Posted on 08/10/2009 7:36:14 PM PDT by gusopol3
June E. O'Neill and Dave M. O'Neill address the NHI issue by comparing Canada's publicly funded, single-payer health care system to the multi-payer heavily private U.S. system.31 They argue that differences between the United States and Canada in infant mortality and life expectancy -- the two indicators most commonly used as evidence of better health outcomes in Canada -- cannot be attributed to differences in the effectiveness of the two health care systems because they are strongly influenced by differences in cultural and behavioral factors, such as the relatively high U.S. incidence of obesity and of accidents and homicides. Direct measures of the effectiveness of medical care show that five-year relative survival rates for individuals diagnosed with various types of cancer are higher in the United States than in Canada, as are infant survival rates of low-birthweight babies. These successes are consistent with the greater U.S. availability of high level technology, higher rates of screening for cancers, and higher treatment rates of the chronically ill. The need to ration when care is delivered "free" ultimately leads to long waits. The health-income gradient is at least as prominent in Canada as it is in the United States.
Focusing on the United States, Cutler, Dobkin, and Nicole Maestas exploit the sharp change in health insurance characteristics of the population that occurs at age 65 because most people become eligible for Medicare to investigate whether this change matters for health.32 They address this issue by examining differences in mortality for severely ill people who were admitted to California hospitals just before and just after their 65th birthday. They estimate a nearly 1 percentage point drop in 7-day mortality for patients at age 65, implying that Medicare eligibility reduces the death rate of this severely ill patient group by 20 percent.
(Excerpt) Read more at nber.org ...
This article makes salient points in refuting what is Democrats' campaign to trash US healthcare.
That’s an awfully long article at the link. In skimming over it, I noticed that a lot of facts are presented in the absence of a meaningful context, the wrong comparisons are made, or information that seems like it should be there is omitted.
For instance,
“Focusing on the United States, Cutler, Dobkin, and Nicole Maestas exploit the sharp change in health insurance characteristics of the population that occurs at age 65 because most people become eligible for Medicare to investigate whether this change matters for health. They address this issue by examining differences in mortality for severely ill people who were admitted to California hospitals just before and just after their 65th birthday. They estimate a nearly 1 percentage point drop in 7-day mortality for patients at age 65, implying that Medicare eligibility reduces the death rate of this severely ill patient group by 20 percent. The mortality gap persists for at least two years following the initial hospital admission.”
makes no sense whatsoever. It seems to be saying that having government coverage in the form of Medicare leads to better health incomes than having other, non-government, coverage—which is totally ludicrous.
In another paragraph, the authors discussed a study of people who, apparently, had never had health care until their country got socialized medicine, at which time their health improved. But that’s the wrong comparison. The proper comparison is between people who have socialized medicine vs. people who have private insurance and/or the means to pay for all their medical needs themselves.
I take it to mean that people who had been uninsured as they approached their 65th birthday, when they obtain Medicare coverage, do better when they do have access to medical care , i.e, just after their 65th birthday, than when they didn't, i.e. just prior to that, when they are severely ill and in the hospital. It's fairly easy to see how that could happen, although I certainly agree, it's not examined sufficiently to be proven in this review article.
On the other hand, as I said, the article refutes nicely the talking point I'm hearing all the Democrats make, that US health outcomes are worse than other countries. For instance, Ben Cardin at his town hall last night, absolutely trashing US health system. The litany usually begins with "44th in infant mortality, 17 th in life expectancy" as outlined in World Health Organization report (I made the rankings up, but you get the idea). There's a long list they have, including heart disease and cancer; this article makes clear those things are no measure of the excellence of the health care system. For instance, among Sicko's lies was the "fact" that Cuban infant mortality was better than US's. Humberto Fontova says that any problem pregnancy there is terminated, bingo, you've just improved your infant mortality statistic. Here, with our advanced technology, we try to save the 30 wk preemie, and consequently end up with a statistic. Can you imagine being as craven as the Dems are to try to use that to advance their purposes?
I guess that passage could be interpreted different ways, if you read into it things that were not specified. People admitted into the hospital are going to get treated; it looked to me like it was saying that Medicare coverage alone resulted in better outcomes, with no mention of the care received, or other coverage.
“For instance, among Sicko’s lies was the “fact” that Cuban infant mortality was better than US’s. Humberto Fontova says that any problem pregnancy there is terminated, bingo, you’ve just improved your infant mortality statistic. Here, with our advanced technology, we try to save the 30 wk preemie, and consequently end up with a statistic.”
I remember reading that in East Germany, they used to call every premature birth an abortion, so that they could allow the premies to die without making any effort to save them, and keep infant mortality rates low at the same time. The comparisons of mortality rates that Dems love so much are really meaningless, unless the comparisons are among precisely defined categories (e.g. 5 year survival rates of melanoma in specific age groups).
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