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Letter to the editor in today's Post-Dispatch

Mimi Signor’s letter ("Anecdotes can show problems of health care system," Oct. 9) hits the health care nail squarely on the head. To paraphrase former state Rep. Tim Harlan (D-Columbia), who was instrumental in legislating landmark health care reform in Missouri, the plural of "anecdotal evidence" is data.

Every time I hear a politician rail to the effect that we have the best health care system in the world, and that we shouldn’t tinker with it, I am stunned. We still rank a shameful 38th in the industrialized world in health care outcomes and report 100,000 deaths annually attributed to medical error. We should be doing everything possible to change that.

Leah S. Rubin • Wildwood

http://www.stltoday.com/news/opinion/mailbag/health-care-sys...
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Every time I hear a politician rail to the effect that we have the best health care system in the world, and that we shouldn’t tinker with it, I am stunned. We still rank a shameful 38th in the industrialized world in health care outcomes

That's from a totally debunked UN "study." Can anyone really name 37 other countries in which they'd rather be treated if they had a serious medical condition?

--fleg
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Please provide a link wherein the UN Study was debunked.

Donna
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http://online.wsj.com/article/SB125608054324397621.html

Philip Musgrove, the editor-in-chief of the WHO report that accompanied the rankings, calls the figures that resulted from this step "so many made-up numbers," and the result a "nonsense ranking." Dr. Musgrove, an economist who is now deputy editor of the journal Health Affairs, says he was hired to edit the report's text but didn't fully understand the methodology until after the report was released. After he left the WHO, he wrote an article in 2003 for the medical journal Lancet criticizing the rankings as "meaningless."

...

A WHO spokesman says the organization has no plans to update the rankings, and adds, "We would not consider it current."

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Please provide a link wherein the UN Study was debunked.

Donna


Here's a detailed analysis of the 2000 WHO (World Health Organization, a division of the UN) report:


http://www.facs.org/fellows_info/bulletin/2009/wenger0709.pd...



It's a very thorough scholarly analysis of the criteria used for ranking different counties. It points out that only 2 of the 5 criteria used by the WHO are clinically based. In the words of the report,

"The remaining criteria (accounting for 62.5% of the health systems grade)are nonmedical socioeconomic pseudo-objective measures that look at inequality of the distribution of the health care services within a country. It would have been more valuable to have examined the quality of care received by each country's poorest citizens."

In other words, "inequality" is not a valid measure of a health system if it downgrades a country if some citizens receive excellent health care while the poorest citizens still receive very good health care.

The analysis also points out that criteria included in the "health level" grade are typically not related to the quality of the health care system - specifically life expectancy and infant mortality. Socioeconomic (lifestyle, genetics, etc.) factors are far more critical to life expectancy than the quality of a health care system. Infant mortality is inaccurately measured in many other countries (many infant deaths are not recorded) and the US is penalized for making heroic efforts to save extremely preterm infants.

In a nutshell, the rankings are bogus.


The article is actually an excellent overall analysis of the US health care system. It concludes that the US has a "very good" system but it could be better. It makes some excellent suggestions for reform which would decrease costs while maintaining quality. These include tort reform (citing research that it could lower overall costs 5-9%), tax reform (making ALL health care costs deductible for EVERYBODY) and health insurance reform (allowing purchase of insurance across state lines). It also recommends portability of health insurance and government subsidies for those who are chronically ill or uninsurable due to pre-existing conditions.


dave
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Another shady trick the study pulled was in failing to disclose the parameters that go into determining "infant mortality." In the US, heroic efforts are made to save babies with serious defects and very early preemies. When those efforts fail, they're counted as deaths, thus lowering our statistic. In other countries they don't even try and they don't count those babies as deaths.

Do you want to give birth some place where a problem pregnancy means a dead baby or in the US with its "worse" infant mortality stats where the baby has a fighting chance?

--fleg
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Every time I hear a politician rail to the effect that we have the best health care system in the world, and that we shouldn’t tinker with it, I am stunned. We still rank a shameful 38th in the industrialized world in health care outcomes and report 100,000 deaths annually attributed to medical error. We should be doing everything possible to change that.

As for the bogus ranking of 38th, see my recent response and linked article.

As for the "100,000 deaths annually attributed to medical error," this number comes from a nonscientific paper authored by proponents of a single-payer system who wished to denigrate our current health care system. It has no basis in reality. Medical errors will always exist and cannot be completely eliminated. The exact number of deaths attributable to avoidable medical error is completely unknown. Based on my lengthy experience in emergent life-and-death health care, I would guess that it is exceedingly rare.


dave
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