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Why the methodology for health care rankings (where U.S. was ranked #37) is flawed

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Don1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:17 PM
Original message
Why the methodology for health care rankings (where U.S. was ranked #37) is flawed
That title comes from another forum where some right-wingers are using arguments like these to attack the World Health Organization study that Michael Moore cited in SiCKO. Here are some of the right-wing arguments:
1. Cuba aborts 60% of its babies!!
2. The people who did the surveys could theoretically have been incompetent.
3. There is a lot more racial inequality (which does not really exist, only economic inequality) in healthcare in the USA than in other countries.
4. The effectiveness of securities like healthcare insurance should not be measured by how frequently they keep people economically secure.
5. Life expectancy is not a measure of how well a healthcare system performs.
6. Americans probably eat more cheeseburgers in a week because of the cheap access to beef than a Cuban eats in an entire year.
7. Loss of 2 weeks of work pay due to injury/illness isn't medical.
8. Sick people dying and births are not medical expenses.
9. Random confounding variables affect the measurements in the study on average such that the USA should be higher than #37.
10. Medical debt is not a significant cause of bankruptcy if it is only responsible for 1/3 of bankruptcies.

http://www.iidb.org/vbb/showthread.php?t=213725

Take a look at how frothy the mouths of the right-wingers are getting over Michael Moore's movie.
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defendandprotect Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:21 PM
Response to Original message
1. Did they happen to mention we still have an EMBARGO against Cuba?
In fact, I think only a few years ago we actually were ranked LOWER than Cuba --

but Bush and the GOP have probably been working them over pretty good in the last years.

What a crock that whole thing is . . .
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Don1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:33 PM
Response to Reply #1
5. Why would they mention that?
They are coming up with excuses for the healthcare status quo in the US...
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1932 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jul-17-07 12:40 AM
Response to Reply #1
18. Yeah, we're not exporting our crappy health care system to them.
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HysteryDiagnosis Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:22 PM
Response to Original message
2. Amurka is probably the most over drugged nation on the planet and
I do believe that there is solid evidence to back up this ASSumption.

http://www.worstpills.org/public/page.cfm?op_id=5

*
Each year, in hospitals alone, there are 28,000 cases of life-threatening heart toxicity from adverse reactions to digoxin, the most commonly used form of digitalis in older adults.2 Since as many as 40% or more of these people are using this drug unnecessarily (see discussion on digoxin), many of these injuries are preventable.
*
Each year 41,000 older adults are hospitalizedand 3,300 of these die from ulcers caused by NSAIDs (nonsteroidal anti-inflammatory drugs, usually for treatment of arthritis).3 Thousands of younger adults are hospitalized. (See list of drugs that can cause gastrointestinal bleeding.)
*
At least 16,000 injuries from auto crashes each year involving older drivers are attributable to the use of psychoactive drugs, specifically benzodiazepines and tricyclic antidepressants.4 Psychoactive drugs are those that affect the mind or behavior. (See list of drugs that can cause automobile accidents.)
*
Each year 32,000 older adults suffer from hip fracturescontributing to more than 1,500 deathsattributable to drug-induced falls.5, 6 In one study, the main categories of drugs responsible for the falls leading to hip fractures were sleeping pills and minor tranquilizers (30%), antipsychotic drugs (52%), and antidepressants (17%). All of these categories of drugs are often prescribed unnecessarily, especially in older adults. (See section on sleeping pills and tranquilizers, antipsychotic drugs, and antidepressants.) The in-hospital death rate for hip fractures in older adults is 4.9%.7 Multiplying this times the 32,000 hip fractures a year in older adults attributable to drug-induced falls, 1,568 older adults die each year from adverse drug reactions that cause hip fractures. (See list of drugs that can cause hip fractures because of drug-induced falls)
* Approximately 163,000 older Americans suffer from serious mental impairment (memory loss, dementia) either caused or worsened by drugs.8, 9 In a study in the state of Washington, in 46% of the patients with drug-induced mental impairment, the problem was caused by minor tranquilizers or sleeping pills; in 14%, by high blood pressure drugs; and in 11%, by antipsychotic drugs. (See list of drugs that can cause or worsen dementia.)
* Two million older Americans are addicted or at risk of addiction to minor tranquilizers or sleeping pills because they have used them daily for at least one year, even though there is no acceptable evidence that the tranquilizers are effective for more than four months, and the sleeping pills for more than 30 days.10
* Drug-induced tardive dyskinesia has developed in 73,000 older adults; this condition is the most serious and common adverse reaction to antipsychotic drugs, and it is often irreversible. Tardive dyskinesia is characterized by involuntary movements of the lips, tongue, and sometimes the fingers, toes, and trunk. Since most of the older people taking these drugs were not actually psychotic, they have a serious side effect from antipsychotic drugs prescribed without justification.11 (See list of drugs that can cause tardive dyskinesia or other movement disorders.)
*
Drug-induced parkinsonism has developed in 61,000 older adults due to the use of antipsychotic drugs such as Haldol, Thorazine, Mellaril, Stelazine, and Prolixin. There are also other parkinsonism-inducing drugs, such as Reglan, Compazine, and Phenergan, prescribed for gastrointestinal problems.12 As mentioned above, most (about 80%) older adults receiving antipsychotic drugs do not have schizophrenia or other conditions that justify the use of such powerful drugs. (See list of drugs that can cause parkinsonism.)
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silverweb Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:24 PM
Response to Original message
3. They don't even make sense.
Par for the course, naturally.

:eyes:
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Don1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:32 PM
Response to Reply #3
4. You're right.
The excuses are ad hoc. You kinda have to read the whole thread to get the context of the list, too.
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barack4prez Donating Member (128 posts) Send PM | Profile | Ignore Mon Jul-16-07 09:34 PM
Response to Original message
6. I don't know about that, but
my main concern with overhauling the current system is possibility that the quality of the doctors will decrease. I believe in free enterprise, and I believe that the best motive to get the best and the brightest to go into careers in the health care system is the profit motive. How else do we get someone to spend 100+ hours per week studying for four years in medical school, except by financial rewards at the end? I don't want my future heart bypass done by marginal brains who went into medicine only to "help people." I want the very best minds there are. I don't want Cuba and I don't want Canada. If I did, I'd move there.
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SharonAnn Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:45 PM
Response to Reply #6
8. Medical schools have limited enrollment (thanks AMA) and have far more qualified
Edited on Mon Jul-16-07 09:45 PM by SharonAnn
applicants then they have openings. There's no way a "marginal brains" person would be considered a qualified applicant.

The number of medical school seats is artificially restricted. We don't produce enough doctors now, that's why you see so many foreign doctors in the United States. There are empty jobs to fill.

And, the medical/health care system isn't really a competition for the best. As a patient, it's hard to find out what the success rate is for a particular doctor or a particular hospital. There's a reason it's hard to find out. They don't the information easily available to the public.

These are "just the facts".

BTW, if you can't pay for the best, you won't get the best. Hope you've got lots of money!


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drm604 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:45 PM
Response to Reply #6
9. Exactly how many people need to go without health care
for your plan to work?

How many direly ill people need to be sent across town to a different hospital in order to increase the quality of our doctors?

How many people must spend sleepless nights worrying about getting sick in order for the rest of us to receive world class medical care?

How many people do we need to kick out of line altogether in order to make the line shorter for you?

How does decreasing the demand (by eliminating many from the system altogether) increase the quality?
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drm604 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:36 PM
Response to Original message
7. Theoretically incompetent.
2. The people who did the surveys could theoretically have been incompetent.

The people who made this argument could theoretically have been incompetent... well, perhaps not theoretically.
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melody Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 09:48 PM
Response to Original message
10. These people should not try thinking. It might be hazardous for them. n/t
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beyurslf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 10:20 PM
Response to Original message
11. #5 is true.
When calculating life expectancy, every death counts, whether it was a "medically=related" death or not. Getting hit by a bus at age 20 will drop the average and "universal health care" doesn't stop that.
If Americans have more non-health care related deaths (i.e. "accidents") than other countries, then our lower life expectancy may not be related to health care.
That being said, higher infant mortality greatly decreases life expectancy.
So do deaths from "preventable" or "treatable" diseases that go undiagnosed because of lack of health care.
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Don1 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 10:32 PM
Response to Reply #11
13. the question is not whether it is a perfect match but instead
whether it is strongly associated with it. Thus along with 4 other indicators, it is decent for measuring healthcare.
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Warren Stupidity Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 10:38 PM
Response to Reply #11
14. Life expectancy and infant mortality are very good measures.
Yes of course other factors come into play, but if your population's average life expectancy is, say 50, that is not because you have a lot of busses, it is because you have a shitty health care system and you have a lot of preventable disease (for example you don't have clean water.) As a broad measure of a population's health, of the quality of its health care infrastructure, life expectancy and infant mortality are the two standard measures, despite the rightwing propaganda being spewed forth from the well funded think tank propaganda machines.
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beyurslf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 11:42 PM
Response to Reply #14
16. I agree with you. I guess it depends how you read it.
I read that life expectancy is not <only> a reflection of health care. It is an average of ages from births to deaths.
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Warren Stupidity Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jul-17-07 06:11 AM
Response to Reply #16
19. Yes sure, so it only correlates with healthcare, and other variables
have to be looked at as well. Which is what the various studies, such as the WHO studies, do.

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Lydia Leftcoast Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 11:52 PM
Response to Reply #11
17. Accidents DO count because the quality of trauma care
influences the overall death rate.

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Bread and Circus Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 10:25 PM
Response to Original message
12. deleted text... wrong thread :P
Edited on Mon Jul-16-07 10:26 PM by Bread and Circus
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rucky Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jul-16-07 11:38 PM
Response to Original message
15. 60% abortion rate, my ass.
It's high for the region, but try 6% of pregnancies.



Then again, zero is worth nothing, so what's the harm in adding one to the end of a number?
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Vinca Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jul-17-07 08:57 AM
Response to Original message
20. If 1/3 of bankrupticies caused by medical debt isn't significant,
what is? Actually, it's half, but why quibble. This must be the top ten RNC talking points to use on stupid people.
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