How many people take statistics at face value without diving deeper? In a larger sense that’s the point behind our irregular Fun With Statistics series. It’s unfortunate that the improper use of statistics can sometimes create popular perception, which is then very difficult to counteract even with the proper application of statistics. So it is with today’s edition.
We all heard about The New York Times study that declared "the disturbing truth is that the United States is a laggard not a leader in providing good medical care." Luckily this time people like John Stossel of ABC News decided to poke at the statistics used by the Times.
As usual, the Times editors get it wrong. They find evidence in a 2000 World Health Organization (WHO) rating of 191 nations and a Commonwealth Fund study of wealthy nations published last May. In the WHO rankings, the United States finished 37th, behind nations like Morocco, Cyprus and Costa Rica. Finishing first and second were France and Italy. Michael Moore makes much of this in his movie "Sicko."
Don’t get me started about Sicko. But let’s dive directly into Stossel’s analysis of the statistics.
First let’s acknowledge that the U.S. medical system has serious problems. But the problems stem from departures from free-market principles. The system is riddled with tax manipulation, costly insurance mandates and bureaucratic interference. Most important, six out of seven health-care dollars are spent by third parties, which means that most consumers exercise no cost-consciousness. As Milton Friedman always pointed out, no one spends other people’s money as carefully as he spends his own.
Ok, sorry. The free marketeer in me insisted on including that quote. Now let’s get down to the statistics…
The WHO judged a country’s quality of health on life expectancy. But that’s a lousy measure of a health-care system. Many things that cause premature death have nothing do with medical care. We have far more fatal transportation accidents than other countries. That’s not a health-care problem. Similarly, our homicide rate is 10 times higher than in the U.K., eight times higher than in France, and five times greater than in Canada. When you adjust for these "fatal injury" rates, U.S. life expectancy is actually higher than in nearly every other industrialized nation. Diet and lack of exercise also bring down average life expectancy.
We have other problems, but not necessarily a quality of health care quality problem. I’ve actually discussed the transportation issue in a different light before, comparing how chaotic Italian traffic is actually safer than supposedly controlled U.S. traffic.
As other lean bloggers have pointed out, there are many areas for improvement, such as the reduction of mistakes. Stossel ends with:
For all its problems, the U.S. ranks at the top for quality of care and innovation, including development of life-saving drugs. It "falters" only when the criterion is proximity to socialized medicine.
Don Boudreaux over at Cafe Hayek also weighs in on this article, and the comments to his post are intriguing as his readership includes many other noted economists. For example,
If you look at actual, micro-economic health care statistics you will see that the United States still has the best health care syste. The survival rates for almost all types of cancer, are much higher in the United States because in this system the patient is diagnosed and treated much faster, and the treatments and drug therapies are much more effective. Also, the United States has much higher rates of procedures like knee and hip replacements, and other quality of life improving procedures. Our health care system is more expensive because it is more effective.
Yes… until the last line. The U.S. health care system is still incredibly inefficient, as health care providers that implement lean manufacturing methods, like Thedacare, are demonstrating every day. Another interesting tidbit:
US numbers are being skewed by rising infant mortality, which is being driven by increased use of fertility treatments and improved prenatal care, which are causing more marginal fetuses to carry to term. Funny how too much healthcare can drive up mortality rates.
Which is then supported by another economist:
The United States counts many infant births as live which other countries do not and therefore usually appears to have a much higher rate of infant mortality than similar countries. The US counts an infant exhibiting any sign of life as alive, no matter the month of gestation or the size, but other countries differ in these practices.
There are literally a hundred more comments (yes, his posts get quite the reaction), and a lot of discussion of socialized vs privatized health care, which I won’t go into here.
My point is, as usual, to not take statistics at face value. There are often underlying contributing reasons competely different than the original presumption, and sometimes the underlying reasons even have statistical problems. Some of the comments on Boudreaux’s post even point out issues with Stossel’s statistics.