I hear many doubting the quality of care delivered in the
1. Does it even make sense?
2. Should I look a little deeper to see how the writer/researcher/TV personality reached that conclusion?
Higher Infant Mortality Rates
Our higher infant mortality rates and shorter life expectancy are often used to argue against the quality of our system. Infant mortality statistics are difficult to compare as other countries don't count as live births infants below a certain weight or gestational age.7
* 49 % of all infant deaths in the U.S. in 2003 occurred in infants whose birth weight was less than 1,000 grams (less than 2 pounds)8
* 55% of all infant deaths in
These are infants that fall below threshold standards for other countries and are not counted as infant mortality. They are considered unsalvageable.
But we value life in the
But even beyond those differences, studies like those from the National Bureau of Economic Research (NBER), a nonpartisan economic think tank that boasts of having 16 of the past 31 US Nobel prize winners in economics, has come out with research that states, “Efficacy of healthcare systems cannot be usefully evaluated by comparisons of infant mortality.”5
And as far as longevity, too many factors aside from the healthcare system impact the length of ones life. These include lifestyle choices such as:
- exercise and eating habits
- genetics within the population
- environmental factors
- social factors like homicides and war
None of these things has anything to do with healthcare.
Again, the NBER comes along with a study that states, “We conclude that the low longevity ranking of the
WHO Ranking #37
I am going to list a few countries above us in the rankings to see if this passes the “does that make sense” test:
#35
#24
#18
#12
#1
Now without meaning any disrespect to these countries, but does anyone really feel that healthcare is better in these countries? This then begs the question, what are the criteria behind the WHO rankings? Well, the rankings are based on five indices, some of which are objective, some of which are subjective. I won’t break all of these down at this time, maybe later if some wish. The Cato Institute has a paper that covers this in detail: http://www.cato.org/pub_display.php?pub_id=9236.
But suffice to say, one of the major effectors of the rankings is whether the government shoulders more of the health spending burden, thus increasing the scores for countries with strong governmental involvement in healthcare. Other factors like health distribution can be just plain silly. A country that delivers excellent healthcare to half and good healthcare to the other half will rank lower than a country that delivers uniformly poor care. Again, that just does not make sense.
Cancer Cure Rates
So let’s look at some factors that we can affect—I like cancer cure rates. This now takes into account:
- early screening
- testing
- treatment outcomes
So where does the
We are first ahead of
This means that out of every 100 men diagnosed with cancer in the
And the numbers for prostate cancer, where I specialize, are even more staggering: 99 % versus 77% 5-year survival differences and 1 out of 6 men will get prostate cancer in their lifetime. Those numbers should be worrisome. These are death rates from cancer. And we beat cancer the best.
So while I will discuss later how I and others think we can continue to improve the quality of medicine delivered in the
In the next post, I will address increasing access.
BH
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