Comments on: Questionable Comparisons, Questionable Conclusions

By: Christine Harbin

Christine Harbin — Thu, 24 Jun 2010 23:52:00 +0000

Great post. It relates to a lecture I attended yesterday by Michael Tanner, Senior Fellow at Cato, on "How To Fix Health Care." Just as you describe in your post, Tanner said that it is difficult to compare health care systems across countries because the definitions are often inconsistent. He also gave the example of infant mortality. He also said that life expectancy is a poor measure of health care systems because it is affected by many other things, such as murder rates, suicide, car accidents, and lifestyle choices. (I've blogged before that personal responsibility is the best medicine.) This explains why there are differences in life expectancy within single health care systems. For example, people in Utah live 3 years longer than people in Nevada, and they have the same system.

By: Papillon

Papillon — Thu, 24 Jun 2010 16:51:42 +0000

Is there any data out there comparing Massachusetts v. the rest of the country on like metrics? Mass. has universal coverage of a kind and there should be some some data point differences that start to show themselves over the few years they have had it. I am thinking things like cancer survivor/heart attach survivor/whatever in MA vs. USA before and after it went into effect.

The data would probably have talking points for both sides, but the trends should be starting to show. At we would know what we were trading in/trading for.

By: Bill H

Bill H — Thu, 24 Jun 2010 05:07:53 +0000

This study is very interesting. There are just enough data presented to make you think the results might be real. However:
the surveys in these countries were supposedly random samples of a few thousand adults, some of whom were deemed “sicker.” However, the demographic data for those sampled is not presented – age, sex, marital status, smoking history, obesity, etc, so we can’t really evaluate those claims. Those who are deemed “sicker” in the US might not be alive in the UK, because certain diseases aren’t treated there! (It is hard to sample patients who are already in a cemetery.) Studies of people diagnosed with cancer consistently show the highest survival rates in the US, and lowest (among US/Canada/northern Europe) in the UK; renal dialysis is often not offered in the UK beyond a certain age. And you are right – the lifestyle choices in the US mean that the overall population is skewed toward higher risk / less healthy.

The mission and goals of the Commonwealth Fund are listed on the first few pages of this “study.” It looks as though they reached their conclusions first, then went looking for the data to support those conclusions.