The Economist Weighs In


Look, I’m just a guy with a college degree.  I’m not an economist but I am handy with numbers.  And, mostly, I am capable of free thinking.  Which is why I find this article from The Economist laughable.

We start off well, in fact I had high hopes after just the first sentence.

DIAGNOSING what is wrong with America’s health-care system is the easy part.

I happen to agree with the author’s take.  I DO think that it’s easy to diagnose what’s wrong with America’s health-care system.  Which is why I was disappointed when The Economist got it wrong.  Not even 30 seconds later we are stunned to learn that nearly 50 million Americans don’t have coverage.  This is gross and simply unacceptable for a major news source to make a statement this absurd.  50 million.  Americans.  Uninsured.  Really?  Let’s take a look.

  • The real number being used is 47 million
  • Of those 47 million it’s been reported that 9 million are enrolled in Medicaid and failed to report it
  • 8 million are kids.  These kids are now covered by SCHIP

We’re down to 30 million now.  Fully 40% off the 50 million number quoted by the Economist.  But there’s more–way more.

  • 1.7 million are parents making more than 300% of FPL [federal poverty level]
  • 5.9 million are non-parent adults making more than 300% of FPL
  • 3.1 million are adult parents eligible for assistance today
  • 2 million are non-parent adults who are eligible for assistance today

Now we’re at 17.3 million.  17.3 million people who are not covered.  Now for the best part.  Wait for it—wait…waaiit……9 million aren’t even US citizens.  How AWESOME is that?!?

So, after getting the number down to 17.3 million, we’re able to shave off another cool 9 mill  bringing us to the grand total of 6.3 million.  And we get 50 million from The Economist.  Gross.

Next the author compares the benefits of American health services with OECD and their averages.  As far as I can tell, the comparison used three metrics:

  1. Infant mortality rate
  2. Life Expectancy
  3. Survival Rates for Heart Attacks

Again, the depth, or lack thereof, in reporting is surprising.  It has been documented that the infant mortality rate in the US is much higher than other countries because of the methods used in reporting.  According to WHO the definition of birth is:

Live birth refers to the complete expulsion or extraction from its mother of a product of conception, irrespective of the duration of the pregnancy, which, after such separation, breathes or shows any other evidence of life – e.g. beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles – whether or not the umbilical cord has been cut or the placenta is attached. Each product of such a birth is considered live born.

However, in many cases, countries fail to report all births due to their own definitions; for example:

  • In Switzerland and other parts of Europe, a baby born who is less than 30 centimeters long is not counted as a live birth. Therefore, unlike in the U.S., such high-risk infants cannot affect Swiss infant mortality rates.
  • In Belgium and France — in fact, in most European Union countries — any baby born before 26 weeks gestation is not considered alive and therefore does not “count” against reported infant mortality rates.
  • Some of the countries reporting infant mortality rates lower than the U.S. classify babies as “stillborn” if they survive less than 24 hours whether or not such babies breathe, move, or have a beating heart at birth.
  • In Canada, Germany, and Austria, a premature baby weighing <500g is not considered a living child.

When these and other reporting anomalies are factored in, Norway, which has the lowest infant mortality rate in the world, ranks no better than the United States.  Further, since 2000, 42 of the world’s 52 surviving babies weighing less than 400g (0.9 lbs.) were born in the United States.  Hardly an indicator that the United States if failing in the area of infant health.

The CIA has the United States ranked 50th in life expectancy.  And, as noted above, the article uses this metric in it’s assessment of the United State’s system.  However, it has been reported that Life Expectancy is not a valid measure of a country’s health care system:

…robust statistical analysis confirms that health care spending is not related to life expectancy.  Studies of multiple countries using regression analysis found no significant relationship between life expectancy and the number of physicians and hospital beds per 100,000 population or health care expenditures as a percentage of GDP.  Rather, life expectancy was associated with factors such as sanitation, clean water, income, and literacy rate.8 A recent study examined cross-national data from 1980 to 1998.  Although the regression model used initially found an association between health care expenditure and life expectancy, that association was no longer significant when gross domestic product (GDP) per capita was added to the model. Indeed, GDP per capita is one of the more consistent predictors of life expectancy.

Yet the United States has the highest GDP per capita in the world, so why does it have a life expectancy lower than most of the industrialized world?  The primary reason is that the U.S. is ethnically a far more diverse nation than most other industrialized nations.  Factors associated with different ethnic backgrounds – culture, diet, etc. – can have a substantial impact on life expectancy.  Comparisons of distinct ethnic populations in the U.S. with their country of origin find similar rates of life expectancy.  For example, Japanese-Americans have an average life expectancy similar to that of Japanese.

And this is just the first paragraph.  Keeping up with the Liberal press is simply exhausting.


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