The NHS & the United States of America

[FlashLackey]

You have demonstrated only that you are willing to ignore the main indicators that are used to judge healthcare globally, infant mortality rates and life expectancy, in favor of extremely narrow "cherry-picked" stats based on unreliable test results to try and prove a false point because apparently you're unable to disagree with your ideology based on contradictory facts.

Infant mortality has all kinds of problems as an indicator of health care quality:

Like census data, survey data on infant mortality may omit births and deaths, include stillbirths along with live births, and suffer from survivor selection bias and age truncation. Direct estimates of infant mortality based on survey data may also suffer from mothers misreporting their children’s birth dates, current age or age at death—perhaps more so if the child has died. The heaping of deaths at age 12 months is especially common. Age heaping may transfer deaths across the one-year boundary and lead to underestimates of infant mortality rates.

http://mdgs.un.org/unsd/mdg/Metadata...0&SeriesId=562

First, it's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country.

Infant mortality in developed countries is not about healthy babies dying of treatable conditions as in the past. Most of the infants we lose today are born critically ill, and 40 percent die within the first day of life. The major causes are low birth weight and prematurity, and congenital malformations. As Nicholas Eberstadt, a scholar at the American Enterprise Institute, points out, Norway, which has one of the lowest infant mortality rates, shows no better infant survival than the United States when you factor in weight at birth.

http://health.usnews.com/usnews/heal...924/2healy.htm

Sounds like "unreliable test results to try and prove a false point" to me.

If you remove fatal injuries from life expectancies, as one logically would if they were interested in the quality of care rather than mixing peoples life decisions into the results, the US ranks very high: http://politicalcalculations.blogspo...in-united.html

Much like the "evidence" for going to war in Iraq or the

You don't believe that Saddam Hussein was in violation of multiple international laws consistently for several years?

"evidence" against manmade climate change, this appears to be another issue where the rightwing faith-based community is not allowed to agree with the reality-based community and is willing to twist the facts until they can claim that they fit their faith.

You have this backward. The burden of proof for a claim is on the person that makes it. It is for those making the claim to prove that climate change is man-made. The opponents you speak of are against basing new policy on the premise of man-made climate change because it has not been convincingly demonstrated.

The only people with faith on that issue are the vast majority of climate change believers. Don't believe me? Ask any one of them that you know to explain how they know that climate change is man-made. Then tell me with a straight face that there was no faith involved in their answer. That or a bunch of "uhhh... well... i'm no expert... [joke] hahaha..."

Actually it's extremely plausible to only focus on the couple of tests that show good results out of the thousands of others that don't when you are trying to catapult the propaganda that you're #1 in an area where independent global statistics place you at about 37th.

The WHO is about as independent to health care as members of a crowd selected to ask Obama specific questions.

Try ALL of them if you can't afford the treatments, have no insurance, are under insured, can't afford the deductibles or copays, or get denied by your insurance company.

Why dodge the question? Do you think we have good quality care or not? Is it access or quality that is the problem in your view?

That is a red herring.
The whole "across state lines" issue is about allowing an insurance company to sell insurance in a particular state while ignoring the state laws that govern insurance companies within that state.
This would allow an insurance company to cherry-pick which one state's laws they will follow while ignoring every other.
Nothing is currently stopping an insurance company from selling in any state so long as they want to setup shop there and abide by that state's laws.

Big whoop. Then create a federal body of laws that governs all health insurance the same. It would cost about three trillion dollars less in 10 years than the current proposal.

The problem with the industry is not too much regulation but not enough.
Competition won't come from removing the existing regulations. That will only allow bigger companies to force out more competition than they already do allowing more monopolies and less choice.
What kind of regulation do you propose to prevent that from happening?

None would be needed regarding that issue. It's possible that some small companies wouldn't be able to compete. However, large pools of insurance holders is what allows insurance companies to offer lower rates. And there are many nation-wide industries that have healthy competition, providing consumers with many affordable options.

The burden of proof is on you to substantiate why you believe that nationwide competition between insurance companies would create anti-trust issues.

Your "evidence" has been debunked by a new study on the Dept. of Health and Human Services website here:
http://www.ahrq.gov/news/press/pr2009/faminspr.htm

What? This doesn't "debunk" what I've posted at all. I can see how having such an ambiguous, low standard of evidence to support your assertions has led you into a wilderness of strange conclusions.

Yes, I know they did.
If you are willing to ignore 98% of the data and only cherry-pick the 2% that agrees with your assumption then you can "prove" just about anything.

The only twisting of numbers going on here is you saying that they are ignoring 98% of the data. The study is not cherry picking because it is data that applies to all subjects based on the same criteria.

Using McKinsey's methods I could prove to you that most people shopping at Wal-Mart only purchase yellow Hello Kitty underwear if I define the criteria enough to exclude the other 98% of shoppers and products in the store.

Every study defines criteria. I find it strange that you think that is a method unique to McKinsey.

The question is whether or not the criteria allows for meaningful data. I think that knowing where people travel for inpatient treatment is a meaningful indicator of the quality of care between countries. Can you explain why you think it is not?

No? Then perhaps your definition for "statistical error" is different from the rest of the world?

I like how you see yourself as representative of the rest of the world. Good one.

No, I'm simply stating that your so-called "evidence" is a gross distortion of the facts.
Considering that your own "study" only stated that "most" of less than 40% are going to the US, even they contradict your assumptions by leaving unspoken that more than 60% are not going to the US.

With people going between all kinds of countries for medical care, 40% of all of them going to the US is a strikingly high number. What do you think the next highest percentage is for a single country?

No, that is a false assumption.
Quality of surgery has nothing to do with whether it is an in-patient or out-patient procedure.
Are you saying that people who have corneal transplants or any other surgery done to their eyes (all out-patient) aren't concerned about quality???

I'm sure that people are always concerned about quality but to various degrees. I'm saying that inpatient procedures are more likely to involve problems that are life-threatening. Nobody wants poor quality for a corneal transplant. But, do you seriously deny that more scrutiny goes into where a person will go for a heart transplant or brain surgery?

Yes, and the criteria was exclusive.

That is what having criteria means.

How many non-JCI hospitals out of the total?

I don't know. I don't see how it is particularly relevant anyway. It's speculation that these hospitals wouldn't receive a representative number of inpatient travelers.

So, I forget, too much to re-read ...How did we get to where the number of overnight stays in US hospitals from medical tourists somehow measure the quality of the health care system in the US overall?

It's not a clear measure. Especially since it has a lot to do with cost. Many people may go to some other countries because it's cheaper, even though the quality is lower than in more expensive countries.

I just wrote that it was an indication of quality since, as the study noted, a large proportion of people are willing to spend a lot to have treatment here. We all know that health care is expensive here. It speaks to the quality of our care that people spend more than they would elsewhere to have treatment here.