John Krehbiel
Op-Ed Columnist – Unhealthy America – NYTimes.com
by John Krehbiel on 5 November 2009
Important political decisions seem to be made most often on the basis of statements taken to be true with no basis in fact at all.
Op-Ed Columnist – Unhealthy America – NYTimes.com.
The sad fact is that everybody else in the modern world can do it. Why do people still believe we can’t?
2009-11-05 » John Krehbiel
5 November 2009 @ 8:36 pm
Wait a minute. Are we unhealthy because of our “health care” system, or because we eat at McDonald’s? Or eat too much meat?
Or is it because we don’t have Germany’s 4-weeks of vacation?
Or is it because we’re too materialistic?
I can never keep all the accusations against America quite straight.
For every columnist who praises Canada’s health care system you can find one who says it’s horrible.
And I’ve also heard that the rest of the world benefits from the medical advances of American companies, so that if we weren’t here to come up with new drugs, devices, procedures and whatnot, their socialized medicine wouldn’t work.
But … again … the issue is so politicized that you can’t believe anything you read about it. Everybody interprets the data through their biases.
5 November 2009 @ 10:48 pm
The comparisons are skewed. Our infant mortality rates are skewed because we attempt to save premature babies at an very young gestational age. Then, in Hong Kong and Japan, they count a child who survives less than 24 hours a stillbirth where we call it a fatality. Other countries count certain small premees as stillbirths, even if they show live signs. (see http://en.wikipedia.org/wiki/Infant_mortality#Comparing_infant_mortality_rates)
Life expectency is skewed down in the US from our high rate of Highway traffic fatalities. This page gives data that indicates that our life expectency is #1 when you adjust for traffic fatalities.
We pay a lot for drugs because half of all pharmaceutical profit comes from the US. So, we effectively develop the drugs the rest of the world uses. They keep prices down through cartel buying.
6 November 2009 @ 7:18 am
Here’s the link about life expectancy being high in the US, when you adjust for fatal auto accidents:
http://www.outsidethebeltway.com/archives/us_life_expectancy_were_number_1/
6 November 2009 @ 7:41 am
I like the four weeks of vacation argument, myself
6 November 2009 @ 9:35 am
Interesting stuff about life expectancy. It shows — again — that people can interpret data any number of ways.
The idea that U.S. life expectancy goes up once people get into the wonderful world of socialized medicine (Medicare) is one possible explanation, but there are many others. E.g., the kinds of things that kill you in America usually happen before you’re 65.
6 November 2009 @ 9:36 am
BTW, Anonymous, feel free to post under that name, but it might be easier for people to reply to you if you come up with a handle. Just pick something. Sassafras or Ibuprofen or Coffee Cup or whatever.
6 November 2009 @ 11:12 am
It is a complicated question. But my main point is that the “We have the greatest health care system in the world” argument is suspicious for a great many reasons.
It’s a common conservative rhetorical device, like the “Golden Age when we stuck to our values and everything went right” idea. Mostly bunk, but people find it persuasive because they want to.
BTW, Kristof is dependably even more liberal than I am.
7 November 2009 @ 12:34 pm
JohnK,
I agree that we need to get away from rhetoric. I agree that we don’t have the “best medical system in the world” because the phrase is meaningless. No system is the best for everyone.
When people on all sides of this argument feel they can lie and distort freely, I instinctively grab my wallet and advocate for no change until we really know who and what is behind each option.
You might feel like I’m just another conservative idealogue, but it’s not true. I agree with the leaders of the Catholic Church that everyone should be provided for with healthcare.
I don’t believe that’s the goal of the current legislation. The current legislation is clearly aimed at eliminating the true voiceless and weakest, the unborn. I’m concerned that others will suffer disproportionally, also. Note that Congress consistently avoids going on the public option themselves. Why is that? Note also that the Democrat proposals won’t kick in until 2012, after the next Presidential election. Do they perhaps know it’ll be a disaster?
I agree that the present system is not fair to all, but it’s better than the options.
There has to be real, solid proposals that will control healthcare costs. Experts examining the present Democrat proposals see little in there that will control costs. I think costs are best controlled by markets, but that implies that some people will get no healthcare to motivate people to find new cost-effective solutions. That’s unacceptable.
Right now, my preference would be for healthcare provided at the local level first, with state support as necessary. Doctors and other practitioners would necessarily be called upon to give more of their time to charity cases, contracts could be let for large buys of needed medicines (possibly at the federal level), etc. It’s only when people are confronted with real healthcare choices at the local level will we be able to come up with solutions where people will feel that they are getting the best available. The Federal Government running things is always going to be subject to Federal Politics, where almost everyone loses so a few protected groups can be showcased as successes.
This strange belief that costs will necessarily go down if only the Federal Government took it over is bizarre. Medicare costs are going through the roof.
It’s true that individuals can’t afford the increasing costs of healthcare, but if that’s true, neither can Insurance companies, nor even the Federal Government. I’d rather have a failed healthcare system than a failed healthcare system and a failed Federal Government (and currency).
22 November 2009 @ 12:29 pm
Could anyone supply the percentage of taxes are for the citizens who live in countries with socialized medicine? I have heard they are very high. I think we need an overhaul but not a “start from scratch” policy.
22 November 2009 @ 2:20 pm
Try here.
But what you have to remember is that first, European countries have much higher rates of services in general. It’s not all “socialized” medicine, it’s a bunch of other benefits.
Second, taxes are the way we pay for services. They are not intrinsically evil or destructive. When people want services, they have to pay for them somehow, Saint Ronald notwithstanding.
I’m afraid that we are about to follow California as a nation. IOW, people will vote themselves services and benefits, but will not be willing to pay for them. That’s why California is ungovernable- the idiotic direct democracy of the “propositions” on their ballots.
22 November 2009 @ 3:37 pm
I object to calling what we get from the government “services.”
I get “service” from my car mechanic, my dentist and the conscierge at the hotel. I don’t want “service” from the government. I want them to pave the roads and kill our enemies.
22 November 2009 @ 5:11 pm
Even there, they are more likely to pave our enemies and kill our roads.
22 November 2009 @ 6:45 pm
Four weeks? When I lived in Germany I had six weeks for vacation. The same here in Austria. In both cases medical insurance comes with the job, though in Germany I had the option of private coverage.
22 November 2009 @ 7:49 pm
Sounds like a distinction without a difference.
But seriously, don’t you want to be confident that the food you buy in a store or restaurant won’t kill you? Or that you can breathe the air and drink the water? That someone who claims to be a physician is qualified to practice medicine?
Do you really want to stand alone against your employer? Do you really want to have to defend yourself on the street, fortify your own home?
If there were half a billion people on the planet, and the average of their IQs was 130 or so, then libertarianism would make sense. With the world over-filled with morons, it’s just silly.
22 November 2009 @ 7:53 pm
Sounds like a better argument against Democracy than against Libertarianism.
22 November 2009 @ 8:24 pm
It certainly is a good argument against the kind of direct democracy that has gotten California in such trouble.