with access to preventive care, and the real endgame for extremists on the right is to blame individuals for any bad outcomes and let people die in the streets like a third-world country. I know that sounds inflammatory (it did when Rep. Grayson said it), but having needed care in such a country and having been effectively a part-time "health care exile" for about 7 years now
I think I'm qualified to say it. Being the next Mexico is a lot scarier to me than possibly being the next Canada.
Quote:
Finally, since when does unaffordability equate the necessity for the government to provide it?
If the private sector can't or won't provide certain basic necessities affordably, there's a legitimate role for government to at least guarantee access and affordability. That may not mean running things necessarily, but it does mean that practices like gouging or profiteering to a level that denies access or affordability won't be tolerated. The more basic the need, the more likely you'll see government involvement. Those who might compare health care to some luxury item and make entitlement arguments miss that one entirely. Yet if we have a gas supply crunch like in Atlanta last September and some stations raise prices above $6 THEN you'll see a real outcry and the government stepping in.
Rather than argue the ideological point, the real question should be why anyone would expect the disenfranchised NOT to use their vote as a means to change things.
Quote:
Unless those people are already financially on the edge, it is extremely unlikely that medical bills is going to bankrupt you.
And if everybody had six figures in the bank they could lose that and not get bankrupted. In the real world, something like half of all bankruptcies have health expenses as a major if not decisive factor. A five-figure hospital bill is easy to get, and a condition like cancer could easily get six figures. Insurance companies will comb it line by line and partially deny or reimburse based on their own figures, leaving you holding the bag for tens of thousands of dollars. One of the most dangerous misconceptions people have is that their out-of-pocket will be capped by the deductible and copay (one of the goals of reform legislation is to make caps a reality).
Again, more and more people, myself included, know someone it happened to. That's turning the debate, plus the realization that the current system is simply unsustainable. The default path is a collapse to a third-world model where everything becomes fee-for-service and those who can't pay are literally left to die in the streets. Sounds hyperbolic to some, but it's the literal truth in most of the world.
Yes, the US has the best healthcare in the world. The US does not have the best healthcare system. I suspect Kristof would agree with this distinction.
I would also posit that the US has the best education in the world without having the best education system. (link)
The reasons that this is an emotional issue for Americans are:
1) The current US system provides something like the healthcare-equivalent of an excellent 4-year university education to the significant majority of people. There is, of course, a sizable minority that is left out and gets very little.
2) The reason there is a current "crisis" is not so much because of this sizable minority that has always existed but because of worries (real and imagined) amongst those in the majority that they will lose these benefits.
It is frankly idiotic to argue that the US has the best healthcare system. It is equally idiotic to argue that the average American (as opposed to an outlier) will have better healthcare if things change.
Of course, the other issue is the cost of the system, which is not sustainable. As far as I can tell, the current proposal will do little if anything to deal with this problem. If anything, it will exacerbate it.
First you complain about generalizations and then you drop this doozie.
Care to provide some study that shows that people who enter bankruptcy due to medical bills were financially on the edge to begin with?
If you do your own reading (and no, I'm not going to provide the lazy with a link) you would see that even the most widely cited statistics for "medical bankruptcies" only has bills amounting in the thousand (not tens or hundreds of thousands) for the vast majority of cases.
There's a difference between generalization without evidence and citing facts.
Quote:
Originally Posted by Klm is Dead - Long Live KLM
The OP is not the topic of the thread.
The topic of the thread is "Do those who Parrot the Claim that US has Best Health Care believe in their own BS"?
Can I put you down for a "yes"?
I doubt it because the whole point is to reject the false premise the Kristof put forward and you parrot.
Quote:
Originally Posted by Klm is Dead - Long Live KLM
Perhaps a bit of the reason behind this is because Americans suffer from a "treat the symptoms, not the problem" health care system with all the wrong incentives that doesn't educate citizens. Have a cholesterol problem? Don't change your diet, take a pill! It is much more profitable for the system and the patient gets to indulge his "there really is a free lunch" fantasy.
And as Europeans know from similar attempts to "treat the symptoms" of social ills - it just makes the problem fester and create radicals who want to solve the problem by destroying the whole system out of wrongheaded frustration.
Quote:
Originally Posted by Klm is Dead - Long Live KLM
It is telling that you consider that individuals "making regular claims" for timely, preventative, regular, disaster-preventing, wellness promoting, cost saving, rational health care provided reliably and conveniently at affordable rates is a "perverse expectation."
It is telling that you completely misinterpreted a simple statement because of tunnel vision and myopia. It was NOT about individuals but the product itself, but in your eagerness to fit me into the parody built up in your mind - little things like fact and logic get tossed to the side.
The problem is the use of "insurance" to pay for what would be considered routine expenditures. It's as if people bought "auto insurance" which covered oil changes and flat tires. Car owners generally don't consider those items to be insurance-reimbursement items but rather something they pay out of pocket or purchase a separate warranty for.
Ditto for homeowner insurance. Nobody expects routine maintenance to be reimbursable through insurance.
But routine medical care - that's something which people expect to be reimbursed through their medical insurance. Thus the entire product (not the individuals) has been transformed into a case of "perverse expectations".
A more rational system is to make health insurance more like other forms of insurance - something to be used in cases of catastrophe. Not its present form of almost routine reimbursement.
Quote:
Originally Posted by Klm is Dead - Long Live KLM
I suppose that expecting that clean water will come out of your tap, or that the garbage will be collected or that the street will be mended are all also "perverse expectations" of "the socialist types"?
Only if people expected to receive those services without paying for them.
Quote:
Originally Posted by Klm is Dead - Long Live KLM
I agree with your fundamental assumption that medical insurance in practice (and I would say when done right also philosophy) is very different from other forms of insurance. That difference is the reason why those national health insurance systems that are leaving the nation America and her increasingly unhealthy, overpaying, short-lived, restricted from or even excluded from proper care, dying in droves from preventable deaths citizens in the dust:
Yeah - Europe is really leaving America in the dust. It's a wonder why such advanced and enlightened people haven't become the paragon of human existence and the premiere power in the world, instead of languishing in America's shadow.
Quote:
Originally Posted by Klm is Dead - Long Live KLM
The recognition that expecting the square peg of a poorly regulated private insurance market system into the round hole of what makes effective and efficient health care provision a success is a "perverse expectation".
Logical, once you ignore the inconvenient truth that it worked for many decades until the absolute costs of medical care skyrocketed.
So the system did work, except that the vast increase in the ability of patients to run up huge bills has overpowered the system.
Much like how the European model of segregating immigrants worked until the number of immigrants skyrocketed to the point of overpowering the system by which the white-European preconceptions are threatened.
Quote:
Originally Posted by Klm is Dead - Long Live KLM
Social Security works because it is social insurance not private for profit speculation.
Medicare works because it is social insurance not private for profit marketing shell games.
Both statements show appalling ignorance of the fact that both Social Security and Medicare run much bigger deficits than the private health care system.
In additional, social security has already seen multiple increases in tax rate in order to fund it and STILL is projected to run a deficit.
I suppose I shouldn't find it surprising that you think government programs which run massive deficits despite increasing funding are example of things that "work".
Quote:
Originally Posted by Klm is Dead - Long Live KLM
The health insurance markets and national health services of those countries whose citizens are spending much less to get the same or much more than Americans while treating all citizens as equally valuable, all have a social insurance element with the simple but elegant truth at their core: that the best risk pool for a nation is the entire nation and that insurance works best when it is organized to do everything it can to provide health care instead of everything in its power to deny it.
Simple but elegant - yes.
Truth? No.
Not unless you have a truly perverse understanding of what the term "best risk pool" means. It's "best" for the least healthy but it's the absolute worst for the health people who are required to shoulder costs and share resources with those who utilize far more than they put in.
Quote:
Originally Posted by Klm is Dead - Long Live KLM
If you want to see a real example of a wealth transfer program, you don't have to look any further than the voodoo economics introduced by Ronnie "Medicare will turn us into Communists" Reagan which were justified to remove taxation from the rich and starve the government of funding.
True - both are wealth transfer programs.
Fortunately, Ronald Reagan's foolish tax policy was rolled back after only 1 year because the deficits became glaringly obvious early on.
Quote:
Originally Posted by RustyC
Uh, no. The basic fact is that any claims costs paid by insurance companies reduce profits by the same amount (i.e. drop straight to the bottom line), and that's the way they look at it and treat it. They won't say on camera something ridiculous like that they expect no claims, but the actions speak louder. Sometimes profit and people directly collide and often you have to make a choice. And yes, they'll deny claims knowing full well they may have a fight on their hands that they may ultimately lose, but the bet there is that you'll tire of it or die.
How is any of this relevant other than as an off-topic tirade against insurance companies?
See above on how you missed my point of the major difference between health insurance and other types of commonly carried insurance.
Quote:
Originally Posted by RustyC
We can quarrel over details, but I think a big change in the political debate this time vs. 1993 or earlier is the additional experience and awareness many people have over insurance companies and their practices. The right can try to bat down "Sicko" all they want, but more people today know someone personally who had a bad experience (in my case, a 60-year-old cancelled after 20 years of exorbitant rates).
In what ways has any of the practices of the insurance companies changed between 1993 and now? None.
By 1993, private insurance has been covering employees for decades. What "additional experience and awareness" did you think appeared in the last 15 years? None.
The fundamental difference is simple. Medical care costs more because there's a vast increase in the number of available services. When absolute costs rise higher than inflation and wages - people are more unsatisfied. We see the exact same dynamic when it comes to college tuition and home prices.
So there are no dark conspiracies and Michael Moore isn't the prophet enlightening America. People are more dissatisfied because medical care costs more and we consume more of it. It's that simple.
The system didn't change - the pressure of costs did. Those same costs pressures, btw, is what created the huge deficits in the various national systems and creating the big budget deficits.
Quote:
Originally Posted by RustyC
Depends how you count. There would certainly be more office visits than major operations, but which one's the stronger cost driver? If we average $12,000 a person in health care spending and the check-ups are $150x2, what's causing the other $11,700?
There are 3 major components of disproportinately high costs.
1) The minority who run up millions in medical bills who pay a tiny fraction of that. Then complains that they can't keep receiving that care without paying.
2) Chronic conditions. Diabetes and heart disease are the top. In the past, the patients died. Now, they can be kept alive for decades at high cost.
3) End of life care. People who make it to the age of 60 will run up greater medical expenses in the last 18 months of their life than the 60+ years which came before.
It's pork-barrel medical spending.
Quote:
Originally Posted by RustyC
People fear the bankrupting emergency.
Yes, they do.
Which is why UHS is primarily about the wallet. People don't want to pay in their own money when they think it's possible to get OTHER people to pay for it.
Quote:
Originally Posted by RustyC
The uninsured and underinsured don't get the check-ups and have economic disincentives there that need to be removed, but the cost problems are a lot bigger and more complex than fighting with employees over who pays for preventive care and from where. As it stands we're penny-wise and pound-foolish with access to preventive care, and the real endgame for extremists on the right is to blame individuals for any bad outcomes and let people die in the streets like a third-world country. I know that sounds inflammatory (it did when Rep. Grayson said it), but having needed care in such a country and having been effectively a part-time "health care exile" for about 7 years now.
This is false. People who have UHS don't get checkups that often either, and neither do the insured.
The best predictor of preventative care - socio-economic status. The white collar worker who has worse insurance than the auto worker will get check-ups even when he has to put in co-pay while the assembly-line guy who can get the same service absolutely free won't.
Ditto with Medicaid. Lower incidence of routine preventative care despite there being no out of pocket costs.
Quote:
Originally Posted by RustyC
I think I'm qualified to say it. Being the next Mexico is a lot scarier to me than possibly being the next Canada.
Is your fear credible?
No.
Quote:
Originally Posted by RustyC
If the private sector can't or won't provide certain basic necessities affordably, there's a legitimate role for government to at least guarantee access and affordability.
Then why is it that the government doesn't provide universal housing, food, and utilities on the same terms that you are asking for UHS?
What is "affordable" gene therapy? If the costs the private sector quotes is $500k a year, at what level do you set "affordability"???
Seems that for UHS advocates, the only acceptable level is... ZERO COST.
But make that same argument for any of life's OTHER necessities and suddenly it's not actually the government's role to provide universally high quality housing, food, utilities, transportation, etc... to everyone.
That's because UHS remains, at its heart, an entitlement program for the middle class where they claim that most selfish expenditure - taking care of their body - and make it a public expense. It's a mockery of the concept of social responsibility, doubly so when they take the funds which could help many MORE of the needy and spend it instead to save the wallets of the middle class.
Quote:
Originally Posted by RustyC
Those who might compare health care to some luxury item and make entitlement arguments miss that one entirely. Yet if we have a gas supply crunch like in Atlanta last September and some stations raise prices above $6 THEN you'll see a real outcry and the government stepping in.
Yes, it did happen.
The government stepped in and RATIONED the gas available to the public.
Quote:
Originally Posted by RustyC
Rather than argue the ideological point, the real question should be why anyone would expect the disenfranchised NOT to use their vote as a means to change things.
Who exactly got disenfranchised?
Are the unemployed "disenfranchised" from the job market?
Are all non-homeowners "disenfranchised" from the housing market?
You think it's possible to simply vote for something and have it magically appear? That didn't work at all for the communists.
Quote:
Originally Posted by RustyC
And if everybody had six figures in the bank they could lose that and not get bankrupted. In the real world, something like half of all bankruptcies have health expenses as a major if not decisive factor.
Completely false.
In the real work, the average medical bill in bankrupties is a matter of thousands - not even five figures.
Their largest debt, beside mortgage, is always credit card bills.
Quote:
Originally Posted by RustyC
A five-figure hospital bill is easy to get, and a condition like cancer could easily get six figures. Insurance companies will comb it line by line and partially deny or reimburse based on their own figures, leaving you holding the bag for tens of thousands of dollars. One of the most dangerous misconceptions people have is that their out-of-pocket will be capped by the deductible and copay (one of the goals of reform legislation is to make caps a reality).
People have misconceptions. Seems many of them also think of the minimum balance on their credit card as what they should be paying.
But it'd be ridiculous to propose an universal consumption program to provide everything which people used credit cards for in order to correct the misconception and debt people get into.
You might as well just nationalize the whole economy.
Quote:
Originally Posted by RustyC
Again, more and more people, myself included, know someone it happened to. That's turning the debate, plus the realization that the current system is simply unsustainable. The default path is a collapse to a third-world model where everything becomes fee-for-service and those who can't pay are literally left to die in the streets. Sounds hyperbolic to some, but it's the literal truth in most of the world.
The historical dialectic predicts that the proletariat will rise up once they realize that the capitalist system is simply unsustainable....
The inevitability of UHS is by no means guaranteed.
If anything, it's degrading to our humanity to listen to the self-satisfied advocates claim that UHS is part of necessity of life even though the more basic necessities of life aren't subject to government funding.
Except, of course, they are. They're subsidized and heavily regulated. One can, and should, question whethe they're the RIGHT subsidies and regulation (or even DECENT ones[*]), but it's disingenuous in the extreme to claim that they're not "subject to government funding."
Programs: Piggly Wiggly "Shop the Pig!" Preferred Shopper
Posts: 8,145
Quote:
Originally Posted by Klm is Dead - Long Live KLM
I suppose it depends on what you are trying to defend, or rationalize or fight for.
* * *
Whose interests are you advocating?
This is a common OMNI/PR misunderstanding. I am critiquing Kristof's argument. He does a very poor job of supporting his conclusion. I am not advocating anyone's interests here. Sure, I have my own opinions on health care, but whether those are sound or flawed, Kristof's argument remains weak for the reasons I gave.
If he wants to show that U.S. health care is worse than that of other nations, he shouldn't compare life expectancy, infant mortality rates and the like. So many things other than the quality of health care influence those measures. He should instead compare things like patient outcomes for the same treatment/surgery, disease detection, etc.
To do this comparison properly you need to adjust for the general health of the patient population. For example, it should come as no surprise that 50-year-old obese American with type II diabetes is less likely to have a successful kidney transplant than an Austrian marathoner of the same age. That is not something you can blame on the American health care system -- there is only so much cajoling it can do to get people off their duffs and away from the buffet tables.
Kristof ignores such critical differences in his useless comparisons.
This is a common OMNI/PR misunderstanding. I am critiquing Kristof's argument. He does a very poor job of supporting his conclusion. I am not advocating anyone's interests here. Sure, I have my own opinions on health care, but whether those are sound or flawed, Kristof's argument remains weak for the reasons I gave.
If he wants to show that U.S. health care is worse than that of other nations, he shouldn't compare life expectancy, infant mortality rates and the like. So many things other than the quality of health care influence those measures. He should instead compare things like patient outcomes for the same treatment/surgery, disease detection, etc.
To do this comparison properly you need to adjust for the general health of the patient population. For example, it should come as no surprise that 50-year-old obese American with type II diabetes is less likely to have a successful kidney transplant than an Austrian marathoner of the same age. That is not something you can blame on the American health care system -- there is only so much cajoling it can do to get people off their duffs and away from the buffet tables.
Kristof ignores such critical differences in his useless comparisons.
If you wanted to show the the childcare and educational system was better in one country or another would you look at the end result of what became of the children (are they happy, well adjusted, mature reasonable adults) and what the knowledge the actually can apply (objective test scores, prepared for work or university, the ability to reason, critical thinking skills, lifelong learning, landing on their feet) or would you look at micro "child intervention outcomes" and "classroom discussion techniques" perhaps both, but not the details without looking at the whole and the final outcomes.
Only a pedant would say that the technicalities of a system are more important than its total aggregate results. Kind of like "the operation was a success but the patient is dead."
Some Americans claim that the comparisons are not fair because health is influenced by other factors -- yet they are unwilling for those other factors to be put on the table. See the rejection of some of Pelosi's suggestions to educate consumers on calories and require labeling.
At the same time, it appears that Europeans have even more significant "unfair disadvantages" by smoking more, etc. So the knife cuts on both sides.
By the way, how do figure coming in dead last (pardon my pun) in the Robert Wood Johnson Foundation and the Urban Institute preventable deaths report is just because of too many McFlurries?
Yeah - Europe is really leaving America in the dust. It's a wonder why such advanced and enlightened people haven't become the paragon of human existence and the premiere power in the world, instead of languishing in America's shadow.
