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  1. groovy's Avatar
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    #2201  
    Quote Originally Posted by Woof View Post
    And you have proof that all the countries in question measure everything the same?
    They don't. Infant mortality is a prime example. Though the WHO has set out standards of reporting infant mortality rates, many countries do not follow these rates and show much lower declared infant mortality rates. That's why, if you look at raw country reported data, the US, who follows WHO guidelines strictly, ranks 46 in infant mortality rates (depending on the study you read). But when UNICEF tries to adjust the rates to account for countries that aren't reporting properly, the US ranks much higher (33rd, I believe).

    I suspect we're much, much higher than that since UNICEF still shows we rank below Cuba (which is a ridiculous proposition, IMO). But, because different countries have different reporting methods, we just don't know.
    Last edited by groovy; 09/16/2009 at 05:59 PM.
  2. 1thing2add's Avatar
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    #2202  
    Quote Originally Posted by groovy View Post
    They don't. Infant mortality is a prime example. Though the WHO has set out standards of reporting infant mortality rates, many countries do not follow these rates and show much lower declared infant mortality rates. That's why, if you look at raw country reported data, the US, who follows WHO guidelines strictly, ranks 46 in infant mortality rates (depending on the study you read). But when UNICEF tries to adjust the rates to account for countries that aren't reporting properly, the US ranks much higher (33rd, I believe).

    I suspect we're much, much higher than that since UNICEF still shows we rank below Cuba (which is a ridiculous proposition, IMO). But, because different countries have different reporting methods, we just don't know.
    Show a demonstration where the statistical analysis of either the WHO's or Unicef's "list" has a p-value > .05 and you may have a point. The hurdle you will not be able to overcome is that the deviations in reporting criterion are compensated for within the statistical analysis. SOP.
    Last edited by 1thing2add; 09/16/2009 at 07:52 PM.
  3. groovy's Avatar
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    #2203  
    Quote Originally Posted by zelgo View Post
    Epidemiologists spend their entire careers making sure data are comparable.

    So even though countries may officially report infant mortality statistics based on certain criteria, there are many different sources of information for health statistics everywhere. Policy experts (including the Commonwealth Fund) are very aware of the differences in the way statistics are collected and do everything they can to get the same measurements everywhere.

    Anyone who didn't would not be taken seriously in the world of healthcare policy. For infant mortality, for example, some countries use "birth" and other use "Carried to term" as the point at which to start counting infants who die. This and other discrepancies in data.

    Sadly, there are a number of studies constantly hawked by partisan groups (both left and right), which ARE based on unscientific methods and very questionable data. Unfortunately, partisans continue to present that data as fact in the current health reform debate.

    Consequently, much of the public is totally confused. Interestingly, this also shows how easily the public can be confused.

    Sadly, both sides will learn from the chaos caused in this health reform "debate" (no real debate is happening now--it's just name-calling) and use it to their advantage on many future issues.

    By the way, don't assume Cuba's health statistics have to be worse than ours. Cuba has an excellent public health system and graduates many of the doctors who give care throughout Latin America. In fact, in many health measures (not just infant mortality), Cuba ranks above the US.
    Closed, totalitarian countries and countries who depend on foreign aid are a bad combination. This is a prime reason why I have serious doubts about Cuba's health care rankings:

    The Cuban Ministry of Health [MINSAP] expects physicians to structure their clinical
    interventions to achieve the Ministry’s annual health goals. As with other sectors of the
    economy, MINSAP sets statistical targets that are viewed as the equivalent of production
    quotas. The most carefully guarded of these health targets is the infant mortality rate.
    Any doctor who had an unusually high rate of infant deaths in his or her jurisdiction
    would be viewed as having failed in a number of critical respects.
    One of the family doctors I worked with in Havana was quite politically militant and took
    these health goals very seriously. One day during my clinic observations I observed her
    scheduling an ultrasound for a pregnant woman.
    "What happens if an ultrasound shows some fetal abnormalities?" I asked.
    "The mother would have an abortion," the doctor replied casually.
    “Why?” I queried.
    "Otherwise it might raise the infant mortality rate.”
    http://www.miscelaneasdecuba.net/med...feld-Press.pdf

    Anecdotal? Sure. But in a closed society, you don't get much in the way of reliable statistics.
  4. #2204  
    Quote Originally Posted by Woof View Post
    And you have proof that all the countries in question measure everything the same?
    Do you, or anyone else here, have any to support that the US has the best health care system, as has been frequently cited here (apparently using "American-ness" as its main criterion)?

    So far, all I've heard is "based upon my experience, it's the best", and "it's obviously the best...look at the other countries on the list".
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  5. groovy's Avatar
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    #2205  
    Quote Originally Posted by Bujin View Post
    Do you, or anyone else here, have any to support that the US has the best health care system, as has been frequently cited here (apparently using "American-ness" as its main criterion)?

    So far, all I've heard is "based upon my experience, it's the best", and "it's obviously the best...look at the other countries on the list".
    If you're referring to my post, I'd ask you to address my response above. I'd prefer to do this in the first-person, if you don't mind.
  6. #2206  
    Quote Originally Posted by groovy View Post
    If you're referring to my post, I'd ask you to address my response above. I'd prefer to do this in the first-person, if you don't mind.
    Actually, I wasn't just referring to your post. It's a pretty common occurance on this board for folks to poke holes in any inconvenient data, and yet use none to support the other side. What data do you have to support that our country is better than the 36 others, other than suppositions that the data must be flawed simply because the USA is so awesome?

    I mean, you state that we're not 46th in infant mortality, but maybe as high as 33rd....doesn't that prove the point, if that's the most positive spin on the data?
    Everything's Amazing and Nobody's Happy

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  7. groovy's Avatar
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    #2207  
    Quote Originally Posted by Bujin View Post
    Actually, I wasn't just referring to your post. It's a pretty common occurance on this board for folks to poke holes in any inconvenient data, and yet use none to support the other side. What data do you have to support that our country is better than the 36 others, other than suppositions that the data must be flawed simply because the USA is so awesome?

    I mean, you state that we're not 46th in infant mortality, but maybe as high as 33rd....doesn't that prove the point, if that's the most positive spin on the data?
    I personally never liked setting up strawmen in order to knock them down. Too much work. But if you'd like to address me real point, I'd welcome that.
  8. #2208  
    Quote Originally Posted by Bujin View Post
    Actually, I wasn't just referring to your post. It's a pretty common occurance on this board for folks to poke holes in any inconvenient data,
    It's also a pretty common occurrence on this board to claim you have data, and then when questioned on whether the data supports your point to avoid the question and instead either ignore the questioner or advance an ad hominem attack on them or try to politicize the question.
    and yet use none to support the other side. What data do you have to support that our country is better than the 36 others, other than suppositions that the data must be flawed simply because the USA is so awesome?
    I have no data to support that our country is better than any others because better is a value judgment I'm not prone to make. However, I suspect that infant mortality rates are influenced by what a particular locale considers 'viable' and worth heroic measures to attempt to save. That does not mean the data is flawed, but it can certainly skew the way it's evaluated and presented. And now for your regularly scheduled link.... Preventing Preemies - Health Care Around the World - TIME
    ‎"Is that suck and salvage the Kevin Costner method?" - Chris Matthews on Hardball, July 6, 2010. Wonder if he's talking about his oil device or his movie career...
  9. groovy's Avatar
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    #2209  
    GovTrack: House Record: OSCAR ELIAS BISCET (111-h20090210-60)

    A physician by training, he began his opposition to the totalitarian regime by speaking out against the regime's forced abortion when there is any indication whatsoever that a pregnancy may have an abnormality policy. Biscet described that policy as inhuman. He was immediately fired from his job at the hospital, prohibited from practicing his profession as a physician, and his wife Elsa Morejon was also fired from her job as a practicing nurse. Within hours, the couple and their son were summarily evicted from their apartment and their physical possessions thrown into the street.
  10. #2210  
    Quote Originally Posted by Toby View Post
    I have no data to support that our country is better than any others because better is a value judgment I'm not prone to make. However, I suspect that infant mortality rates are influenced by what a particular locale considers 'viable' and worth heroic measures to attempt to save. That does not mean the data is flawed, but it can certainly skew the way it's evaluated and presented. [/url]
    You have no data because it doesn't exist. Tell you what, you're a smart guy....describe what you would think is "better" health care. Being able to get an appointment quickly? Your satisfaction with your doctor or hospital? Being able to afford your bills? Do you really think "better health care" can only be determined by individual value judgement? If the US sucked only in infant mortality, and the definitions vary by country, then you might a viable argument. But the fact is the US falls behind most nations in many many measures of quality, per the reference I've already posted. Infant mortality isn't even included in two of the studies.
  11. #2211  
    So? And this has what bearing on whether or not we should have health care avaible for all in this country? Or are you making something up about the future of, say, Medicare?
  12. #2212  
    Quote Originally Posted by zelgo View Post
    Epidemiologists spend their entire careers making sure data are comparable.

    So even though countries may officially report infant mortality statistics based on certain criteria, there are many different sources of information for health statistics everywhere. Policy experts (including the Commonwealth Fund) are very aware of the differences in the way statistics are collected and do everything they can to get the same measurements everywhere.

    Anyone who didn't would not be taken seriously in the world of healthcare policy. For infant mortality, for example, some countries use "birth" and other use "Carried to term" as the point at which to start counting infants who die. This and other discrepancies in data.

    Sadly, there are a number of studies constantly hawked by partisan groups (both left and right), which ARE based on unscientific methods and very questionable data. Unfortunately, partisans continue to present that data as fact in the current health reform debate.

    Consequently, much of the public is totally confused. Interestingly, this also shows how easily the public can be confused.

    Sadly, both sides will learn from the chaos caused in this health reform "debate" (no real debate is happening now--it's just name-calling) and use it to their advantage on many future issues.

    By the way, don't assume Cuba's health statistics have to be worse than ours. Cuba has an excellent public health system and graduates many of the doctors who give care throughout Latin America. In fact, in many health measures (not just infant mortality), Cuba ranks above the US.
    Amen, amen, amen. But as someone who is also trained in epi and health policy, allow me to tell you that you will just be frustrated here. There is no logic to this discussion, just smoke and mirrors.
  13. groovy's Avatar
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    #2213  
    Quote Originally Posted by davidra View Post
    So? And this has what bearing on whether or not we should have health care avaible for all in this country? Or are you making something up about the future of, say, Medicare?
    I'm showing how the WHO numbers can be manipulated. Since the WHO numbers are constantly used to justify our need for a public "option", I'd think you'd be interested.
  14. #2214  
    Quote Originally Posted by davidra View Post
    You have no data because it doesn't exist. Tell you what, you're a smart guy....describe what you would think is "better" health care. Being able to get an appointment quickly? Your satisfaction with your doctor or hospital? Being able to afford your bills? Do you really think "better health care" can only be determined by individual value judgement? If the US sucked only in infant mortality, and the definitions vary by country, then you might a viable argument. But the fact is the US falls behind most nations in many many measures of quality, per the reference I've already posted. Infant mortality isn't even included in two of the studies.
    Being a doctor I guess we could say that some of the blame for our poor standing in the world ranking falls on you. You must be proud.
    “There are four boxes to be used in defense of liberty: soap, ballot, jury, and ammo. Please use in that order.”
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  15. #2215  
    Quote Originally Posted by Woof View Post
    Being a doctor I guess we could say that some of the blame for our poor standing in the world ranking falls on you. You must be proud.
    You could say that....if you had any evidence that the quality of doctors in this country was worse than in other countries. How much you want to bet you won't be able to find that info? Actually, I do feel guilty that doctors can't convince the skeptics that health care should be available to all....even you.

    There are, however, lots of reasons for poor quality.....

    More than half of all physicians in the United States and a large percentage of those in four other English-speaking countries believe their ability to provide quality health care to patients has deteriorated over the past five years, according to a new international survey of doctors released today by the Harvard University School of Public Health and The Commonwealth Fund. In addition, the survey finds that fewer than one of six U.S. physicians thinks his or her ability to provide quality care improved over the last five years, despite increased spending and medical advances seen in the same period. No more than a quarter of doctors in the other countries surveyed-Australia, Canada, New Zealand, and the United Kingdom-think their ability to deliver quality care has improved

    Quality of Care Decline
  16. #2216  
    Quote Originally Posted by davidra View Post
    You have no data because it doesn't exist.
    And it may not be possible to exist. You see, I also think that value judgments like 'better' which compare most countries to the US are not exactly in parity. The only similar government structure is the EU, and even that isn't exactly on par since they were able to pick and choose from already formed countries. 'We' started out with 13 'countries' and went in a hodge podge fashion from there.
    Tell you what, you're a smart guy....describe what you would think is "better" health care.
    Better compared to another country is going to be subject to all sorts of factors that usually aren't weighted in, which is why I'm not prone to make that sort of judgement. Our country is not very homogeneous compared to most others. That being said, I'll try to answer your questions from my perspective. Hopefully you'll be able to contain your temper and address them in the spirit given.
    Being able to get an appointment quickly?
    Being able to get an appointment quickly is generally only important to me in the case of an urgent care or emergency situation, which really isn't an appointment then. Also, quickly is going to be a relative term. If I'm scheduling a general physical, there's no reason why I shouldn't be able to make my appointment months in advance.
    Your satisfaction with your doctor or hospital?
    That one I'm certainly not prone to trust since satisfaction is an emotional decision which may be solely based on the last event experienced rather than an overall experience.
    Being able to afford your bills?
    That could certainly fit into an area that could use improvement.
    Do you really think "better health care" can only be determined by individual value judgement?
    No, which is why I never suggested that it could.
    If the US sucked only in infant mortality, and the definitions vary by country, then you might a viable argument.
    Here's where you're getting off the track. I'm not advancing an argument that the US is better than anywhere else. AAMOF, I clearly stated that I'm generally not prone to making those sorts of value judgments. What would ultimately be needed to make the 'US system' better (in comparison to itself) would be very hard, if not impossible, to legislate, especially at the Federal level, imo.
    ‎"Is that suck and salvage the Kevin Costner method?" - Chris Matthews on Hardball, July 6, 2010. Wonder if he's talking about his oil device or his movie career...
  17. haydur's Avatar
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    #2217  
    The OP needs to stop watching Fox News. I am not going to go through this entire thread, but just in case no one has pointed this out before...

    The Government is not going to make this a 1-healthcare-plan state. Instead, it will offer a cheap plan for all those who can't afford healthcare insurance or do not want it through their employer for whatever reason. The Government will also mandate that everyone get healthcare coverage.

    I can't believe you are OK with others not having any coverage and dying off diseases they can't afford to get cured from, because letting them live may require an an extra quarter or two out of your pocket.
  18. phlegm's Avatar
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    #2218  
    I'm a Canadian, so I don't want to hijack your discussion, but I'm not sure I understand the argument against public healthcare.

    Believe me, I'm neutral on this - not trying to cause an argument - it's your country.

    From my perspective, it's pretty good though:

    -In Canada, when I need to see the doctor, I just go. If I lose my job, I can still go. That takes a lot of worry away from me and my family.

    -Small businesses don't have to worry about paying for a health plan. Your employees are just covered. I'm thinking that could really help the bottom line.

    -I noticed that in union negotiations, that US labour costs were more expensive relative to Canada since US firms had to factor in a cost-per-head for healthcare. This was not part of the expense for Canadian workers, thus a reason for some Canadian auto plants. (Maybe a bad example given the current climate, but it applies to organized labour overall.)

    -Re coverage for older folks/retirees, that has not been an issue either. My wife's great aunt fell, and broke her hip. She had a hip replacement at the age of 92. (Even surprised me!)

    -I'm not aware of any lack of quality here, so I don't think that's an issue.

    Are taxes higher in Canada? You bet.
    Is the government extremely efficient at running healthcare? Nope.
    Can we get an MRI, etc. immediately? No way - always have to wait, but I'm not sure if you can get an MRI immediately in the US? (Please let me know.)

    But, it works pretty well, and although - if I'm honest - it does bother me that I'm paying for "freeloaders" under this system, there are a lot of honest people that deserve healthcare, so overall I'm for it.

    And it kills me to see people in the US who get a serious condition, and maybe even with a healthcare plan they need to pay for a substantial portion themselves. It just seems like a shame that they'd have to incur so much debt to get healthy.

    Cheers.
  19. KAM1138
    KAM1138's Avatar
    #2219  
    Quote Originally Posted by phlegm View Post
    And it kills me to see people in the US who get a serious condition, and maybe even with a healthcare plan they need to pay for a substantial portion themselves. It just seems like a shame that they'd have to incur so much debt to get healthy.
    Its a shame many things happen in this world.

    Its a shame people go hungry--should the government provide food to everyone? They do provide it to some. We don't tell those who pay for themselves what food they must buy.

    Its a shame some people don't have homes--should the government provide housing to everyone? They do provide to some. We don't tell those providing their own housing where they must live or in what size home.

    Its a shame that some people don't have adequate medical care--should the government provide it to everyone? We already do to some...so why should the government get into the business of involving itself with my healthcare?

    I don't want the government involved in my health care, nor what I eat or the home I choose to live in. If someone else can't afford it--well, use the tax money we give government wisely and efficiently and pay for those people if that is our moral obligation.

    If I'm left begging for Government Aid, then I'll do what they say, and decide is best for me. Until then, leave me out of it. I'll keep paying, and unlike someone else claims--it is a helluva lot more than a few quarters.

    KAM
  20. haydur's Avatar
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    #2220  
    Quote Originally Posted by KAM1138 View Post
    Its a shame people go hungry--should the government provide food to everyone? They do provide it to some. We don't tell those who pay for themselves what food they must buy.
    Yes, we have food stamps and they work for those who can't afford all their edible needs. Is that wrong?

    Quote Originally Posted by KAM1138 View Post
    Its a shame some people don't have homes--should the government provide housing to everyone? They do provide to some. We don't tell those providing their own housing where they must live or in what size home.
    Housing isn't the same as healthcare. You don't die because you have to rent or have or live in a shelter. Don't compare it to healthcare.

    Quote Originally Posted by KAM1138 View Post
    Its a shame that some people don't have adequate medical care--should the government provide it to everyone? We already do to some...so why should the government get into the business of involving itself with my healthcare?
    That's where we are completely different in our thinking. I believe healthcare is an essential human right. Just like you might think that the constitution gives you the right to bear arms anytime and anywhere.

    Quote Originally Posted by KAM1138 View Post
    I don't want the government involved in my health care, nor what I eat or the home I choose to live in. If someone else can't afford it--well, use the tax money we give government wisely and efficiently and pay for those people if that is our moral obligation.

    If I'm left begging for Government Aid, then I'll do what they say, and decide is best for me. Until then, leave me out of it. I'll keep paying, and unlike someone else claims--it is a helluva lot more than a few quarters.

    KAM
    The government doesn't want to get involved in YOUR healthcare. It wants those who don't have any or can't afford it to be able to get treatment when they need it. You can keep yours. Yes, a public option would use your tax money to pay for those same people's healthcare. Again, you need to stop listening to conservative scare tactics and actually educate yourself on what the Obama administration is proposing.

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