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>Fudging health care figures

October 31, 2009 4 comments

>“Lies, damned lies, and statistics” is part of a phrase attributed to the 19th Century British Prime Minister Benjamin Disraeli, among others, and later popularized in the United States by, among others, Mark Twain: “There are three kinds of lies: lies, damned lies, and statistics.” The statement refers to the persuasive power of numbers, the use of statistics to bolster weak arguments, and the tendency of people to disparage statistics that do not support their positions. The phrase is not found in Disraeli’s works nor is it known within his lifetime and for years afterward. Many coiners have been proposed. The most plausible, on current evidence, is Charles Wentworth Dilke (1843-1911).

How remarkable that in the 21st century a phrase that was coined before air travel, before radio, before telephones, before elevators and (gasp) before the Internet can be so applicable.

Financial market models and global warming models are just two examples du jour.

Health care is another. Have a look at the following from good.is:

The 78.11 is life expectancy and $7,290 is the cost of health care. If you knew nothing else then you would think that Americans spend a lot of money to achieve ordinary outcomes. Zooming in on the graph gives:


(click to embiggen)

Gee, higher infant mortality than Norway? Worse cardiovascular results? More money spent? What a waste? Right?

Wrong.

You see, nearly every country listed on the image leeches off of the innovation of the US health sector in order to provide their health outcomes. Take away the US and the cost to each nation would be much, much higher, as they would be forced to take on the R&D costs currently borne by the US.

Not that left wing politicians and their supporters will ever make that argument, of course, in spite of its truth.

Here is an inconvenient fact for people who believe the above represents the whole picture – if you are diagnosed with cancer, heart disease, diabetes and a whole host of other conditions you will live longer post-diagnosis in the US than anywhere else in the world.

The issue in the US is not quality of care but access to care, brought about completely by ridiculous government intervention in the market, which restricts access across state lines, as well as tying health care to employment.

There is another problem with the above image – it compares a nation of 300 million people with much smaller ones.

Norway has a population of under 5 million. Every other country on the image has a much larger population than Norway. The bigger question is how is it that Norway can have such poor outcomes compared to the rest of the countries listed?

Of course, the comparison of the US can only be valid when compared to the whole of the European Union (500 million) or the whole of South America (385 million). There are states of the US that outdo Norway, Canada, Germany or Australia. So what?

Speaking selfishly, I hope that the health care bill as proposed in the US is defeated, otherwise our healthcare costs here in Australia will start to increase, as they will in the rest of the world.

And another thing – if health care reform is so urgent then why won’t it be implemented until 2013, after the next presidential election?

(Nothing Follows)

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Categories: Health

>More socialised medicine success

October 11, 2009 3 comments

>Another terrific story for the UK’s socialised medical system with news that doctors had successfully transplanted donor lungs to a former British soldier who served in Iraq.

Problem number one. The lungs were cancerous.

Problem number two. Because he already had cancer he wasn’t allowed to get a new transplant.

A British veteran of the war in Iraq has died after receiving cancerous lungs from a heavy smoker in a transplant, media reports say.

Matthew Millington, 31, a corporal in the Queens Royal Lancers, had the operation to save him from an incurable respiratory condition, The Times reported on Monday.

But the organs were from a donor who was believed to have smoked 30 to 50 roll-up cigarettes a day.

A tumour was found after the transplant, and its growth was accelerated by the drugs Millington took to prevent his body rejecting the organs.

Under hospital rules, as a cancer patient he was not allowed to receive a further pair of lungs.

The soldier died at home in Stoke-on-Trent in February last year.

His widow, Siobhan, said: “All Matthew wanted was another set of lungs”.

“He said: They have given me a dud pair, get me another set. He thought he could beat it, but his condition deteriorated so fast from then.”

Papworth Hospital in Cambridge, Britain’s main heart and lung transplant centre, carried out the operation but said early X-rays on the organs to be transplanted did not find any signs of cancer, The Times reported.

An inquest was told last week that an internal investigation at Papworth pinpointed a string of problems and in Millington’s case a radiographer had failed to highlight the growth of the cancerous tumour.

The hospital defended using smokers’ lungs for transplants, saying that all organs were screened rigorously.

Matthew Millington was killed by the medical system. No other way to look at it.

Many people lose their lives due to mistakes by individual health practitioners. However, Matthew lost his life due to systemic issues within the UK’s health service.

Can his family sue for medical malpractice in the same way they would be able to in a free market health system? I don’t think so.

The Obama administration is completely nuts in its attempts to implement a government paid health system. They could make some improvements to the health insurance system and achieve terrific gains, for which they would gain political capital.

(Nothing Follows)

Categories: Health

>Explaining the problems with socialised healthcare to your nitwit friends

August 17, 2009 3 comments

>The healthcare debate currently raging in the United States has produced some terrific comments not least of which was when one wag asked why President Obama was trying to slam healthcare reform through Congress in 3 weeks when he took 6 months to choose a dog for his kids.

On one side of the argument are those who understand that the US provides the highest level of healthcare in the world but accept there are issues that need to be addressed.

On the other are those who think that the moral high ground is achieved through a government provided scheme, which requires tearing down the existing structure and starting again.

Organisations such as the United Nations and The Economist don’t help the argument by coming up with world rankings on healthcare that show the US a long way down the list.

How can this be when it’s the US that all world leaders choose to fly to when they’re ill? The country that has John Hopkins, Mayo Clinic etc etc?

The answer is that these rankings heavily weight whether the healthcare is ‘free’, insofar as anything is when provided by the government. When health outcomes are analysed, how long people live when diagnosed with cancer, diabetes, heart disease etc the US far exceeds the rest of the world.

Quality

Time and again we are asked by proponents of Obamacare, and its predecessors, whether it is fair that only the wealthy can afford the best healthcare.

For some reason, the questioners fail to appreciate the truism that wealth means health. One only needs to compare the outcomes in Africa to any halfway advanced country to find the proof.

Here’s another question. Is it fair that only the wealthy can buy $100,000 Mercedes?

If the government provided cars to everyone then do you think everyone would get a Mercedes or, perhaps, something of much, much lower quality?

If there were no wealthy people then there would be no $100,000 Mercedes.

Equally, no wealthy people means no high cost medical procedures.

The fact is that the advancement in the quality of healthcare that has come about due to the remarkable achievements of the pharmaceutical companies in the US – which are responsible for two-thirds of the world’s medicines – can only occur because of the free market system that allows them to spend billions of dollars developing a single drug and getting it to market. Even the large European drug companies can only develop the solutions they do because of the sales they achieve in the US.

Make no mistake about it. Without US drug companies the world will have lower quality medical solutions going foward.

Comparisons with the rest of the world fail to take into account that the rest of the world is sponging off the US health dollar by being able to buy treatments that it couldn’t afford to produce itself.

Do proponents of the government plan think that these drugs will still be developed when it’s the government deciding how much will be spent?

Rationing lowers quality. It increases the length of time to receive treatment including for serious conditions.

Is it fair that people die who otherwise wouldn’t simply because they can afford better healthcare but can’t get access to it?

If the public option was so great then Congress wouldn’t exempt itself from it.

Public kills Private

Most non-Americans don’t understand how the US health insurance system works.

Here in Australia we take out insurance with our preferred insurer and to the level we desire/can afford, pay the premiums for the rest of our lives and receive an OK level of service. With our low population and large area it’s not possible to make a proper comparison with other countries, as we have issue unique to Australia, as do all countries.

Most insurance in the US is provided by a person’s employer. You can look up the history of how that came about but it dates back to World War II and companies’ attempts to attract workers in a low unemployment environment in which salaries were fixed by the government due to the war effort.

A major issue in the US is that when someone leaves a job then they have no health insurance until they start their new job. These people who are between jobs need to take out temporary insurance until they start their new job. Bizarrely, the ten or so million of them are included in the statistics that add up to the “47 million Americans without healthcare”, as do more than that many illegals. The question asked in the health insurance survey is ‘Have you at any time through the year been without health insurance?’ Obviously, if you’ve left your job and haven’t taken out temporary cover, or can’t afford to, then the answer is yes in spite of the fact that it might only be for a week or two.

After taking into account the fact that young people choose not to take out health insurance when they can afford to – preferring to spend their money on clothes, a car or a now upside down home mortgage – there are only 15 or so million who are in genuine need.

Better tear down the system to address the 5% of the population with a problem, then.

So how does the public option kill private health insurance?

Let’s leave aside the fact that Congress has a bottomless pit of money to play with and is not going to be inclined to see it fail thus guaranteeing even further increases in spending into the future.

Consider two companies:

Acme Corporation has 1000 employees involved in the production of a very popular widget. It’s a publicly listed company that turns over $150 million and makes an after tax profit of $3 million.

Acme’s major competitor is Blue Sky Enterprises that, coincidentally, has 1000 employees, makes a competing product to the Acme widget, turns over $150 million and produces a profit of $3 million.

Both companies provide the same health insurance cover to their employees, sourced from the same insurance company. The insurance costs them $5,000 per person.

Now, let’s say that Obamacare enters the market offering $3,000 health cover. It’s not quite the same level as the $5,000 cover but people think it’ll generally be OK unless you get really sick.

The management team at Acme decide to shift all of their employees from the private option to the public option. Blue Sky chooses not to.

So what happens?

After one year with this new health insurance in place, Acme has turned over the same $150 million but due to lower insurance cost has increased its profit to $5 million from $3 million (1000 employees x $2000 saving = $2 million).

Meanwhile, Blue Sky has also had a solid year, posting $150 million in sales and at the expected profit of $3 million.

See the problem?

No?

If you’re an investor then which company are you going to invest in?

Obviously, Acme Corporation.

Therefore, Blue Sky Enterprises is forced to take up the public option, as well. Otherwise its competitor gains a huge advantage.

While this is all happening, private insurance companies are having to raise costs to maintain the same health cover level or reduce the level of cover to compete with the government option.

Thus, private health insurance slowly withers on the vine as more and more companies are forced into the government plan.

Who wins?

Not anybody who gets sick, that’s for sure.

Medicare and Medicaid

No pro-Obamacare proponent has yet explained how the public option will not end up the financial black hole that is Medicare and Medicaid.

The following graph highlights the coming crisis, and when I use the term crisis I use it accurately:

Simple improvements are there for the taking

All Congress needs to do to make a huge improvement is the following:

  • Allow healthcare to be portable between health companies and across state lines. This also deals with the situation in which people develop a condition that would inhibit their ability to obtain health insurance if they changed jobs.
  • Implement tort reform. This is the biggest single cost in the medical system. Loser pays will stop people bringing frivilous lawsuits. Trial lawyers are the Democrat Party’s second largest donor behind labour unions so don’t look for this any time soon.

These two steps would allow many more Americans to afford health insurance cover.

President Obama

From President Obama the other day:

“We’ve got some work to do. I don’t mind, by the way, being responsible. I expect to be held responsible for these issues because I’m the president,” Obama said. “But I don’t want the folks that created the mess — I don’t want the folks who created the mess to do a lot of talking. I want them just to get out of the way so we can clean up the mess.

“I don’t mind cleaning up after them, but don’t do a lot of talking,” Obama said.

I wonder whether the President also includes the architects of the current financial crisis – Barney Frank, Chris Dodd, Alan Greenspan, Larry Summer and Ben Bernanke – in the list of those who should shut up and get out of the way?

(Nothing Follows)

Categories: Economics, Health

>Aussies fatter, drunker and carry more STDs than ever before

>A report released today highlights an important social issue:

Australians are fatter, drunker and have more sexually transmitted diseases than ever before…

The truth is that those things are connected.

Women are getting fatter. Men need to drink more to be interested in sex. More alcohol means less chance of remembering to practice safe sex. Thus, more are getting sexually transmitted diseases.

That seems a reasonable enough connection to me.

The report includes:

AIHW director Penny Allbon said about 7.4 million Australians were overweight and almost one-third of those were obese.

That’s about 2.5 millions obese people.

From a report dated 20 June:

Almost four million Australians are obese, according to a comprehensive study.

Can someone please make up their mind about the real figure? It sounds like they’ve pulled a number out of their clacker for the purpose of scaring/forcing us all into action. And if the study that found that 4 million of us are obese was ‘comprehensive’ then what was the study from the Australian Institute of Health & Welfare’s study showing 2.5 million?

According to a report in The Age on 20 June says:

AUSTRALIA has overtaken the United States as the world’s most obese nation, a new report says.

The report, Australia’s Future Fat Bomb, says 26 per cent of adult Australians – almost 4 million people – are now obese, 1 million more than the last calculation in 1999.

Woohoo! First the America’s Cup and now, after years of stuffing our faces with pies and chips, we can claim the World’s Fattest Nation title. Brings a tear of pride to a patriot’s eye…

Naturally, the government is going to tackle the crisis in the same feckless way it’s going about dealing with high fuel and grocery prices – by forming a committee to look into taking action sometime. According to Health Minister Nicola Roxon:

Obesity was a national priority and the government hoped to have an effective nation-wide strategy implemented in the next 12 months, Ms Roxon said.

A government-initiated inquiry into obesity would consider a range of measures, including gym membership rebates, Ms Roxon said.

“We expect to have a full comprehensive strategy in place by the middle of next year … obviously this (report) increases the urgency for that work to be undertaken.”

Rebates on gym membership. That’s the ticket! Why didn’t anyone think of that before?

The whole issue is, of course, a stalking horse for the anti-fast food fascists who want us all to eat lentil soup and spinach as our staple diet.

A Deakin University academic told the inquiry a tax on junk food and reducing junk food advertising targeting children was essential.

Professor Boyd Swinburne, the director of the World Health Organisation Collaborating Centre for Obesity Prevention, said a junk food tax could be offset by subsidies on healthy foods.

Taxing junk food first emerged earlier this year at the Rudd Labor government’s 2020 idea summit.

Taxing food is an idea from the 2020 Summit?

Is there anything that it wasn’t suggested should be subject to a tax at the Summit?

(Nothing Follows)

Categories: Australia, Health