Just Sick

A few weeks ago Andrew Speaker learned that he had a rare form of tuberculosis while in Italy. Warned that he would be barred from flying back to the US, he went to Germany where he caught a flight to Canada and drove back to the US.

Square this with Michael Moore's new film Sicko which quotes a WHO study showing that the US is ranked number 37 in health care, between Costa Rica and Slovenia (and two spots ahead of Cuba). This means that Speaker left Italy (#2), and went through Germany (#25) and Canada (#30) before coming back to the US( #37). Speaker was quoted as saying that he was sure he would die if he didn't get back to the US.

Was he crazy? Or does he know something that Moore doesn't want you to know?

Well... It turns out that the WHO studies are not really based on a nation's health. There are other factors including "fairness" and payment method. In fact, the same study that ranks the US #37 overall puts us at #15 for overall health attainment. This WHO paper admits that, given the uncertainty factor, Switzerland (#2) could be doing worse than the US (#15). We lose points overall because we are ranked #54 in "fairness" (defined as government payments to health care). On the other hand, we are first in responsiveness and expenditure by a wide margin!

We are only ranked #32 in equality of child survival but this is misleading since it depends on member countries to define live birth. In the US, we rank many babies as premature live births where other countries would rank the same child as a miscarriage.

We are ranked #25 for live expectancy but, again, the uncertainty interval is big enough that we could actually be higher.

None of this is really meaningful in a policy debate. By including fairness of financial contribution as 25% of the total score, the people writing the report assured that countries with socialized medicine would score high, regardless of the quality of medicine received.

One thing that should be addressed in the US is the cost. We pay more than anyone else. While this results in high-quality care, much of this cost is wasted. Personally, I blame trial lawyers whose baseless suits have caused innumerable unneeded tests. Presidential candidate John Edwards personally raised the number of Caesarian Sections through class-action suits. Unfortunately, there has been no corresponding rise in health so this is wasted pain and money.

The last thing in the world that is likely to improve health care is a government take-over. This was tried in England 60 years ago. The result is that their medical system is overloaded and 40% of their doctors are from overseas (including a few jihadists). Canada tried this a couple of decades ago. When a bi-partisan panel looked into health care during Bush (41), they liked the Canadian system. A couple of decades later, it is showing its cracks. The waits for treatment, including life-saving treatment, are legendary. Many doctors living near the border have a thriving practice treating Canadians who don't want to wait (or cannot wait) for their number to come up at home. since health insurance is illegal in Canada, these people are paying for treatment out of their pockets.

My father was a doctor and I grew up with stories about how difficult it was to file with Medicare. Their reporting requirements are much worse than insurance companies. This is to be expected. The insurance companies have to process the paperwork on the other side so they also suffer financially if there is too much paperwork. The government has no such limitations. Converting everyone over to a single-payer system would mean putting everyone on Medicare.

The British have recently discovered something else about government-run health care. In the US we look at someone with an unhealthy lifestyle and assume that it is between him and his insurance company. When the government becomes the insurance company then this equation changes. The government has power than no insurance company will ever wield. Just look at some of the excesses done in the name of public health in the last year. New York City banned trans-fats on shaky grounds. Imagine how much more of this we will see if government officials think that it will save public funds.

A few months ago a medical center in England announced that it would stop doing certain procedures on overweight patients. They are strapped for cash and someone needed to be cut. So much for universal health care.

Tort reform and easing testing requirements for new drugs would do more for people than socialized medicine.