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Politics : View from the Center and Left -- Ignore unavailable to you. Want to Upgrade?

To: DanD who wrote (64334)	5/9/2008 2:30:07 PM
From: TimF	Read Replies (2) \| Respond to of 542835

Natural Life Expectancy in the United States (1980-1999 adjusted for differences in fatal injuries) US 76.9, France 76.0, Japan 76.0, Canada 76.2, UK 75.7 ... politicalcalculations.blogspot.com Message 23912656 -- Beyond Those Health Care Numbers November 4, 2007 By N. GREGORY MANKIW nytimes.com Message 24023951 -- "...First, it's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country. Infant mortality in developed countries is not about healthy babies dying of treatable conditions as in the past. Most of the infants we lose today are born critically ill, and 40 percent die within the first day of life. The major causes are low birth weight and prematurity, and congenital malformations. As Nicholas Eberstadt, a scholar at the American Enterprise Institute, points out, Norway, which has one of the lowest infant mortality rates, shows no better infant survival than the United States when you factor in weight at birth..." health.usnews.com theagitator.com Message 23879535 -- WHO's Fooling Who? The World Health Organization's Problematic Ranking of Health Care Systems by Glen Whitman cato.org Full paper (HTML) cato.org (PDF) cato.org WHO's Healthcare Rankings, Part 1 ...Both of these indices include “financial fairness” (FF) as a factor with 25% weight in measuring the system’s performance. FF is measured first by finding a household’s contribution to health expenditure as a percentage of household income (beyond subsistence), and then looking at the distribution of this percentage over all households. The wider is the distribution, the worse a nation will perform on the health performance index (other things equal). But it should not be surprising at all that a larger percentage of poor people’s income will be spend on health than would be spent by the rich. Insofar as healthcare is treated as a necessity, we should expect that people will spend a decreasing fraction (not a decreasing amount, but a decreasing fraction) of their income on healthcare as their income increases. Rich people tend to spend a larger percentage of their income on luxuries than do the poor. More importantly, the distribution of household contributions will obviously decline when the government shoulders more of the health spending burden. In the extreme, if the government pays for all healthcare, every household will spend the same percentage of their income – zero – on healthcare. In other words, this measure of health outcomes necessarily makes countries that rely on private payment look inferior. It gets worse. The ostensible reason for including FF in the healthcare performance index is to consider the possibility of people landing in dire financial straits because of their health needs. It’s debatable whether this factor deserves inclusion in a strict measure of actual health performance – but let’s suppose it does. FF does not actually measure exposure to risk of impoverishment. FF is based on cubing (!), for each household, the difference between that household’s contribution and the average household’s contribution to healthcare. Consequently, FF is negatively affected by households that spend a larger percentage of their income on healthcare than others. But FF is also negatively affected by households that spend a much smaller percentage of their income on healthcare than others! This is senseless, but it’s a natural result of focusing on distribution instead of the effectiveness of the healthcare people receive. agoraphilia.blogspot.com "... But this is not the only problematic factor in the WHO rankings. The rankings result from an index based on five factors, weighted as follows: 1. Health Level: 25% 2. Health Distribution: 25% 3. Responsiveness: 12.5% 4. Responsiveness Distribution: 12.5% 5. Financial Fairness: 25% Only two of these – health level and responsiveness – are direct indicators of health outcomes. Even these are subject to some objections (such as that health level is affected by things like crime and nutrition), but they’re at least relevant. But neither health distribution nor responsiveness distribution properly belongs in an index of healthcare performance. Why not? Because inequality (that’s what “distribution” is all about) is distinct from quality of care. You could have a system characterized by both extensive inequality and good care for everyone. Suppose, for instance, that Country A has responsiveness ranging from “good” to “excellent,” while Country B has responsiveness that is uniformly “poor.” Then Country B does better than Country A in terms of responsiveness distribution, despite Country A having better responsiveness than Country B for even the worst-off citizens. The same point applies to the distribution of health level. To put it another way, suppose that a country currently provides everyone the same quality of healthcare. And then suppose the quality of healthcare improves for half of the population, while remaining the same (not getting any worse) for the other half. This is obviously an improvement – some people get better off, and no one gets worse off. But this change would cause the country to fall in the WHO rankings, other things equal..." agoraphilia.blogspot.com -- Also see Message 24361299 The Facts on the Uninsured in America conservativecolloquium.wordpress.com Comparison of life expectancy of Japanese in Japan, and Japanese Americans Message 24049170