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Saturday, August 25, 2012

An Effective Rebuttal

Writer "Economic Freedom" on the Financial Times, writes in response to an uninformed critic of U.S. medical care. See the whole thing here.

Jescamillo wrote: "Both Canadian and Brits have lower infant mortality . . . the UK and Canada trump the US hands down.

You're comparing apples to oranges: the US has a DIFFERENT DEFINITION of a "live birth" from that of Canada and the UK. In the US, if a baby of ANY WEIGHT WHATSOEVER — EVEN IF PREMATURE — is born and shows any signs of life — takes a breath, voluntary movements, has a heartbeat — it is defined as a "live birth". If the infant dies within the first 4 weeks — from low birth weight or having been premature — it is defined as "infant mortality": a live birth which then died.

Not so in the UK, Canada, Austria, Germany, Norway, and many other countries with seemingly low rates of infant mortality. In many of these countries, a premature baby weighing less than 500 grams is, BY DEFINITION, not considered a living child. It's defined as STILLBORN, so it doesn't get counted in the "infant mortality" statistics. How's that for statistical trickery?

In Hong Kong or Japan, if a child is born alive but dies within 24 hours of birth, it is reported as a "miscarriage," and therefore does not affect the official statistics for infant mortality. More statistical trickery.

A normal pregnancy is considered to be 37-41 weeks. In Belgium, France, and most other European Union countries — any baby born before 26 weeks is, BY DEFINITION, not considered alive, and therefore isn't counted in their reported infant mortality rates. More statistical trickery.

In Switzerland, if a baby is born less than 30 centimeters long, it is, BY DEFINITION, not counted as a live birth. Therefore — unlike the US, where it would be counted as a live birth — such a high-risk infant doesn't affect the Swiss infant mortality rate. More statistical trickery.

Efforts to save these infants are reflected in these figures: between 2000 and 2008, 42 of the world's 52 surviving babies weighing less than 400g (0.9 pounds) were born in the United States.

Ask the parents of those babies that survived and those parents whose babies were defined by their healthcare system as stillborn (even though born alive) and therefore not worth the effort to save, to compare notes on the merits of socialized medicine and see what results you get.

Summing up:
The reason the US appears to have a higher rate of infant mortality than other countries (especially those that brag about the humanity and cost-effectiveness of their socialized healthcare systems) is that the US counts every baby. Most other countries do not.

>>>>Jescamillo wrote: "And what of the cost? The US spends17% of GDP for healthcare."

So what. The US spends an even higher percentage on its GDP for automobiles. Why? We like automobiles, and there are lots of available options to choose from. We CHOOSE to spend a lot of our GDP on automobiles precisely because a large supply is available, and it's a supply that is, in general, increasing in quality, not just quantity.

We spend a lot on healthcare because there are many options that people can purchase voluntarily: lots of elective procedures, lots of new pharmaceuticals, new medical devices, etc. Like automobiles, it's a supply that is increasing in quality — due to innovation from the private sector — and not just in quantity.

Many people — especially from benighted countries like the UK — find it both inconceivable and incomprehensible that Americans voluntarily choose to spend lots of their own income on healthcare because there's lots of healthcare to choose from.

>>>>Jescamillo wrote: "Canada spends 9%. The UK, somewhere in between."

That's because Canada and the UK essentially RATION their healthcare so there's simply less healthcare options for a Canadian or a Brit to choose from; if there were more options available, you can bet the Canadians and the Brits would choose to spend more of their own income on a product or service they value, i.e., healthcare. In fact, however, the way in which Canadian and British consumers of healthcare expand their options is by seeking treatment outside their own countries.

Additionally, you have an unrealistically narrow definition of cost; you're assuming that it's measured only in terms of money. It isn't. It's also measured in terms of time. Socialized medicine vastly increases the demand for medical services and does nothing to increase the supply (in fact, it decreases the supply, as the current FT article makes clear). The result? Long waiting times. Under socialized medicine, you pay a price in terms of time, even if the price in terms of money is made artificially low.

Latest figures: the average waiting time between seeing a GP and a specialist in Canada is about 20 weeks.

Socialized medicine does not guarantee the "right of receiving medical care" to anyone. What it does is to guarantee the right of getting on a waiting list for receiving medical care. That's quite different.

That might explain why a Canadian male has about a 16% greater chance of dying from prostate cancer than an American; a Canadian female has about a 16% greater chance of dying from breast cancer than an American. It appears that cancer doesn't wait, even if Canadians and Brits have to.

Finally, and perhaps most importantly, it is no secret that almost all new medical devices and most new pharmaceuticals originate and are developed in the US (or by US companies residing abroad). Since successful treatment of disease by physicians around the world depends on a steady stream of improved medical technologies and drugs, it appears that US innovation essentially subsidizes everyone else, including those countries that love to boast about how their government-provided healthcare systems are so "humane" and "inexpensive."

Sure. "Humane" achieved by means of statistical and semantic trickery, and "inexpensive" achieved by means of shifting costs from the category of money to that of waiting time. That's nothing to be proud of.

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