United States Health Care ranking

June 6th, 2008 | by Brian Schwartz |

WHO distorted“Dr. Julie Gerberding, director of the federal Centers for Disease Control and Prevention, noted that the United States invests more on health care than any country, but that its health care system ranks 37th.” - Denver Post, April 29 2008

A Google search reveals that many people quote this World Health Organization figure on Denver Post blogs. But do any of them know what the rankings mean? John Stossel dissects the criteria:

In the WHO rankings, the United States finished 37th, behind nations like Morocco, Cyprus and Costa Rica. Finishing first and second were France and Italy. Michael Moore makes much of this in his movie “Sicko.” …

But there’s less to these studies than meets the eye. They measure something other than quality of medical care. So saying that the U.S. finished behind those other countries is misleading. …

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. …

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.

Other good critiques of the WHO study include Glen Whitman, who blogs about it here and published a summary here, which also links a more detailed Cato policy analysis here.

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  • Kathlene
    I noticed you conveniently skipped Vern Taylor's comment too.
  • Brian Schwartz
    In response to Brian (comment 608), who wrote:
    ‘I don’t want to pay from someone elses insurance.’ What exactly do you think insurance is? Its a pooling of risks to soften the financial blow resultant from a House Fire, Health Incident or Car Accident.

    There's difference between voluntary risk pooling and being forced to either (1) Pay for someone else's premiums, or (2) Be forced to pay higher premiums because it's illegal to pay lower ones, or (3) be forced to pay higher premiums because the affordable plan you want is declared illegal by politicians.

    You bring up our more fundamental disagreement in your next comment: whether health care is a right or a privilege. I think it is neither. For why, I suggest reading the article I wrote on this very subject:
    http://pajamasmedia.com/blog/health-care-is-not-a-privilege-nor-is-it-a-right/

    Brian writes: "If I agree with you, can I get a cut of whatever payouts you’re recieving from the health industry?"

    This is just pathetic. First of all, it's a personal attack and avoids the issues. Second, I've written at length about how current tax policy and other political controls shield insurers from competition and punish people for buying medical care directly, rather than through insurance. For example, here:
    http://pajamasmedia.com/blog/health-insurers-sins-dont-justify-reform/

    Lastly, the insurance lobby (AHIP) supports the mandatory insurance scheme promoted by many politicians in Congress. Why wouldn't the insurance industry love "reform"? It forces people to buy their products, and makes affordable insurance illegal, so we're forced to by pricey policies? In case you have not noticed, I oppose this.
  • Brian Schwartz
    "Pinko" wrote: "Brian: Poppet had some very good points. I see you replied to many of the comments but seem to have skipped over that one, which basically shot down (crash and burn) one of the primary arguments in your blog":

    I'm not sure which point I did not address. In any case, I do not want to get caught up in defending the status-quo of health care in the U.S., as I certainly think many changes should be made. I summarize that here:
    http://www.patientpowernow.org/free-market-health-care-summary/

    At risk of repeating myself, a free-market for health care and insurance leaves people free to form and join various types of organizations. If someone wants to start a co-op or company something called "Canadian-style health care" or something, then people are free to join.
  • Brian
    Brian, I would like to address a percieve flaw with your logic and the commentors saying 'I don't want to pay from someone elses insurance.' What exactly do you think insurance is? Its a pooling of risks to soften the financial blow resultant from a House Fire, Health Incident or Car Accident. You don't want to pay for other people's health care, but you don't mind paying to have the bumper on their Civic buffed out or their home rebuilt after a fire?

    In addition, the notion that a free market will do better is assuming health care companies operate with a moral compass. The GOP baby step to free market would be the notion we should let these companies sell accross state lines. As the credit card industry proved so clearly, this would make things worse. Credit Card companies immediately moved their corporate head quarters to the states with the least regulation. They essentially held a carrot of moving shop to the states whoses senates passed laws which benefited their companies versee the consumer. This resulted in competition between states to see who could screw the consumer the most, and they would set up shop there and be able to operate within that states legal guidelines throughout the entire country.

    I work 50-60 hours a week. I have a wife and two children. I've paid taxes every year, on time for over 25 years. I own my own business, and I thought small business were the back bone of America, yet I can't afford insurance for my family. The cost to insure my family with the equivalent plan I had as a sales associate wearing a name badge and selling cellphones at a mall would be about 1000 a month or 20% of my income. I actually paid it becaue I thought it was important. Of the medical bills I incurred during that year I had to pay an additional 5,000, of which only 20% was covered. Which mean I paid 16,000 for my insurance and I had not major medical issues. I went to the hospital once for my a pulled muscle in my back. Despite having insurance, I still had to pay 1000 on a 1400 bill. I couldn't afford it and had to cancel it.

    Corporation have become an amoral cancer which will justify anything as long as its legal and will make them money. Why is it every other industrialized nation in the world has better quality health care for cheaper (and we still don't cover everyone), it costs them less and it covers all of their citizens?

    The true problem is this simple fact. There is a segment of this population, you included, which believe health care is a privelage, not a right. Until we as a nation can come to understand it is every American's right to affordable health care, this problem will never get solved. I don't want free health care, I just want to know I won't be dropped when someone in my family truly does get sick cause I didn't report a wart removal in 8th grade. I want to pay a monthly fee and not have to worry about how much more I have to spend to make sure my children are covered. I want what every other industrialized nation in the world has because they don't have free market, they cover all their citizens and they on average, pay half of what we do.

    If I agree with you, can I get a cut of whatever payouts you're recieving from the health industry? Hell, I'll do it if they give a plan that actually covers my family and I can afford.
  • Pinko
    Brian: Poppet had some very good points. I see you replied to many of the comments but seem to have skipped over that one, which basically shot down (crash and burn) one of the primary arguments in your blog.
  • Brian Schwartz
    Tree,

    It would be of great help if you can point to a statement in this blog post this is not true.

    Why do you think that I am "you are working hand in hand with the health care industry"? On this blog I have posted many times about how they benefit from legislation that shields insurance companies from competition.
  • Tree
    You are spreading more misinformation. My father went to Canada to have a new type of surgery done that was not being done in Michigan at the time. My grand daughter is Canadian, and when my daughter gave birth to her she had several weeks of leave time from work to be with my new grand daughter. A nurse also came to the house every week to check on my grand daughters progress. My cousins in Norway pay less in taxes then I do, and have free health care and education through the college level.
    The problem with you spreading more misinformation, is that you are working hand in hand with the health care industry that is spending millions of dollars a day to prevent any changes to their billion dollar cash cow.
  • Sondylee54
    Abraham Lincoln said, "Democracy is the government of the people, by the people, for the people” Americans pay more for heathcare and get less access to affordable care than most industrialized democratic countires, yet are number one in military spending. Why does the party of Lincoln believe it is not okay to aquire much of what the free world gives to their citizens? I've talked to many Canadians, and have been told that they are happy with their care, and not to believe our politicians. Every lawmaker against health reform has access to affordable insurance paid by our tax dollars. As in education, the quality of health for every American affects us all.
  • Steve
    "A government big enough to give you everything you want, is big enough to take away everything you have” Go ahead and preach, that everyone should have health-care, sounds great in theory. All of the same people will be complaining when the government starts telling them what they can and can’t eat. The funny thing is most believe that the wealthy will pick up the tab "wrong". Anytime we have raised taxes on the rich they raise their prices to cover the cost, or their employees get paid less. Understand our founding fathers studied 6000 years of recorded history, and figured out that all empires and kingdoms eventually failed. They failed because of concentration of power, so they decided to learn from their mistakes. That's why our founding fathers said our country will be run by the many, not the few. This is separation of power, and this separation of power is slowly withering away. Every time we have a crisis we want the government to save us, and end up with more government control. What happened to self responsibility, hard work, and dedication? Instead we now look for the easy way out, and the result is what you see now. More government control and like I said, you all want it until it infringes on one of your luxuries, you want everything handed to you and don’t want to give up anything to get it. I have no problem with helping someone in need I have a problem with the government making me, that is not freedom of anything. If you notice there is a trend, it is entitlement issues. I should have this job because I'm _____ you fill in the blank. Seriously people stop playing on the emotional heart strings of people, "Oh you would let a baby die", nobody said that. Some of us want only what we deserve and have some pride. I have an idea let’s look at the source of health-care cost rising ummmmm yea government involvement. If you removed government and insurance companies that would be reform. Did you know that long ago working for the federal government was a part time job? Government officials use to all have full time jobs along with there congressional duties. That’s because they were meant to have little to do with our lives. Another question have you seen the commercial about raising taxes on energy? The people are so sad and say “now is not the time to raise our taxes on energy".. Perfect example, the same people want free health-care. Raising taxes on them and infringing on there TV time is bad, but believe that raising taxes for health-care is great. How about you stop watching TV, get a job, exercise, and you won’t need me to take care of you.
    One more question, I keep hearing about 47 million Americans don’t have health-care. My question is how many chose not to have it, and how many are ILLEGAL ALIENS?

    The Truth
  • Amazed
    I don’t want to pay for other’s healthcare either. Why should I have to pay for other sick people? I also don’t think I should have to pay for public schools. I don’t have children, why should I have to pay for other people’s children? This is very socialist. Another thing - police. I have several guns, I dare anyone to try and rob me. I don’t need police. I should not have to pay for this. Another thing - roads. Why should I have to pay for roads that I don’t use? I work in my own basement and don’t need roads. It is wrong to make me pay for roads and highways. Another thing - the fire department. Again, very socialistic. I’ve taken volunteer fire fighting training classes and feel very compitent to handle any fires that might arise on my property. Another thing - national defence. Half of the federal budget goes to defence. This is outragious. Socialism OUT OF CONTROL. Let me keep my tax dollars and I’ll provide for my own defence. I’ll colaborate with my neighbors. Communities should look after themselves. Small groups of armed citizens worked in the revolutionary war and worked in Afganistan against the Russians. SOCIALISM IS RAMPANT IN THIS COUNTRY. CITIZENS BEWARE!!

    Wow, Bunker Man, sounds like you don't need anyone, why don't you move to your own island so you won't have to pay for anyone. Roads - you may not use them, but if you get sick & need an ambulence or a ride to the doctor, & they can't get to you because the road is in such bad shape, then you will wish you would have paid for the roads. Police - Proctect everyone not just you, where you shop, protected by the police, proctection from personal robbery is low in the main scheme of things for police, unless you want murders, rapists & other such runnig rampet. Fire Dept -trainig classes are good, but can you honestly know how you will react in a situation where a fire can quickly get out of control. National Defence - sure let's get rid of the military their not needed, small groups of people with shot guns can easily repel armies with tanks, planes, warships, & helicopters, the revelutionalry war was a long time ago, if you think you can fend off a tank with a shot gun, go ahead & try. Schools - if you don't pay for schools even if you don't have kids, you end up with a country full of idiots like yourself who think they are the greatest in the world & don't need help from anyone. By the way, smaill groups in Afghanistan did not defeat the Russians, yest they were an inconvience, but did not defeat them, Russians defeated themselves by spending too much & extending themselves too far, money & public opinion not small groups of fighters is why Russia left that country.


    Brian replies: Hmm. I don't think this tone or attitude is very conducive to civil discourse.

    Do you think it's the police's job to protect you? If so, read this post about the police's duty to protect citizens, or lack of duty.

    If it were possible to fund roads by charging only those who use them, would you be against that? For example, toll roads? Or even a tax on gas, though it's not as targeted, and gas taxes tend to get lost in general funds.

    Is there anything government should not force people to fund for the sake of others? Shoes? Haircuts? Internet access? Is anything outside the scope of the proper role of government? If so, why?

    I suggest reading The Law, by Frederic Bastiat.

    Oh, and if you want to me more persuasive, I suggest more civility. ... And stating your real name would certainly add to your credibility.
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