A few more thoughts on the topic of the extent to which a health care system affects life expectancy at birth and infant mortality:
...
Life Expectancy
While a good health care system may, by intervention, extend the life of a small percentage of a population, it has very little to do with overall life spans. Life expectancy “in all but the least-developed countries” is primarily a result of genetic and social factors (e.g., lifestyle, environment, education, etc.) rather than the quality of medical care.
For example, Japan’s average life expectancy (78.6 years) is one of the highest in the world, about three years higher than that in the U.S. If the three-year difference were the result of lower-quality health care in the United States, you would expect Japanese-Americans living in this country to experience shortened life spans.
They don’t. According to the National Asian Pacific Center on Aging, in 1980 (the latest numbers available) white Americans had an average life expectancy of 76.4 years, while Japanese-Americans had an average life expectancy of 79.7 years - just about the same three-year spread that exists between the populations of the two countries. Similarly, the California Department of Health reports that people of Asian or Pacific Island ethnic origin living in the state and using its health care system have a life expectancy 5.3 years longer (81.2 versus 75.9 years) than white Californians.
...
Infant Mortality.
Critics claim that the second-best indicator of the quality of health care is infant mortality. However, the evidence shows that differences in infant mortality frequently reflect differences in genes, lifestyles and environments rather than in the quality of medical care.
Data from the California Department of Health Services, for example, show that the average infant mortality rate was 8.6 deaths per 1,000 live births in the 1980s. But Americans of Japanese descent living in California had an infant mortality rate of 4.8 deaths per 1,000 live births through 1989 (the latest data available for these populations), while Chinese had 7.1 deaths, Filipinos 7.8 deaths, Hispanics 7.8 deaths, whites 7.7 deaths and blacks 18.0 deaths per 1,000 live births.
Since individuals in the different groups often live in the same communities and use the same hospitals and physicians, the difference clearly is a result of something more than the health care system.
...
Stop crying. You got busted presenting propaganda from a conservative think tank instead of hard facts. No big deal, just try not to do it next time.
The “success” of the US health care system has been known for years. It’s an excellent system if you have the money to access it. That large segments of the US population can’t access it is the problem. That’s why our mortality numbers are behind everyone else’s. It’s been that way for quite awhile now.
By the way, presenting qualifiers from the UN doesn’t refute the position of the US in the list of industrialized countries. That’s a disingenuous argument. You’re attempting to misrepresent what the qualifier means, implying that because there is a qualifier, then the whole analysis is wrong. Dishonest.
Atlan: I’LL TALK LOUDER SO THAT I DON’T HAVE TO ADDRESS THE ISSUE.
Get a life. The arguments presented in the article are cogent, logical, and worth considering. “Crying” does not seem to be what CG is doing. It seems to be what you are doing. You don’t like where those statements lead, so they must be propaganda. Are you saying that:
The statistics collected on these two parameters are collected in a reliable, standard, reproducible manner by all countries compared? If so, how do you know that. If not, then you are not contradicting the statements, are you.
You are so reliably pompous. It’s funny, really.
Oscar77,
Typing in upper case doesn’t increase “the volume” of text, unless you have some sort of disability which requires you to use a text-to-voice conversion program.
The National Center for Public Policy Research is a conservative think tank. Think tanks are tasked to present arguments and viewpoints which are consistent with the desires and ideologies of those parties who fund them. No mystery there. Tell me you’re not so naive up there in Boise as to believe that think tanks are objective?? You can’t be that stupid.
I just pointed out just who the source (and biases) of ChicagoGabriel’s source was, that’s all. That appears to have bothered both you and ChicagoGabriel.
The position of the United States in the World Health Organization standings have been consistent for awhile now. It’s a matter of concern.
You have heard of the World Health Organization, haven’t you??
Am I pompous or are you just out of touch?? I suppose namecalling and ad hominem might get you caught up on your reading but it’s never worked for me.
No, the answer is...........you are pompous. And pretty obtuse, since you didn’t apparently notice that the upper-case letters were me depicting YOU.
Is the pathologist from Boise actually offering a “I know I am but what are you??” argument??
(laughter)
I never use upper case for an entire sentence. Are you confused??
(laughter)
“The position of the United States in the World Health Organization standings” is not in dispute here. What is in dispute is how they got to those numbers, how the UN got to their numbers, etc. So try to stay up, will you?
Actually, ChicagoGabriel’s source is questioning the legitimacy of the ranking system. I surprised and heartened that you agree with me and feel that the position of the United States in the World Health Organization standings is not in dispute. We’re in agreement on that point.
the WHO is quite good when they are doing what they were supposed to be doing. I have several of their publications on various tumor classification systems. When they are talking about diagnosis and treatment, they are fine. What is NOT fine is when they are pontificating about political change. Then, they have transgressed from medical opinion into political opinion, where my opinion is as good as theirs.
Wait, are you now saying that the agency “that is quite good when they are doing what they are supposed to be doing” doesn’t do such a good job when the United States doesn’t rank so high? Sounds to me like someone doesn’t like to hear bad news.
I suppose namecalling and ad hominem might get you caught up on your reading but it’s never worked for me.
ROFL!!!! This one is a classic! (uproarious side-splitting, tear-emitting laughter) Nearly your every response includes an ad hominem! That is what caused me to drop you down the list in terms of liberals that I respect in here. You started that way, you have continued that way, and you are currently that way. If your communication didn’t include such a plethora of ad hominems, you’d never hear one from me directed to you. But, it is apparently your language. That and pomposity.
(laughter)
Do you really think I come here desirous of your approval, pathologist?? Now that’s pompous, especially when you’ve been beaten by an anonymous blogger on an issue of science. Guess again.
Thanks CG for giving us a insightful look into this.
...
My pleasure.
Thresherman - 01 February 2008 07:28 AM
...
Never mind Altan, he is just in a snit because one of the liberal memes to try to justify nationalizing healthcare took a hit from what you posted.
...
Oh, that’s just “Altan” being “Altan”. I wouldn’t expect anything else from him by now.
What I do find interesting is the deafening silence emanating from the usual “The U.S. health care system is an international embarrassment” crowd here on PL. This thread has been up since mid-day yesterday and is coming up on 200 views, so it’s not as if they haven’t seen it. The odds of THAT would be close to nil in my estimation.
A few more thoughts on the topic of the extent to which a health care system affects life expectancy at birth and infant mortality:
...
Life Expectancy
While a good health care system may, by intervention, extend the life of a small percentage of a population, it has very little to do with overall life spans. Life expectancy “in all but the least-developed countries” is primarily a result of genetic and social factors (e.g., lifestyle, environment, education, etc.) rather than the quality of medical care.
For example, Japan’s average life expectancy (78.6 years) is one of the highest in the world, about three years higher than that in the U.S. If the three-year difference were the result of lower-quality health care in the United States, you would expect Japanese-Americans living in this country to experience shortened life spans.
They don’t. According to the National Asian Pacific Center on Aging, in 1980 (the latest numbers available) white Americans had an average life expectancy of 76.4 years, while Japanese-Americans had an average life expectancy of 79.7 years - just about the same three-year spread that exists between the populations of the two countries. Similarly, the California Department of Health reports that people of Asian or Pacific Island ethnic origin living in the state and using its health care system have a life expectancy 5.3 years longer (81.2 versus 75.9 years) than white Californians.
...
Infant Mortality.
Critics claim that the second-best indicator of the quality of health care is infant mortality. However, the evidence shows that differences in infant mortality frequently reflect differences in genes, lifestyles and environments rather than in the quality of medical care.
Data from the California Department of Health Services, for example, show that the average infant mortality rate was 8.6 deaths per 1,000 live births in the 1980s. But Americans of Japanese descent living in California had an infant mortality rate of 4.8 deaths per 1,000 live births through 1989 (the latest data available for these populations), while Chinese had 7.1 deaths, Filipinos 7.8 deaths, Hispanics 7.8 deaths, whites 7.7 deaths and blacks 18.0 deaths per 1,000 live births.
Since individuals in the different groups often live in the same communities and use the same hospitals and physicians, the difference clearly is a result of something more than the health care system.
...
The National Center for Policy Analysis. Yet another conservative think tank. Sponsors include: Sarah Scaife Foundation - $125,000, Earhart Foundation - $40,000, Armstrong Foundation - $45,000, The Lynde and Harry Bradley Foundation, Inc. - $195,000, Gordon and Mary Cain Foundation - $25,000, Claude R. Lambe Charitable Foundation - $25,000
The NCPA web site states that in 2006 it receives 62% of its funding from foundations, 21% from corporations, and 17% from individuals. [4] Between 1985 and 2005, the Center received $8,499,850 in 161 separate grants.
Previous years:
* Castle Rock Foundation
* Earhart Foundation
* JM Foundation
* Koch Family Foundations (David H. Koch Foundation, Charles G. Koch Foundation, Claude R. Lambe Foundation)
* John M. Olin Foundation, Inc.
* Lynde and Harry Bradley Foundation
* Philip M. McKenna Foundation, Inc.
* Scaife Foundations (Scaife Family, Sarah Mellon Scaife, Carthage)
* DaimlerChrysler Corporation Fund
* El Paso Energy Foundation
* ExxonMobil Foundation
* Eli Lilly and Company Foundation
* Lilly Endowment
* Procter & Gamble Fund
(laughter)
Don’t get me wrong. Dick Scaife has as much right to influence public opinion as the next billionaire. Just don’t try to pass it off as wide-eyed & innocent objective research.
Here’s what the The King’s Fund (links to who they are, what they do, etc., are provided below), one of the U.K.’s premier charitable organizations specializing in health care issues, has to say vis-a-vis the various points touched upon in this thread:
...
How valid are comparisons between different countries’ health services?
... defining what a ‘world-class’ health service looks like is in fact far from easy. The reality is that it is difficult to make accurate comparisons between health care in different countries because data are often collected in different ways, and current data are often unavailable.
...
How does expenditure relate to quality?
Across the world, money spent on a health care system does not necessarily translate into better-quality health care services.
...
Can money buy good health?
The connection between the amount spent on health care and the underlying health of people in different countries, measured in terms of life expectancy or death rates, is weaker still.
...
Can meaningful international comparisons be made?
Despite the many difficulties in making meaningful international comparisons, the World Health Organisation (WHO) attempted to rank health systems in its 2000 World Health Report.
In doing so, it factored in: the level of people’s health; the responsiveness of the health care system (for example, how many people waiting at any given time?) and the fairness of financing (who pays and how much?), measured against what might be expected given the country’s level of economic and educational development.
According to this measurement, France topped the league, with the UK trailing in eighteenth place.
Despite having been widely used, WHO’s methodology has been subject to criticism, not least because much of the underlying data proved on closer examination to be very unreliable and inaccurate, leading many experts to question whether such a ranking should have been undertaken at all.
...
Here’s what the The King’s Fund (links to who they are, what they do, etc., are provided below), one of the U.K.’s premier charitable organizations specializing in health care issues, has to say vis-a-vis the various points touched upon in this thread:
...
How valid are comparisons between different countries’ health services?
… defining what a ‘world-class’ health service looks like is in fact far from easy. The reality is that it is difficult to make accurate comparisons between health care in different countries because data are often collected in different ways, and current data are often unavailable.
…
How does expenditure relate to quality?
Across the world, money spent on a health care system does not necessarily translate into better-quality health care services.
…
Can money buy good health?
The connection between the amount spent on health care and the underlying health of people in different countries, measured in terms of life expectancy or death rates, is weaker still.
…
Can meaningful international comparisons be made?
Despite the many difficulties in making meaningful international comparisons, the World Health Organisation (WHO) attempted to rank health systems in its 2000 World Health Report.
In doing so, it factored in: the level of people’s health; the responsiveness of the health care system (for example, how many people waiting at any given time?) and the fairness of financing (who pays and how much?), measured against what might be expected given the country’s level of economic and educational development.
According to this measurement, France topped the league, with the UK trailing in eighteenth place.
Despite having been widely used, WHO’s methodology has been subject to criticism, not least because much of the underlying data proved on closer examination to be very unreliable and inaccurate, leading many experts to question whether such a ranking should have been undertaken at all.
...
Stopped a little quick in your quoting of the British report.
Why make comparisons at all?
Despite all these problems, making international comparisons is not a pointless exercise.
All developed countries currently face similar health challenges, such as increasingly ageing populations, or new diseases and risks, such as SARS or HIV/AIDS.
Their health care systems are under very similar pressures, including limited funding and resources, growing public demand for better services, and more and better drugs and technologies being developed by the day. In every country, the search is on to find the most efficient means of providing health care.
Looking abroad gives policy-makers wider choice of policy solutions. But it is clear from even a brief review of international comparisons that there is no ideal model of health care, and no country can claim to have solved all the issues involved in providing it.
(laughter)
Took you three attempts to get to an organization without obvious bias and you had to go overseas, to a “socialist” country, to find one.
You still seem to have not learned that statistics that are not controlled for all variables are not worth the paper they are printed on. If one tries to compare the health care systems in any two or more countries and does not account for all possible causes for the differences (i.e., racial, ethnic, cultural, economic, political, crime rate, or methods of statistical collection), the resulting analysis is worthless at best, and deceptive at worst. In the case of the statistics you have used, this is clearly so. They are merely a recitation of raw data without any attempt to adjust them for the many factors which must be accounted for to give them proper context.
If you can show us otherwise, please do so. If not, please stop trying to convince us that they have any meaning at all.
I have also noticed that you tend to attack the source of the data, rather than the substance of what is said. Usually this is a tactic used when one is unable to refute the substance, and is a sign of the weakness of one’s position. While it is true that bias can skew the analysis of data, bias is found on both sides of any issue. In this case, your sources are as suspect as CG’s, if not more so.
You still seem to have not learned that statistics that are not controlled for all variables are not worth the paper they are printed on. If one tries to compare the health care systems in any two or more countries and does not account for all possible causes for the differences (i.e., racial, ethnic, cultural, economic, political, crime rate, or methods of statistical collection), the resulting analysis is worthless at best, and deceptive at worst. In the case of the statistics you have used, this is clearly so. They are merely a recitation of raw data without any attempt to adjust them for the many factors which must be accounted for to give them proper context.
If you can show us otherwise, please do so. If not, please stop trying to convince us that they have any meaning at all.
I have also noticed that you tend to attack the source of the data, rather than the substance of what is said. Usually this is a tactic used when one is unable to refute the substance, and is a sign of the weakness of one’s position. While it is true that bias can skew the analysis of data, bias is found on both sides of any issue. In this case, your sources are as suspect as CG’s, if not more so.
No, when someone presents obvious propaganda, I demonstrate that the propaganda does indeed come from a biased source. Nothing wrong with that. Fairly easy to demonstrate the bias, I don’t even work up a sweat doing it.
The only parameter that leads any of you to attempt to criticize the data is the fact that the United States has such low rankings. If the United States was number one, you all would be trumpeting the research from the rooftops. You did notice that Britain wasn’t doing so well in the article from Kingsfund.org, didn’t you?? Same mechanism.
Instead of disingenuously criticizing the results of the study, how about working to improve health care in the US? You all paint yourself into such corners, attempting to deny reality when simply acknowledging and working on the problem would be of much more utility.
You still seem to have not learned that statistics that are not controlled for all variables are not worth the paper they are printed on. If one tries to compare the health care systems in any two or more countries and does not account for all possible causes for the differences (i.e., racial, ethnic, cultural, economic, political, crime rate, or methods of statistical collection), the resulting analysis is worthless at best, and deceptive at worst. In the case of the statistics you have used, this is clearly so. They are merely a recitation of raw data without any attempt to adjust them for the many factors which must be accounted for to give them proper context.
If you can show us otherwise, please do so. If not, please stop trying to convince us that they have any meaning at all.
I have also noticed that you tend to attack the source of the data, rather than the substance of what is said. Usually this is a tactic used when one is unable to refute the substance, and is a sign of the weakness of one’s position. While it is true that bias can skew the analysis of data, bias is found on both sides of any issue. In this case, your sources are as suspect as CG’s, if not more so.
No, when someone presents obvious propaganda, I demonstrate that the propaganda does indeed come from a biased source. Nothing wrong with that. Fairly easy to demonstrate the bias, I don’t even work up a sweat doing it.
The only parameter that leads any of you to attempt to criticize the data is the fact that the United States has such low rankings. If the United States was number one, you all would be trumpeting the research from the rooftops. You did notice that Britain wasn’t doing so well in the article from Kingsfund.org, didn’t you?? Same mechanism.
Instead of disingenuously criticizing the results of the study, how about working to improve health care in the US? You all paint yourself into such corners, attempting to deny reality when simply acknowledging and working on the problem would be of much more utility.
Altan,
It appears that you are the one who takes the approach that any information that disagrees with your position is propaganda. Using your own criteria, your sources are also biased, and therefore, are not to be trusted.
Please show me where I have said anything that would indicate that my objections to the data that you have presented is due to where the U.S. is placed in the rankings. My point is, and has always been, that the data you point to does not account for all factors, and thus is misleading. It could be that once all of those factors are properly accounted for, that the US might still place lower than other countries. But until the data is properly analyzed, only a propagandist would attempt to draw any conclusions based on it.
As for your charge of not working to try to improve health care here in the US, how do you know that I am not doing so? By pointing out the problem with the data, and suggesting how it may be corrected, I am doing a small part to better frame the problems so that they might be worked on by those who are in a position to effect changes. And it may be that the answer is not in the direction of more government intervention.
Are you aware of a growing number of affordable clinics in stores, which are staffed by PA’s or Nurse Practitioners? By providing a lower cost service for minor problems, it gives an alternative to using emergency rooms for acute care.
You still seem to have not learned that statistics that are not controlled for all variables are not worth the paper they are printed on. If one tries to compare the health care systems in any two or more countries and does not account for all possible causes for the differences (i.e., racial, ethnic, cultural, economic, political, crime rate, or methods of statistical collection), the resulting analysis is worthless at best, and deceptive at worst. In the case of the statistics you have used, this is clearly so. They are merely a recitation of raw data without any attempt to adjust them for the many factors which must be accounted for to give them proper context.
If you can show us otherwise, please do so. If not, please stop trying to convince us that they have any meaning at all.
I have also noticed that you tend to attack the source of the data, rather than the substance of what is said. Usually this is a tactic used when one is unable to refute the substance, and is a sign of the weakness of one’s position. While it is true that bias can skew the analysis of data, bias is found on both sides of any issue. In this case, your sources are as suspect as CG’s, if not more so.
No, when someone presents obvious propaganda, I demonstrate that the propaganda does indeed come from a biased source. Nothing wrong with that. Fairly easy to demonstrate the bias, I don’t even work up a sweat doing it.
The only parameter that leads any of you to attempt to criticize the data is the fact that the United States has such low rankings. If the United States was number one, you all would be trumpeting the research from the rooftops. You did notice that Britain wasn’t doing so well in the article from Kingsfund.org, didn’t you?? Same mechanism.
Instead of disingenuously criticizing the results of the study, how about working to improve health care in the US? You all paint yourself into such corners, attempting to deny reality when simply acknowledging and working on the problem would be of much more utility.
Altan,
It appears that you are the one who takes the approach that any information that disagrees with your position is propaganda. Using your own criteria, your sources are also biased, and therefore, are not to be trusted.
Please show me where I have said anything that would indicate that my objections to the data that you have presented is due to where the U.S. is placed in the rankings. My point is, and has always been, that the data you point to does not account for all factors, and thus is misleading. It could be that once all of those factors are properly accounted for, that the US might still place lower than other countries. But until the data is properly analyzed, only a propagandist would attempt to draw any conclusions based on it.
As for your charge of not working to try to improve health care here in the US, how do you know that I am not doing so? By pointing out the problem with the data, and suggesting how it may be corrected, I am doing a small part to better frame the problems so that they might be worked on by those who are in a position to effect changes. And it may be that the answer is not in the direction of more government intervention.
Are you aware of a growing number of affordable clinics in stores, which are staffed by PA’s or Nurse Practitioners? By providing a lower cost service for minor problems, it gives an alternative to using emergency rooms for acute care.
Nah, any information that comes out of a think tank should be evaluated closely for bias before acceptance. You’re using your imagination to provide a probablility space where they could possibly be objective.
If you’re in health care, good for you!! Unless you’re over on “the dark side” where you have to weigh patient outcomes vs cash. Most patients don’t want to know that someone is “framing” a situation that is life or death for them, it brings them down.
Not every situation is cured by a doc-in-a-box or a nurse-in-a-box. Many PA or Nurse Practitioners are quite good but the scope of their care is limited. It would be better to try not to foist auxillary personnel in the function of physicians because they increase profits. Playing a roll-the-dice game of outcome vs cost is dangerous and the patient loses.
You still seem to have not learned that statistics that are not controlled for all variables are not worth the paper they are printed on. If one tries to compare the health care systems in any two or more countries and does not account for all possible causes for the differences (i.e., racial, ethnic, cultural, economic, political, crime rate, or methods of statistical collection), the resulting analysis is worthless at best, and deceptive at worst. In the case of the statistics you have used, this is clearly so. They are merely a recitation of raw data without any attempt to adjust them for the many factors which must be accounted for to give them proper context.
If you can show us otherwise, please do so. If not, please stop trying to convince us that they have any meaning at all.
I have also noticed that you tend to attack the source of the data, rather than the substance of what is said. Usually this is a tactic used when one is unable to refute the substance, and is a sign of the weakness of one’s position. While it is true that bias can skew the analysis of data, bias is found on both sides of any issue. In this case, your sources are as suspect as CG’s, if not more so.
No, when someone presents obvious propaganda, I demonstrate that the propaganda does indeed come from a biased source. Nothing wrong with that. Fairly easy to demonstrate the bias, I don’t even work up a sweat doing it.
The only parameter that leads any of you to attempt to criticize the data is the fact that the United States has such low rankings. If the United States was number one, you all would be trumpeting the research from the rooftops. You did notice that Britain wasn’t doing so well in the article from Kingsfund.org, didn’t you?? Same mechanism.
Instead of disingenuously criticizing the results of the study, how about working to improve health care in the US? You all paint yourself into such corners, attempting to deny reality when simply acknowledging and working on the problem would be of much more utility.
Altan,
It appears that you are the one who takes the approach that any information that disagrees with your position is propaganda. Using your own criteria, your sources are also biased, and therefore, are not to be trusted.
Please show me where I have said anything that would indicate that my objections to the data that you have presented is due to where the U.S. is placed in the rankings. My point is, and has always been, that the data you point to does not account for all factors, and thus is misleading. It could be that once all of those factors are properly accounted for, that the US might still place lower than other countries. But until the data is properly analyzed, only a propagandist would attempt to draw any conclusions based on it.
As for your charge of not working to try to improve health care here in the US, how do you know that I am not doing so? By pointing out the problem with the data, and suggesting how it may be corrected, I am doing a small part to better frame the problems so that they might be worked on by those who are in a position to effect changes. And it may be that the answer is not in the direction of more government intervention.
Are you aware of a growing number of affordable clinics in stores, which are staffed by PA’s or Nurse Practitioners? By providing a lower cost service for minor problems, it gives an alternative to using emergency rooms for acute care.
Nah, any information that comes out of a think tank should be evaluated closely for bias before acceptance. You’re using your imagination to provide a probablility space where they could possibly be objective.
If you’re in health care, good for you!! Unless you’re over on “the dark side” where you have to weigh patient outcomes vs cash. Most patients don’t want to know that someone is “framing” a situation that is life or death for them, it brings them down.
Not every situation is cured by a doc-in-a-box or a nurse-in-a-box. Many PA or Nurse Practitioners are quite good but the scope of their care is limited. It would be better to try not to foist auxillary personnel in the function of physicians because they increase profits. Playing a roll-the-dice game of outcome vs cost is dangerous and the patient loses.
Altan,
Any information that comes from ANY source needs to be looked at critically. ‘Trust but verify’, and ‘In God we trust, all others we monitor’ were the watchwords in MI, where I used to serve as an analyst. I put an equal (or as equal as humanly possible) amount of scepticism into anyone else’s analysis. And in that regard, your sources are no better, especially since they don’t account for any other factors.
Don’t kid yourself, all health care systems, whether private or government, weigh cost against potential outcome. Triage is done no matter what.
As for PA’s or NP’s, I agree that they are not the final answer in some situations, but they do serve as excellent gatekeepers who can handle the day-to-day routine matters. As for the problems that they can’t handle, they are in an excellent position to explain the condition to the patient, who can then go to a physician for more specialized care.
Most people entering ER’s though, are those with acute problems who could be well handled by PA’s or NP’s at a low cost clinic. I nor anyone I know if are attempting to use them beyond their abilities. However, greater use of those clinics, like those in my area, would go a great way in helping to relieve the strain and cost of our current system.
