10 Surprising Facts about American Health Care
“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.’
So what’s wrong with the WHO and Commonwealth Fund studies? Let me count the ways.
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.
Another reason the U.S. didn’t score high in the WHO rankings is that we are less socialistic than other nations. What has that got to do with the quality of health care? For the authors of the study, it’s crucial. The WHO judged countries not on the absolute quality of health care, but on how “fairly” health care of any quality is “distributed.” The problem here is obvious. By that criterion, a country with high-quality care overall but “unequal distribution” would rank below a country with lower quality care but equal distribution.
It’s when this so-called “fairness,” a highly subjective standard, is factored in that the U.S. scores go south.
The U.S. ranking is influenced heavily by the number of people — 45 million — without medical insurance. As I reported in previous columns, our government aggravates that problem by making insurance artificially expensive with, for example, mandates for coverage that many people would not choose and forbidding us to buy policies from companies in another state.
Even with these interventions, the 45 million figure is misleading. Thirty-seven percent of that group live in households making more than $50,000 a year, says the U.S. Census Bureau. Nineteen percent are in households making more than $75,000 a year; 20 percent are not citizens, and 33 percent are eligible for existing government programs but are not enrolled.
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.
WHO’s Fooling Who? The World Health Organization’s Problematic Ranking of Health Care Systems
Here’s the study showing that once violent deaths are taken into account, the U.S. actually ranks #1 in life expectancy within the OECD:
Q. How is Obama going to build public support for government-run healthcare?
A. By offering U.N run healthcare as the alternative.