Comments on: US Medicine — Best In The World http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html Dispatches from a Small Business Wed, 17 Mar 2010 11:52:25 +0000 http://wordpress.org/?v=2.9.2 hourly 1 By: Pieter http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22452 Pieter Tue, 25 Aug 2009 14:23:26 +0000 http://www.coyoteblog.com/?p=8737#comment-22452 Once you start picking and choosing your metric, it's very easy to rearrange rankings. Consider what would happen if, instead of removing the effects of murder and car crashes which are big killers in the US, we left them in and removed suicide and alcoholism, which are even more reasonably classified as "lifestyle" choices since the person killed is actually the one making the choice. I've not checked the data, but I imagine removing suicide and alcoholism wouldn't have a big impact on US life expectancy, but it would make countries like Sweden -with 3 months of continuous darkness- look even better, since suicide and alcoholism are major causes of death there. There's only a few dozen countries even in the running for longest life expectancy, and there's easily dozens of ways that might appear to be reasonable ways to correct it. When there's more choices of metrics than objects to be compared, it's easy to manipulate rankings. That's why, in a situation like this, it makes sense to stick with the raw data when trying to make comparisons. Similarly, it makes little sense to say that US health statistics need to be adjusted to reflect that there's a large Hispanic population without trying to make a similar adjustment to European figures to reflect the larger Muslim population. (This is a response to other posters, not a criticism of Coyotes post which didn't make this error.) This demonstrates why it's important to focus on that there's many countries all quite close to each other in health care outcomes, but with the US being a real outliers in spending, either as a percentage of GDP or even more so in absolute terms per capita. I'm also going to comment on your final point about equality and freedom. In my experience, the overwhelming majority of people on the left believe that increased equality leads to more freedom, not less. This is the basic principle of democratic government: that if we are all treated equally, then we can all be free. We are all much more equal than in the days of aristocracy and slavery, and we are also all much more free. The inequalities and injustices of modern capitalism are much milder, but, for example, the enormous inequality in wealth between me and the owners of the Walt Disney company mean that their opinion prevails over mine on retroactively extending copyright privileges 70 years after the death of an author, an idea for which there is no legitimate economic justification. After 9/11, I had to wait in a long line for lengthy security checks at Newark airport, while employees of major companies had a separate check in system. These are just two examples where wealth wins legal privileges. Once you start picking and choosing your metric, it’s very easy to rearrange rankings. Consider what would happen if, instead of removing the effects of murder and car crashes which are big killers in the US, we left them in and removed suicide and alcoholism, which are even more reasonably classified as “lifestyle” choices since the person killed is actually the one making the choice. I’ve not checked the data, but I imagine removing suicide and alcoholism wouldn’t have a big impact on US life expectancy, but it would make countries like Sweden -with 3 months of continuous darkness- look even better, since suicide and alcoholism are major causes of death there. There’s only a few dozen countries even in the running for longest life expectancy, and there’s easily dozens of ways that might appear to be reasonable ways to correct it. When there’s more choices of metrics than objects to be compared, it’s easy to manipulate rankings. That’s why, in a situation like this, it makes sense to stick with the raw data when trying to make comparisons.

Similarly, it makes little sense to say that US health statistics need to be adjusted to reflect that there’s a large Hispanic population without trying to make a similar adjustment to European figures to reflect the larger Muslim population. (This is a response to other posters, not a criticism of Coyotes post which didn’t make this error.)

This demonstrates why it’s important to focus on that there’s many countries all quite close to each other in health care outcomes, but with the US being a real outliers in spending, either as a percentage of GDP or even more so in absolute terms per capita.

I’m also going to comment on your final point about equality and freedom. In my experience, the overwhelming majority of people on the left believe that increased equality leads to more freedom, not less. This is the basic principle of democratic government: that if we are all treated equally, then we can all be free. We are all much more equal than in the days of aristocracy and slavery, and we are also all much more free. The inequalities and injustices of modern capitalism are much milder, but, for example, the enormous inequality in wealth between me and the owners of the Walt Disney company mean that their opinion prevails over mine on retroactively extending copyright privileges 70 years after the death of an author, an idea for which there is no legitimate economic justification. After 9/11, I had to wait in a long line for lengthy security checks at Newark airport, while employees of major companies had a separate check in system. These are just two examples where wealth wins legal privileges.

]]> By: Corossus http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22403 Corossus Sun, 23 Aug 2009 22:39:47 +0000 http://www.coyoteblog.com/?p=8737#comment-22403 "You may have seen stats that say that, using raw data, the US has the best life expectancy once you reach age 65." No doubt that adjusting for age helps to "correct out" accidents and murder in the U.S life expectancy, which disproportionately affect younger groups. But age 65 is also the qualifying age for Medicare, thus those who make it to that age do indeed have lower risk for accidents and murder AND qualify for health insurance. I won't lay claim to being able to separate out these two effects on life expectancy at age 65. An article that took advantage of the age specificity and universal nature of Medicare estimated the effects of insurance acquisition on morbidity and mortality. Full citation... Frank R. Lichtenberg (2002) "The Effects of Medicare on Health Care Utilization and Outcomes," Forum for Health Economics & Policy: Vol. 5: (Frontiers in Health Policy Research), Article 3. http://www.bepress.com/fhep/5/3 Abstract http://www.bepress.com/fhep/5/3/ “You may have seen stats that say that, using raw data, the US has the best life expectancy once you reach age 65.”

No doubt that adjusting for age helps to “correct out” accidents and murder in the U.S life expectancy, which disproportionately affect younger groups. But age 65 is also the qualifying age for Medicare, thus those who make it to that age do indeed have lower risk for accidents and murder AND qualify for health insurance. I won’t lay claim to being able to separate out these two effects on life expectancy at age 65. An article that took advantage of the age specificity and universal nature of Medicare estimated the effects of insurance acquisition on morbidity and mortality.

Full citation…

Frank R. Lichtenberg (2002) “The Effects of Medicare on Health Care Utilization and Outcomes,” Forum for Health Economics & Policy: Vol. 5: (Frontiers in Health Policy Research), Article 3.
http://www.bepress.com/fhep/5/3

Abstract

http://www.bepress.com/fhep/5/3/

]]> By: HS http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22272 HS Thu, 20 Aug 2009 17:18:47 +0000 http://www.coyoteblog.com/?p=8737#comment-22272 My dad died of cancer. The hard question is... if you can pay to add another year or two to your loved one's life but spend everything in the process, would you do it? Thank God I never had to answer that question, but I came close. I don't want the government answering that question for me. My dad died of cancer. The hard question is… if you can pay to add another year or two to your loved one’s life but spend everything in the process, would you do it? Thank God I never had to answer that question, but I came close. I don’t want the government answering that question for me.

]]> By: Thebastidge http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22227 Thebastidge Wed, 19 Aug 2009 23:05:29 +0000 http://www.coyoteblog.com/?p=8737#comment-22227 I guess I was being prescient in my point # 2 above: At my town hall meeting last night, they brough up this very point, saying that America lags behind Sweden, Cuba and various other socialist paradises specifically in infant mortality. I had to call bullshit VERY loudly on that. Fortunately, several hundred other people did so with me, though I was the first. I guess I was being prescient in my point # 2 above:

At my town hall meeting last night, they brough up this very point, saying that America lags behind Sweden, Cuba and various other socialist paradises specifically in infant mortality.

I had to call bullshit VERY loudly on that. Fortunately, several hundred other people did so with me, though I was the first.

]]> By: joshv http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22216 joshv Wed, 19 Aug 2009 21:55:15 +0000 http://www.coyoteblog.com/?p=8737#comment-22216 IR: We could simply be diagnosing the disease early, and having absolutely no success treating it. If you come up with a new test that allows you to find breast cancer 1 year earlier than was previously detectable and then apply that test to the general population, you are going to see an increase in five year survival rates no matter how effective your treatments are. Even scarier you might see in increase in five year survival rates even if your treatments *decrease* life expectancy. IR: We could simply be diagnosing the disease early, and having absolutely no success treating it. If you come up with a new test that allows you to find breast cancer 1 year earlier than was previously detectable and then apply that test to the general population, you are going to see an increase in five year survival rates no matter how effective your treatments are. Even scarier you might see in increase in five year survival rates even if your treatments *decrease* life expectancy.

]]> By: IR http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22197 IR Wed, 19 Aug 2009 17:32:46 +0000 http://www.coyoteblog.com/?p=8737#comment-22197 joshv, What's the difference how the result is achieved? Whatever we doing seems to be better than whatever they are doing in other country. This is the point of the statisitc. joshv,

What’s the difference how the result is achieved? Whatever we doing seems to be better than whatever they are doing in other country. This is the point of the statisitc.

]]> By: joshv http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22194 joshv Wed, 19 Aug 2009 16:15:11 +0000 http://www.coyoteblog.com/?p=8737#comment-22194 Coyote, coyote - five year survival rates are pretty much meaningless - a statistical conflation of actual treatment efficacy and diagnostic timeliness. It's impossible to tease out whether or not an increase in five year survival rates is due to the fact that you are catching the cancers earlier, or treating them more effectively. Coyote, coyote – five year survival rates are pretty much meaningless – a statistical conflation of actual treatment efficacy and diagnostic timeliness. It’s impossible to tease out whether or not an increase in five year survival rates is due to the fact that you are catching the cancers earlier, or treating them more effectively.

]]> By: Current http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22193 Current Wed, 19 Aug 2009 15:31:31 +0000 http://www.coyoteblog.com/?p=8737#comment-22193 DrT, Coyote, See http://www.sciencedaily.com/releases/2005/06/050627061421.htm DrT, Coyote,

See http://www.sciencedaily.com/releases/2005/06/050627061421.htm

]]> By: ilovebenefits http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22176 ilovebenefits Wed, 19 Aug 2009 00:41:44 +0000 http://www.coyoteblog.com/?p=8737#comment-22176 Thank you for posting this information. It is an interesting result when you remove the two factors (accidents and murders). This is something that to my knowledge is not exposed elsewhere. www.ilovebenefits.wordpress.com Thank you for posting this information. It is an interesting result when you remove the two factors (accidents and murders). This is something that to my knowledge is not exposed elsewhere. http://www.ilovebenefits.wordpress.com

]]> By: Anonymous http://www.coyoteblog.com/coyote_blog/2009/08/us-medicine-best-in-the-world.html/comment-page-1#comment-22175 Anonymous Wed, 19 Aug 2009 00:38:56 +0000 http://www.coyoteblog.com/?p=8737#comment-22175 I'm glad that the figures bear this out, but the fact remains that arguing about un-Constitutional legislation's fiscal favorability is still arguing about the favorability of un-Constitutional legislation. The fact that we've gotten this far proves that legality takes an implicit back seat in voting to redistribute wealth. I’m glad that the figures bear this out, but the fact remains that arguing about un-Constitutional legislation’s fiscal favorability is still arguing about the favorability of un-Constitutional legislation. The fact that we’ve gotten this far proves that legality takes an implicit back seat in voting to redistribute wealth.

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