Well, the usual suspects are gleefully touting the latest Commonwealth Fund study as if it settles the health care debate in their favor. Here’s the chart that has set their hearts aflutter:
Looks bad. But, as is usually the case with the Commonwealth Fund, there is less here than meets the eye. The most significant problem with the study is its data source:
For this study, the researchers used data from the World Health Organization on deaths from conditions considered amenable to health care …
Using W.H.O. data to compare these kinds of outcomes is a very dodgy business. Why? Because accuracy in diagnosing and recording causes of death varies wildly from nation to nation. That’s why the W.H.O. issues the following warning:
Comparison of cause of death data over time and across countries should be undertaken with caution … coding underlying causes of death involves some extent of misattribution or miscoding … incorrect or systematic biases in diagnosis, incorrect or incomplete death certificates, misinterpretation of ICD rules for selection of the underlying causes.
The people who produced the “study” were apparently heedless of this warning. They have therefore produced the mother of all apple-to-orange comparisons. That hasn’t given a moment’s pause to the single-payer crowd.
But, then again, facts have never mattered much to the advocates of government-run health care.
Comments 3
No such thing as perfect numbers, all studies have variables as you aptly discuss. However, you failed to discuss statistical significance. The greater the number and effect of variables the harder it is to reach statistical significance. If you understand the concept you can apply it, i.e. the UK, the US, and Canada have very similar reporting methods and consistency but the numbers are so close I would say they are not statistically significant. However, if you review the counterpart to health and human services department in France and judge how they report you will see they are not that much different, makeing those numbers statistically significant. I suppose if you dont have more than a basic understanding of statistics you should neither use this info to suppor nor debase an arguement. Oh and we should all remember that cause of death on dealth certificates has been shown to be 90% inaccurate (we dont usually autopsy).
Posted 10 Jan 2008 at 7:00 am ¶What I don’t understand is why you would think the US should come out better, as you have the most inequality of any developed nation. And if you actually read the study you’ll see they have been careful in selection:
…for this paper we considered conditions such as bacterial infections, treatable cancers, diabetes, cardiovascular and cerebrovascular disease, and complications of common surgical procedures. We also included ischemic heart disease (IHD); however, in line with accumulating evidence suggesting that only up to half of premature mortality from IHD may be potentially amenable to health care, we here considered only half of IHD deaths to be “amenable.” A general age limit was set at seventy-five years, because the extent to which deaths can be prevented by health care and the reliability of death certification become increasingly questionable at older ages.’
And another point for you. Have a look at this story - what with your reforms would you envisage thisi person paying in terms of a premium and deductible?
http://www.philly.com/inquirer/opinion/pa/20080108_Self-employed__and_going_it_alone_.html
Posted 10 Jan 2008 at 8:45 am ¶Have you had a chance to come up with some figures that would materialise under your reforms?
‘And another point for you. Have a look at this story - what with your reforms would you envisage thisi person paying in terms of a premium and deductible?
Posted 14 Jan 2008 at 4:34 pm ¶http://www.philly.com/inquirer/opinion/pa/20080108_Self-employed__and_going_it_alone_.html‘
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