Health Stats Table as a Blog Post

I thought I would present some health care statistics in a handy table. All data is from the World Health Organization.

I was quite surprised to find that the under 5 mortality rate in America is twice what it is in Spain. Unless my math is mistaken, this means children in America are twice as likely to die before they reach the age of 6, even though America spends three times as much on health care.

Here's another chart that I find revealing:

More Government Health Care Facts for Those Who Like the Truth

So, here are some actual facts to consider. In Britain, which is apparently the most despised example of evil Orwellian government health care that the opponents of government health care can think of, people are free to buy and use private health insurance for private health care. I know quite a few British people who do this. These are not people who make things up.

• Britain's NHS sees one million people every 36 hours and 93 per cent of patients rate their care as good or excellent.
• The CIA says that Brits can expect to live longer under government health care than Americans can under the current free market system: http://ff.im/6zU3G
• Measured as a percentage of GDP, Britain spends about half of what America spends on health care, yet Britain enjoys greater life expectancy, lower infant mortality, lower maternal mortality.
• My 80 year-old mother lives in Britain and has never experienced age-related government health care restrictions.
• The World Health Organization ranks Britain's health care as 18th in the world, while the US is in 37th place.

In other words, Britain, along with many other countries, has figured out how to get better health care results while spending a less than America does. Indeed, Spain has even better outcomes than Britain and spends even less.

So, there is no reason that America can't cut medical spending while improving health care. Okay, well there are reasons. I think they are excess profit and inefficiency.

Just the Facts? The CIA, Stephen Hawking, and the government health care option

I had almost abandoned this blog...as 2007 wore on it looked more and more like health care reform in America was just a fading dream. Then came 2008 and candidate Obama. Health care reform went from "distant hope" to solid plank in a triumphant campaign platform. No need to blog about health care reform if it was now a presidential mandate. Then came the reality of extremism, people prepared to twist and distort reality to scare up opposition to health care reform, particularly an expanded government health care option.

(For the record: All Americans already have a government health option if they become physically disabled or poor, it's called Medicaid.)

These opponents of an extended U.S. government health care option are not content to say "I am happy with my private health insurance and don't want change." Instead these people had to make things up. And America's ethically bankrupt mainstream media seems prepared to give voice to these fabrications. Blogging to deconstruct these fabrications is now imperative.

Consider Investor's Business Daily. In an attempt to articulate the argument that Americans should not adopt the same kind of government health care that has existed for over 50 years in the United Kingdom, IBD actually printed this: "Stephen Hawking wouldn't have a chance in the UK."

There is zero basis in fact for this statement, but worse than that, the statement is the exact opposite of the truth. For many decades the UK's government health care option, the National Health Service, has provided Stephen Hawking with great care, at no cost. Indeed, Stephen Hawking, one of the world's most celebrated scientists, was moved to make a statement to the press. He said: "I owe my life to the NHS."

So, here is the strategy adopted by opponents of government health care in America: "Make false and alarming statements about how bad things will be if there is an expanded government health care option in America. Make these statements as often and as loudly as you can. Don't worry about the truth at this point because the ends [killing an expanded government health care option] justify these means."

Health Care Dollars: Got your missing billions right here

Further evidence today to support my theory that the free market is an inefficient provider of health care. Happened on a short article in today's business section of the Florida Times Union. Just a one page piece about a small local company, E&S, with operations mostly located in Amelia Island and seven employees. What do they do? They work on behalf of hospitals to collect money that insurance companies owe them (and would not pay them without prompting--keeping that money to themselves). E&S has just five clients right now. Pretty small stuff huh?

Well consider this, last year the company identified about $850 million in under-reported claims for its clients. That's right $850 million! For just 5 clients! Using just 7 people! The implications are many and some of them are amazing. The cynic in me wants to buy stock in E&S because you just don't see many business models this good (the company had revenues of about $1 million per employee, taking a 25% cut of the amount collected for clients).

But think of how much waste this implies. There are about 6.000 hospitals in America. Some 3,000 are medium to large hospitals (100 or more beds). There are 900 with over 300 beds. Even if we assume that the 5 clients of E&S each have 4 large hospitals the math is pretty staggering: Over $120,000 in uncollected insurance money per hospital bed. There are about 950,000 hospital beds in American hospitals. Total uncollected insurance money could easily top $100 billion.

What a waste!

Black White Gap Widens in Some Areas: Black infant mortality higher now than in 1946

One of my favorite columnists is Tonyaa Weathersbee in the Jacksonville Times Union. She is determined not to let anyone forget the facts. Like these:

In 1943, black babies died at a rate that was 87 percent higher than white babies. Last year [2005], black babies died at a rate that was 122 percent higher than white babies.

Until Katrina, it was hard for most Americans to picture what life was like for black folk in the Southern states. From what I've seen, it's not healthy, that's for sure.
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Death Rating of Doctors Hurting Healthcare? Study highlights complex issue

The statement of purpose for this blog pulls no punches. From my choice of words the reader can easily deduce that I am "mad as hell" and often ask myself how much more I can take. However, I fully recognize that the challenge of improving health care is, like most challenges we face today, complex and far from clear-cut. Sure, there are some things that ARE clear, at least IMHO, starting with television adverts for drugs. They don't help anyone but the shareholders of drug companies. Drug ads on TV should be banned. The laws that prevented them for so many decades should re-applied. Period. Do a little free reading here if you doubt this or dig into some of the scientific papers here.

But other issues are less clear cut. For example, should the public have access to a doctor's 'stats' such as survival rates for individual surgeons. This sounds like it might be a good idea. If I was about to have major surgery I would like to get some assurance that the doctor wielding the knife had a good track record. Indeed, a good friend of mine is facing hip surgery and found a set of stats in USAtoday that gave him pause. He was going to have the surgery done at Flagler Hospital in Saint Augustine, but Flagler only got one star in the ratings he found on the web, versus four stars at the hospital he chose instead. However, these ratings are tricky. Consider this chart. Flagler gets three stars for 2007, an improvement over one star for 2006.

Not knowing who or what stats to believe is only part of the problem. Consider this story in the Boston Globe about death rating doctors. And now consider this comment by Twila Brase, president of the Citizens' Council on Health Care:

"Physician report cards threaten patient access to medical treatment. Doctors who fear that the death of a patient will be a black mark against them have been found to avoid the patients that need them the most. Increasingly, patients may find doctors unwilling to try a risky procedure that could actually save them."

I don't always agree with Twila, but have remained on her mailing list because she often highlights the other side of the coin, so to speak. The CCHC web site is certainly worth a look.

As for the answers, well it seems to me that under a free market system anyone can get a good rating for their product or service, they just have to find the right rating entity, and invent one if there is not a pliant one to be found. Wouldn't a government rating system be better? After all, we get government crash test ratings for our cars. And would it not be better for those ratings to apply to a surgical practice as a whole, rather than single out individual doctors? Further research on the effect that Twila highlights is clearly needed.
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More About Racial Inequality in Healthcare

I found this Newsweek article interesting for the comments people made. You can see that there are some pretty heartless souls out there, as well as some more mindful and prepared to take the time to try and educate their fellow citizens. One comment points to this very useful set of resources based on the Institute of Medicine's report: Unequal Treatment, Confronting Racial and Ethnic Disparities in Healthcare. This was published in 2002 and the basic finding was that

a consistent body of research demonstrates significant variation in the rates of medical procedures by race, even when insurance status, income, age, and severity of conditions are comparable. This research indicates that U.S. racial and ethnic minorities are less likely to receive even routine medical procedures and experience a lower quality of health services.

I think there will be several reports in 2007 that ask "How far have we come in five years?"
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Racial inequality in healthcare

Even when enrolled in identical Medicare health plans, black patients have worse health outcomes than white patients, according to a study by researchers from Harvard and Brown universities, who studied data from 431,573 patient visits covered by 151 Medicare managed care plans from 2002 to 2004. The findings appear in the Oct. 25 issue of The Journal of the American Medical Association (as reported by WebMD).
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