Statistics can be fun, and we’ve pointed out some of their vagarities in the past. Such as the impact of offshoring on U.S. productivity numbers and the effectiveness of government programs.
Over the past couple weeks our friend Mark at the Lean Blog has been tackling a subject I’ve astutely avoided… Michael Moore’s latest rant, Sicko. His two main posts on the subject are here and here. I’ll comment a bit on his posts in a minute, but first I’d like to quote an interesting tidbit of his statistical analysis.
Michael Moore keeps screaming that 18,000 Americans without insurance die each year. That’s awful, don’t get me wrong. If you take the number as approximately 47,000,000 Americans who don’t have insurance, that’s a "death rate" of 0.000383.
The U.S. population, per Google, is approximately 301,000,000. That gives us 254,000,000 WITH insurance. If you believe the oft-cited Institute of Medicine numbers, 98,000 Americans die each year because of preventable medical mistakes. Also a tragedy. That’s a rate of 0.000386. Basically the same rates.
Hmmm… kinda makes you think. Of course there are reasons and nuances, but the bottom line is that the analysis of statistics should always be questioned, especially when they come from an… uh… slightly biased perspective.
Mark knows a lot about lean healthcare, and correctly analyzes the movie and current healthcare situation.
One thing that was powerfully reinforced to me during the Global Lean Healthcare Summit that I just attended is that we have to separate our world’s healthcare problems into a few categories:
- Problems with access to care
- Problems with delivery of care
“Sicko” appears to focus solely on the first problem.
With a large number of uninsured, the U.S. does have a problem with access to care. Or perhaps cost effective access to care, as many of those without insurance do actually access care via very expensive emergency rooms.
The first problem, the lack of access to care – and Moore focuses less on the uninsured than on those with insurance who get systemically screwed by the insurers and HMO’s. Moore than beats the audience over the head with his simplistic view that socialized, government-run systems are better (and practically Utopian).
From what I’ve read, “Sicko” largely ignores (or completely ignores) the problem of waiting times for people who DO, in theory, have coverage in socialized medicine countries like Canada and the U.K. You have coverage and can get routine or elective care, but the waiting times might still be outrageous. Is waiting two years for a hip replacement surgery any better for your quality of life (when you’re 85) than NOT being able to get the surgery?
Anyone who has dealt with the current Social Security or Medicare bureaucracy knows the nirvana that socialized medicine would become.
Those of you that watched CNN (not Fox!) last night saw how their medical correspondent Sanjay Gupta systematically discounted many of Moore’s statistics, or in most cases lack of the full story. As Mark eloquently put it,
Ironically enough, Moore complained that he would probably be edited and parts of the interview would be left on the cutting room floor to make him look bad. I guess he’s familiar with the method…
Probably the one I liked best was how Moore points to France as the perfect model of socialized medicine. In his movie you hear about the wonders of a system that charges less for sicker patients, short waiting times, and the like. What you don’t hear is that their system is running rapidly increasing deficits, and to close them France is looking at privatizing and capitating many aspects by implementing the U.S. HMO model. As Gupta puts it,
Americans do pay more, but the United States also ranks highest in patient satisfaction. And Americans have shorter wait times than everyone but Germans when seeking non-emergency elective procedures like hip replacement, cataract surgery or knee repair. That’s not something you’ll see in Sicko.
In business, and especially politics, look for all the statistics. Sometimes they might tell an inconvenient truth… about inconvenient truths.
Mark Graban says
I’m probably done posting about Moore or Sicko on my own blog, but not done posting about lean healthcare! Most of the TV debate and discussion is about Moore instead of the real issue at hand.
That said, the site http://www.moorewatch.com has some interesting analysis and discussion, particularly about statistics.
Moore keeps saying the World Health Organization ranks the US “37th” in healthcare. But, if you dig into the methodology, that does this mean? The ranking is a subjective weighted creation based on a number of factors.
Check out this link:
http://tinyurl.com/2e34el (points to MooreWatch)
The U.S. is ranked #1 in “customer satisfaction” measures and ranks very good in not having waiting times. We have the 15th ranked “effectiveness” system (not great, but not as bad as 37th). The other factor is that we spend the most (#1), to the overall “value” ranking is 37th. We get decent healthcare at very HIGH costs.
Plus, the WHO methodology dings the U.S. for an unfair distribution of care. I’d like everyone to have healthcare, but measuring “fairness” smells like Marx and Moore’s frequent quoting of Marx, to each according to their needs…
Don’t get me wrong, we have HUGE problems with healthcare in this country. I don’t like the system the way it is, but I don’t buy into socialized medicine as a cure all.
I’d rather see us devote our efforts to improving quality of care and reducing preventable errors and deaths. That’s something that shouldn’t be political, eh?
Lisa Statam says
What is also often not reported is that the U.S. has by far the most diverse population on the receiving end of health care, which very significantly skews most statistics. Diverse in terms of income, culture, and even lifestyle desires. As just one example, France does not have a significant segment of the population that prefers to live very isolated, very remote from healthcare like we have in some parts of the west.
A similar statistical imbalance is with the supposed “no increase in earnings.” Statistics is based on populations, and when a very significant (around 12 million at last count) part of your population is streaming across a border for minimum wage jobs and adding to that population, then it is virtually impossible for the mean wage to increase. If you looked at a specific population of people, tracked that exact same population, you would then see very significant increases. Or if the U.S. adopted policies like virtually every other country in the world where education and income-producing ability was near the top of the list of criteria for allowed immigration, you would drive the entire population upward. I’m not saying what’s right or wrong, just that it has a very major impact on the statistics that somehow gets lost in the sound bites.