Blog on the Run: Reloaded

Saturday, March 20, 2010 10:49 pm

Another urban legend sussed out; American civic discourse goes to hell


A Facebook friend who opposes the health-care bill now being debated in Congress sent me the following:

COMPARE THE MEDICAL RESULTS OF NATIONS WITH UNIVERSAL HEALTH COVERAGE AND THE UNITED STATES

Some interesting statistics from a survey by the United Nations International Health Organization.

% Men & Women who survived a cancer five years after diagnosis:
U.S. 65%
England 46%
Canada 42%

% Patients diagnosed with Diabetes who received treatment within six months:
U.S. 93%
England 15%
Canada 43%

% Seniors needing hip replacement who received it within six months:
U.S. 90%
England 15%
Canada 43%

% referred to a medical specialist who see one within one month:
U.S. 77%
England 40%
Canada 43%

Number of MRI Scanners (a prime diagnostic tool) per Million people:
U.S. 71
England 14
Canada 18

% of seniors (65+), with low income, who say they are in “excellent health”
U.S. 12%
England 2%
Canada 6%

It sounded bogus to me, primarily because although I’d covered health care as a journalist, I’d never heard of anything called the United Nations International Health Organization. So I Googled it. Didn’t find the organization, but I found a lot of mentions of it, most in the same context as you see here. A couple claimed this report had appeared in Investor’s Business Daily, but I ran a Google search of various phrases pulled at random from this piece against that site but didn’t get a single hit.

I suppose it’s only fitting that even on the eve of the vote, lies are still making their way around the world.

Relatedly, the Rev. Julie Peeples of Congregational United Church of Christ here in town had a nice piece in the N&R today in support of the health-care reform bill. As you would expect, the IGMFY crowd jumped on it. And at a rally in Washington today, opponents were calling Rep. John Lewis “nigger” and Rep. Barney Frank “faggot.” (And as you would expect, the wingnuts are either silent, in denial or blaming the victims.)

I get that they’re angry. What I don’t get is what they’re angry about. I further get that when people are angry, it’s usually because they’re, at bottom, afraid. But, in this case, afraid of what? Afraid of socialism? The majority of health care is in private hands now and will remain so if this bill is enacted. Afraid of higher costs? The CBO says it’ll reduce the deficit by $130 billion over 10 years and $2.2 1.2 trillion* the 10 years after that. Afraid that 30 million currently uninsured people will now have some kind of insurance? Scary.

We’ve had some truly scary stuff happen in this country in the past decade — terror attacks; illegal invasions; torture; warrantless wiretapping; theft of national wealth from the middle class to benefit a tiny, hyperwealthy elite. And this is what brings the spittle-spraying crowds to the steps of the Capitol?

Y’all oughta be ashamed. Thomas Jefferson would dopeslap every last one of you.

*Rather significant typo fixed. Savings are still huge, however.

UPDATE: The Facebook friend who originally sent me this asked some follow-up questions, which I figured might be of interest to those interested in this post. Here’s what I told her:

Comparing quality of health care among different countries is, as I learned while covering the medical beat, a complicated subject that’s measured in complicated ways. There’s no single link that will give you “the answer.” Moreover, systematic efforts to do so are barely 15 years old, so there’s not a ton of reliable data yet. (A generation from now we should be in better shape to draw some meaningful conclusions.)

The two most heavily used indicators of quality of health care are infant mortality rate (that is, number of deaths of children younger than 1 year per 1,000 live births) and average life expectancy at birth. In fact, infant mortality has been found to be a reliable indicator of not just health care but the effectiveness of national government in general.

But even those basic stats aren’t always reliable. For example, the former Soviet Union fudged infant mortality by not counting a lot of neonatal deaths as “live births”.

Still, those are starting points and most people can understand them without any special education or training, so let’s look at them.

The 2009 CIA Factbook’s ranking of 224 countries by infant mortality rate is at https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

You’ll find the U.S. with the 180th highest infant morality rate out of 224 countries, with 6.22 infant deaths per 1,000 live births. Countries with significantly lower rates — say, under 5 infant deaths per 1,000 live births — include pretty much all of Europe, along with such other countries as Israel, Macao, Hong King, Singapore, Japan and Bermuda. (Canada’s rate is 5.04.)

The life-expectancy-at-birth ranking is here: https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html

The U.S. ranks 49th out of 224 countries. We lag not only the usual suspects but also such places as Bosnia & Herzegovina, which not that long ago was one big shooting gallery.

And remember, we pay more than twice as much per capita for our health care as do citizens of anywhere else on the globe. If the care we were getting were twice as good — or even, by professional consensus, the best — that’d be one thing. Instead, we’re paying beyond top dollar for, comparatively speaking, mediocre care. So while no one could rationally claim that we have the worst health care system among industrialized countries, one can certainly claim rationally that we’re getting the least health care for our money of anyone. Indeed, it would be hard to argue rationally otherwise.

One reason this is so is because we place much more emphasis on treatment than prevention. And I mention this because the biggest public-health care problem of the next 20 years is going to be obesity, the best way to treat obesity is to prevent it, and we do an abominable job of preventing obesity.

A good overview of the subject of comparing nations’ health care, with some interesting examples, is here: http://www.rwjf.org/files/research/qualityquickstrikeaug2009.pdf

One thing I recall reading back in my newspaper days is that the gap between the U.S. and other countries gets a lot narrower when you look just at people older than 65, starting with the simple statistic of remaining life expectancy at age 65. Why? Simple: Medicare.

Also: here’s some interesting commentary on that report I linked earlier: http://www.thestatisticaltruth.com/BestinWorld.html

UPDATE: My friend replies:

I guess I’m listening to too much FoxNews. How come that is the only network that seems to bring up the uncomfortable issues like: the how the IRS will be involved and why I should be concerned about intrusion of the feds:

From The Washington Examiner, Byron York:

In short, health care reform, as currently envisioned by Democratic leaders, would be built on the foundation of an expanded and more intrusive IRS.
Under the various proposals now on the table, the IRS would become the main agency for determining who has an “acceptable” health insurance plan; for finding and punishing those who don’t have such a plan; for subsidizing individual health insurance costs through the issuance of a tax credits; and for enforcing the rules on those who attempt to opt out, abuse, or game the system. A substantial portion of H.R. 3200, the House health care bill, is devoted to amending the Internal Revenue Code of 1986 in order to give the IRS the authority to perform these new duties.

Read more at the Washington Examiner: http://www.washingtonexaminer.com/politics/Health-care-reform-means-more-power-for-the-IRS-56781377.html#ixzz0iq0AJBDg

P.S. This is not “stoopid.”

And I replied:

This is one of a number of aspects of the bill with which I do not agree. Like I said, the bill is not perfect, it’s just preferable to the status quo, which is the only other option on the table.

And Fox is far from the only outlet that objects to this provision. A lot of people far to my left objected to it as well. (Example.)

That said, most people who already have health insurance through their employers aren’t going to notice any much difference. (Update: premium changes are in the range of 1% in most categories; some go down, some go up.) Fox is simply trying to use the IRS to scare people because appealing to them on the basis of factual argument wasn’t getting them anywhere.

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9 Comments

  1. My husband is a doc, and another doc just emailed him the exact same original healthcare comparison information today! I think the reason doctors immediately spark to that info is because it rings completely true… in Canada and the UK health outcomes are not as good as they are here. That is why Canadians and Brits of means come here for their treatments! I don’t see too many of us moving away…yet. So far it’s been better than anywhere else. My left-leaning friends seem to enjoy sending links to WHO and citing infant mortality rate comparisons… but I think my aunt’s macular degeneration treatment, my dad’s neuro-surgery for a pinched nerve in his neck, my husband’s MRI to rule out certain health problems and my anterior-cruciate ligament surgery have given extra value to our lives that we would not be getting in Canada or the UK.

    Doctors have absolutely had it with Medicaid and Medicare already. I think the patients are also fed up. Now we are adding ObamaCare? We are adding 15 million new patients to Medicaid, already overburdened. We are gutting Medicare Advantage to pay for ObamaCare? What a mess. Mayo Clinic here in my town does not accept new Medicare patients. Hospitals can only take so many Medicaid recipients, and the waiting lines are long. No smart and ambitious kids will enter med school if this is the new system. Already there are dire shortages of medical personnel. Further, which smart and ambitious kids will want to be the productive citizens that are not just asked but mandated to care for the weak brothers who can’t or won’t care for themselves? Who wants to pay 40-50-60% of their hard-earned income in taxes?

    The come-to-Jesus meeting will be when we head to the hospital with some bad symptoms and the only ones working there are some community organizers and the IRS compliance agents.

    Comment by Liz Reiman — Sunday, March 21, 2010 9:45 pm @ 9:45 pm

  2. My practice experience goes back to 1965, with active practice on salary in a respected multi-specialty clinic in rural New Hampshire (1971-2004). Atul Gawande’s writing is a beautifully crafted perspective on where we’ve been and where we’re going in medicine in the U.S.

    The traditional capitalist system offer a poor model on which to shape medical care insurance: short-term assessment of profit/loss, cut your out-lays to the bone, shed your cost centers (everyone submitting claims), leave the young, healthy citizens alone (leaving your subscriber base skinny), and ramp up your exclusions to the max, even if you have to do it retro-actively. Bankruptcy, anyone?

    Comment by Michael Mayor — Tuesday, August 28, 2012 6:16 pm @ 6:16 pm

  3. So Liz thinks as long as she has hers all is good. Of course things are faster in the US. A lot of citizens don’t have insurance vs countries where everyone does. Which also affects the statistics in the story. If you don’t have insurance you die from cancer never knowing you had it.

    And why would there be a wait for treatment of Diabetes? How long does it take a Dr write a script for insulin and a someone else to explain how to change your diet.

    Comment by Steve Wimmer — Wednesday, June 19, 2013 10:22 am @ 10:22 am

  4. Yeah, Steve, Liz is a card-carrying member of the IGMFY crowd. She was in my younger brother’s high-school class, and to this day she remains the only Facebook friend (out of 800+) I’ve ever de-friended because I finally got tired of her bullshit. For someone who’s married to a physician, her ignorance regarding health-care macroeconomics was stunning, bordering on willful. I realize there’s research on how conservatives are less able to cope with cognitive dissonance than liberals, but even by those standards, she struck me as someone who ate magic mushrooms with every meal.

    Comment by Lex — Wednesday, June 19, 2013 10:46 am @ 10:46 am

    • Back in 2010 – those were the days! – when Lex was working as an arm of the state to verbally bludgeon us into accepting the health care reform proposals coming from the top down in Washington. Here is a quite from his blog at the time (replying to me):

      That said, most people who already have health insurance through their employers aren’t going to notice any much difference. (Update: premium changes are in the range of 1% in most categories; some go down, some go up.) Fox is simply trying to use the IRS to scare people because appealing to them on the basis of factual argument wasn’t getting them anywhere.

      Lex! Fox was just using the IRS to try to scare people? That sounds funny in light of the recent Revelations about the IRS. People who already had employment-based health insurance would keep their plans? Who was eating magic mushrooms and drinking the Kool Aid?

      I think you de-friended me because I would not just accept your expertise or your abuse, which was always vibrantly sarcastic, vitriolic and personal. Being on a health care beat at a newspaper is like being a PR writer for whichever Democratic plan is being pushed through at the time.

      Comment by Liz Reiman — Saturday, June 22, 2013 10:14 am @ 10:14 am

  5. Sorry, Liz, but my last day in the newspaper bidness was Jan. 2, 2009. Also, as an investigative reporter who specialized in tax-exempt organizations, I can tell you that the IRS has committed some screwups in the context of an enormous flood of new 501c4 groups post-Citizens United — roughly 20 on the right for every one on the Left, most of them nothing but blind PACS and many of them created by people, unlike the activists of the Left, with no experience in the laws, rules and paperwork of exempt organizations. The problem originated in the Cincinnati office, which handles exempt organizations, and most of those staffers have only seen the White House on television. The acting director of the IRS — who, by the way, was a Bush appointee — was fired.

    And let me get this straight: *I* defriended you because *you* would not accept *my* abuse? Liz, darlin’, you’re a walking case of borderline personality disorder. You need to get that checked.

    Comment by Lex — Saturday, June 22, 2013 5:36 pm @ 5:36 pm

  6. This whole thing is evidence of your abuse. My last comment here before you decided to rip me a new one Wednesday morning was in March 2010!! Talk about a personality disorder!

    Just because your last day on a newspaper was in 2009 doesn’t mean you quit working for the cause: Big Government. Have at it, noble warrior! Current problems with the IRS, Obamacare, and the NSA are examples of how wrong this can go, and things are getting worse. It is in fact a brave new world that I can’t believe you want your children to live in! Good luck!

    Comment by lizreiman — Sunday, June 23, 2013 10:41 am @ 10:41 am

  7. I responded to a new comment that was directly about you. If you think I do not have the right to do that on my own blog, you really DO have borderline personality disorder. And for the record, as documented in multiple places on this blog for those who care to look, I supported Obamacare because the only other option on the table was the status quo, which was simply unacceptable.

    And while you call Obamacare a Big Government cause, let me remind you that all its major concepts originated with the Heritage Foundation, not the government and certainly not an arm of the Democratic Party.

    Finally, as I pointed out above, the IRS is a tempest in a teapot, and the NSA problem is something I started raising hell about one HELL of a long time before you and your friends. (I also raised hell about the New York Times’ holding its original wiretapping story for more than a year to help Bush 43 get re-elected.) All of this is available to anyone who wants to go back through this blog and peruse the statements in real time, as the events in question were happening.

    But that’s it, Liz. We’re done here, and you’re done on this blog, period. The house rules are quite clear.

    Comment by Lex — Sunday, June 23, 2013 2:50 pm @ 2:50 pm

  8. thank you Lex, Saved me a lot of writing :)

    Comment by Doug King — Friday, December 27, 2013 3:40 pm @ 3:40 pm


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