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Rank Ranking

John Stossel of ABC News writes a regular column.  Every one is worth reading.  His most recent column exposes some of the flaws in those now-celebrated rankings that purport to find that medical care in the U.S. is inferior to that in countries such as France, Morocco, and Cyprus.

Here’s a chunk of Stossel’s column:

So what’s wrong with the WHO and Commonwealth Fund studies? Let me count the ways.

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.

Similarly,
our homicide rate is 10 times higher than in the U.K., eight times
higher than in France, and five times greater than in Canada.

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.

It’s when this so-called "fairness," a highly subjective standard, is factored in that the U.S. scores go south.

The U.S.
ranking is influenced heavily by the number of people — 45 million —
without medical insurance. As I reported in previous columns, our
government aggravates that problem by making insurance artificially
expensive with, for example, mandates for coverage that many people
would not choose and forbidding us to buy policies from companies in
another state.

Even with
these interventions, the 45 million figure is misleading. Thirty-seven
percent of that group live in households making more than $50,000 a
year, says the U.S. Census Bureau. Nineteen percent are in households
making more than $75,000 a year; 20 percent are not citizens, and 33
percent are eligible for existing government programs but are not
enrolled.

(HT Sandy Baillie)

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