Wednesday, July 04, 2007
Discussion with a Conservative about Universal Health Care
Here is a series of e-mails between S, R, and myself. My friends all have access to this blog and they can judge for themselves whether I have faithfully presented their arguments and opinions in these e-mails. The series starts with an e-mail from S to R and others:
What does Socialized medicine buy Canada versus our patch work of medical coverage?
It buys a lot if you look or compare two statistics.
- Canada infant mortality rate within 24 hours is 4.6 per 1000 live births and the U.S is 6.4.
- Mean life expectancy is 80.3 years for Canada and 78.7 for the U.S.
I came up not with socialized medicine but a public health plan. This thought occurred to me while sitting in the waiting room at a woman's clinic. Jean was sent there to see a gynecologist. Poor Jean, she was by far the oldest and the only one positively diagnosed as not pregnant.
Attempting to study the group indicated most were by far much over weight. If overweight and lack of prenatal care were publicly available, could this reduce infant deaths? Not much there as training is very important in prenatal care. Trained nurses could handle this. The Red Cross offers classes to train parents for the new born in the home. Jean and I took the course and poor Jean was out of place as we were adopting and in our thirties.
Now on to longevity. Most people get some training in health in high school. However only something like 85% graduate by eighteen. Adult school does not cover health very much. I think this area would be another boost to senior's longevity.
My mother spent a huge number of volunteer hours with the county health department. She knew what it took to provide clinics of various types and some of her greatest friends were public health nurses. The nurses keep my Typhoid shots current as I was often drinking water out of North Georgia springs. nutrition was a big thing with the prenatal and post natal clinics. Doctor's cost was very little and often was a donation.
So conservatives, what is wrong with such a start towards some UHC by this method? Will it not help the most in need? I do not want to hear an answer about how one can not purchase batteries for a hearing aid in Canada.
Liberals, I have come to understand, have a protective shell that keeps out facts no matter how over repeated or how well documented. Facts are not just lamely refuted, they are totally ignored.
1.0 Canada infant mortality rate within 24 hours is 4.6 per 1000 live births andThe reason infant mortality rates are higher in the US has nothing to do with the health care system, it is due to social problems. We have a huge population of drug-addicted mothers that Canada, nor any other country, cannot match. This is certainly a major problem, but it is not going to be cured by health insurance.
the U.S is 6.4.
2.0 Mean life expectancy is 80.3 years for Canada and 78.7 for the U.S.The lower life expectancy in the US, compared to other first-world nations, is due to the much greater number of deaths in the age group from about 15-45. These deaths are due to traffic accidents, violence (e.g. gang shootings), drug overdoses, and suicides. If you make it to 50 in the US, life expectancy is the longest in the world. Quite obviously, changes in health care insurance will have no effect whatsoever on traffic accidents, violence, drugs, and suicides.You point out correctly, that American high-fat high-sugar diets and lack of exercise are major problems. More can be done with educational programs, but changes in health insurance are not going to have any effect. Note, for example, that countries with a lot of mass transit involve their population in a great deal of walking. The US has too low a population density to support much mass transit outside of a few city centers. Health insurance is not going to change that. I have a profit-making health insurance plan. They contact me regularly by phone and by mail with all sorts of suggestions about a healthier lifestyle. They have an incentive to improve my health. Why would a non-profit care?Medicare lowers their administrative costs by never checking bills for error or fraud. They spend zero on that. Profit-making insurance plans comb hospital bills and dispute overcharges. I have little doubt that more than pays for itself. Why would a non-profit care?
Finally, note that countries like Canada can get away with imposing price controls on drugs. Since it is a small market, the drug companies do not cut them off. But try it in the the US, and you will drive drug companies offshore and refusing to ship. But facts are just to be ignored.
I specifically looked those figures up. Does that make me a Liberal?
At least we agree on one thing. Education helps. When I started volunteer tutoring years ago, the school was overrun with pregnant teens. Lots of effort of education was put forth by the school about protection with respect to aids. They had a guard who worked for the local prison talk on how he had contracted aids in a fight with a prisoner. We now have very few pregnant girls and a much larger coed enrollment.
I am proposing more health centers where teens can learn more about prenatal care plus child care. Schools hardly can afford full time medical trained faculty members.
Your point about the age group 15-45 has much merit. Canada has a much lower speed limit. You seldom even see a 100 KM speed limit which is close to 60 MPH in this country. I do not remember ever seeing a higher speed limit there. Their speed limit enforcement is well in place too.
I am not sure about the mass transit argument. Does this mean that our death rate is less in the bigger cities like San Francisco? I thought that most centenarians live in rural Midwest. Am I wrong?
Lastly, our schools now sell machine soft drinks and chips through machines. Not much help there if the student body has a number of pregnant girls.
I have no idea about the life expectancy over 50. Do you have a reference? IRS bulletin 590 has lots of longevity tables for IRA distributions. If this is so, our life insurance costs for those over 50 would be higher. Moreover, the other countries with a SS type plan would be more solvent too would it not?
The data you quoted is more elaborate then mine. Does this mean Conservatives have a better source. Who is using more statistics?
Pessimistic and Liberal, S
I specifically looked those figures up. Does that make me a Liberal?Too soon to tell. If in a week or two you claim that life expectancy numbers prove the US health care system is inferior, then you are a certified Liberal.
At least we agree on one thing. Education helps.We do agree on that.
Canada has a much lower speed limit. You seldom even see a 100 KM speedI don't think speed limits are the main problem. In this country, if a person has his driver's license suspended for DUI or whatever, he usually drives out of the courthouse parking lot -- ignoring the court completely. In Japan, by contrast, first DUI means you lose your license forever, second offense is a year in jail. Their tradition is that the youngest person in every group will be the driver, and will be served nothing but coke that evening.
limit which is close to 60 MPH in this country.
I am not sure about the mass transit argument. Does this mean that ourI don't know. I was just observing that exercise is one factor in a healthy lifestyle, a factor often missing in the US. I lived in Tokyo for a while, and found mass transit to be quite a workout. One can easily climb 20 flights of stairs and walk four or five miles every day making connections. If the Japanese did not drink so much and eat so much salt, they would live forever.The broader point is that the quality of health care is not the only factor in health. It also depends upon the health habits of the population. The increase in obesity, for example, is expected to lower life expectancy in the US over the next few decades.
death rate is less in the bigger cities like San Francisco? I thought that
most centenarians live in rural Midwest. Am I wrong?
I have no idea about the life expectancy over 50. Do you have a reference?From MIT course notes on Public Health Policy:
"Significant improvements in life expectancy lies not in cures for chronic disease—heart, cancer---but in reducing accidents, suicide, homicide, AIDS, the big causes of premature death."
Posted here "First, it would be great if people would recognize the limits to health care, even high-tech health care. Diet and exercise matter more to your quality of life than treatment does. For example, you could stop treating cancer completely and only drop the overall life expectancy by a couple of years. If this seems ridiculous to you, do the math. ...." [he does]http://www.oftwominds.com/journal/goodfellow5b.html
"... The United States spends roughly $4,500 per person on health care each year. Costa Rica spends just $273. That small Central American country also has half as many doctors per capita as the United States. Yet the life expectancy of the average Costa Rican is virtually the same as the average American's: 76.1 years."
How can that be? According to public health researchers, the biggest reasons are behavior and environment. Costa Ricans consume about half as many cigarettes per person as we do. Not surprisingly, they are four times less likely to die of lung cancer. The car ownership rate in Costa Rica is a fraction of what it is in the United States. That not only means that fewer Costa Ricans die in auto accidents, but that they do a lot more walking, and hence they get more exercise. Thanks to a much lower McDonald's-to-citizen ratio, the average Costa Rican thrives on a traditional diet of rice, beans, fruits, vegetables, and a moderate amount of fried food--and therefore enjoys one of the world's lowest rates of heart disease and other stress-related illnesses." http://www.washingtonmonthly.com/features/2003/0304.longman.html
Lastly, our schools now sell machine soft drinks and chips through machines.I am all in favor of parents exerting control over the diets of their children.some places are banning the soft drinks. Do you think Libs still have superstitious fears about dangers of artificial sweeteners?
Moreover, the other countries with a SS type plan would be more solvent tooNo. SS is a Ponzi scheme whose solvency depends upon the ratio of the number of active contributing workers to the number of recipients.The data you quoted is more elaborate then mine. Does this mean Conservatives have a better source. Who is using more statistics?I have been repeatedly criticized by Libs on message boards for citing facts. They tell me that facts are unreliable, whereas feelings are reliable. Therefore, they tell me, one should develop policy positions by cultivating sensitive feelings, and then reject statistics that contradict those feelings.
would it not?
[The discussion is continued in my next post. - AJS]