Last week, I noted a serious flaw in the Commonwealth Fund study that purports to show how badly the U.S. compares to other nations in “amenable mortality” rates. Well, it’s worse than I thought. Warren Meyer points out the following:
The authors do not look at any patient data … They arbitrarily defined a handful of conditions as “amenable” to care. These are:
Ischemic Heart Disease (IHD)
Other circulatory diseases
Neoplasms (some cancers)
Diabetes
Respiratory diseases
Surgical conditions and medical errors
Infectious Diseases.
Perinatal, congenital, and maternal conditions
Other (very small)All the study does is show how many people died in each country from this set of diseases and conditions … This study was not an effort to identify people who died when their particular condition should have been preventable or amenable to care; all it measures is the number of people in each country who died from list of conditions.
Not that single-payer advocates are terribly concerned about this or any other flaw in th study. What matters to them is that they have another talking point to deploy in the cause of government-run health care.
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So David, let’s get this clear. Are you accepting the higher mortality rates in the US from the selected conditions, and if so, what factors are in play?
Bear in mind that what the study authors say: ‘By 2002–03 the United States had among the highest death rates from causes amenable to health care of the countries studied, for both males and females. From the preceding discussion of potential limitations, it does not seem plausible to dismiss the comparatively poor performance of the U.S. health care system
Posted 14 Jan 2008 at 4:31 pm ¶as an artefact of the data.’
Are you insinuating that they cherry-picked data to show the U.S. in particularly bad light? Or are you saying they’re just using bad data that happens to depict the U.S. poorly?
I guess I’m trying to get at where you think the malice (if there is any) exists. All the study authors are saying is that more people die in the U.S. of preventable diseases than anywhere else in the Industrialized World.
So this is a criticism of our entire Public Health System rather than just our Health Care System. You win.
Posted 14 Jan 2008 at 6:25 pm ¶“Are you insinuating that they cherry-picked data to show the U.S. in particularly bad light?”
They committed three offences:
1) They used flawed W.H.O. data.
2) Then, they cherry-picked it.
3) Finally, they made claims that are not supported by the flawed, cherry-picked data.
The “study” is a joke.
Posted 14 Jan 2008 at 8:14 pm ¶multiple studies by multiple organizations indicate that the US spends much more than other countries yet has outcomes that are ‘worse’.
if you disagree with WHO data, what data exists to the contrary? is there data that shows the US has better health care outcomes than other countries?
Posted 14 Jan 2008 at 9:22 pm ¶“If you disagree with WHO data, what data exists to the contrary?”
The quality of W.H.O. info is undermined by variations in data collection methods between nations. Thus, when a study compares national outcomes using W.H.O. data, it isn’t comparing apples to apples.
As to contrary data on this general topic, some articles of interest can be found here, here, and here. But these can be probably be picked apart as well (where there’s a will there’s a way).
The difference is that most of the people quoting this study use it (and similar studies) as a call to action (i.e. for making HUGE changes in our health care delivery model). But, if their “study” is suspect, then their call to action is suspect as well.
Posted 14 Jan 2008 at 10:04 pm ¶So - I take it you don’t accept there are higher mortality rates in relatively low ages in the US from the selected conditions - is that right?
Posted 15 Jan 2008 at 3:44 am ¶What I “don’t accept” is that this study tells us what it claims to tell us. The quality of the data and the study’s slipshod construction disqualify it as a serious piece of analysis.
Posted 15 Jan 2008 at 7:20 am ¶Have you read the study? If not, you can’t really comment I would respectfully suggest.
Posted 15 Jan 2008 at 7:22 am ¶Sigh … How do you suppose I got the information I discuss in my original post on the subject?
Posted 15 Jan 2008 at 9:48 am ¶The data is no more suspect than the data you often post and sadly propogate to support your claims.
1. There is no such thing as un-flawed data, also, what motive does the WHO have to not collect the best data available?
2 How do you figure it was cheri picked? they simply chose categories that were “most likely” to support treatable causes of death
Your links dont make sense? the first one says mortality dropped in the hospitals over a decade? considering the advances in medical technology it had better, and I am sure it has in all civilized nations, the second link is an article, might as well post a link to the readers digest. And the third one, look at how close the death rates are for the top 10-15 countries? this does NOT reach a statistically significant difference, which means despite double to triple the spending rate we are doing no better.
Posted 15 Jan 2008 at 10:41 am ¶“The data is (sic) no more suspect than the data you often post and sadly propogate to support your claims.”
Even if that were true, it misses the point.
I offer various surveys, studies, etc. merely to show that the claims of single-payer advocates are open to doubt.
You guys, on the other hand, use surveys, studies, etc. to justify a “redo” of the whole medical delivery system.
Thus, your side has a higher credibility bar to get over. Your data have to be like Caesar’s wife—above reproach.
And they’re not.
Posted 15 Jan 2008 at 1:29 pm ¶Actually, you also offer surveys, studies etc. that support your point and purport them to be gold standard fact. Of course single payer is open to doubt, there is no such thing as a perfect system, it doesn’t and wont happen. Who is “you guys”? I am just a person, I represent no political affilliation, I have no financial gain to be had whether we have changes or no changes in the system. You on the other hand work in hospital finance, I suspect a single payer system would put you out of a job. What’s the matter David, haven’t you planned for your retirement?
Posted 15 Jan 2008 at 2:41 pm ¶PS, my girlfriend is due to give birth to my first boy anyday now, so if I suddenly disappear and stop annoying you for a while, you will know why. wish me luck.
Posted 15 Jan 2008 at 2:55 pm ¶“I suspect a single payer system would put you out of a job.”
Nah. If we ever wind up with single-payer, it will be Medicare-for-All, and a good bit of my expertise involves navigating the shoals of Medicare and Medicaid. So, I’ll be fine no matter what happens.
Believe it or not, I’m genuinely worried about the patients. As each year goes by, CMS edges closer and closer to interfering with actual care. And I think that’s a dangerous trend that would be even more prounounced with single-payer.
Good luck on the wee bairn.
Posted 15 Jan 2008 at 7:33 pm ¶drmatt, congrats! Hope everything goes well for you and your family.
Posted 16 Jan 2008 at 1:35 pm ¶Post a Comment