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Syndicated columnist Deroy Murdock’s comparison of the Clinton and Obama health insurance plans with the British National Health Service was more calumny than column. He characterized their proposals as “single payer” plans, comparable to the British National Health Service. In fact, both have proposed programs much more like the Dutch, German and French universal health insurance systems touted as more effective and “less government dominated.” The Spanish NHS, also listed, is similar to the British one.
Mr. Murdock compares the British system with the best in the world to imply that the candidates’ proposals would cost lives. Why didn’t he compare them with the system we have? A 2008 study of 19 prosperous nations ranked the United States dead last in Murdock’s preferred standard, mortality amenable to health care. The 17,000 deaths in the British system are appalling. Yet the United States racked up 75,000 more deaths than if we had only reached the average in the study, and far more on a per capita basis than in Britain. To make matters worse, the NHS improved the mortality numbers by more than 20 percent from 1997-2003 while the U.S. cut “amenable deaths” by 4 percent in the same period.
On the cost side, the British have universal free coverage for about half the cost of Medicare and Medicaid as a percentage of GDP. Murdock professes to be shocked that the British system would cost $1.05 trillion if imported to the United States. The bill for Medicare and Medicaid was $2.1 trillion in 2006. Every developed country in the world has a system of universal health coverage except the United States; all pay less, and according to the study, get more. We can learn a good deal by comparing what those countries do, but Mr. Murdock’s column did nothing to clarify that debate.
Check the facts. Clinton and Obama have each published their plans on the Internet. I lived in Britain for a year and was under the NHS. Other national plans can be found at Wickipedia, or on the WHO website. The study referred to was by Ellen Nolte and Martin McKee in Health Affairs Jan/Feb 2008, discussed in The Economist Jan. 24, 2008. The figure for Medicare/Medicaid spending was also in the same article.
REX DUNCAN
Grand Junction
One Response to “The British aren’t the only ones with universal health care”
Posted March 7th, 2008 at 8:28 am Login to Send PM Report this comment
You check the facts. The study you cite has been torn to shred for consistantly poor methodology that reveals a deep deficit in stastical ability by the authors.
The actual study can be found by starting here.
Hitting the first hyperlink in the press release will link to a page where you can get the text of the study. This bypasses the gates on the magazine that prevent viewing without buying the article.
The study is pretty well torn apart here.
Long story short, the authors merely counted up the number of people who died of treatable diseases and compared. They made the most minimal effort to deal with the effect of lifestyle, or that people get the diseases at different rates across nations, ie, look at their data on neoplasms, which is cancer. People in the US get cancer at a greater rate than in other countries, but fewer people per capita die from it than even France, which is the lead nation in the study. Not to mention that we find cases of cancer that other countries would miss, because they refuse to screen for it like we do and write off those individuals that could be saved.
Another good example is heart disease, which is where most of France’s advantage comes from. But fewer people in France get heart disease than in the US in the first place. The authors don’t bother to deal with this, but they do recognize that lifestyle is more of an issue than medical treatment. They cut every nations heart disease numbers by 50%, completely ignoring that the lifestyles are different across countries (only a fool would expect the same factor in Japan as in the US).
Surgeries are another good example. More surgeries per capita in the US, no surprise there’s more errors per capita. How about errors per surgury that lead to death instead? Was there any attempt to accomodate that detail? No.
And then there’s the perinatal catagory, a darling of the socialized medicine boosters, aka infant mortality. The problem here is that the US is less restrictive about what it considers a live birth. In many European countries a newborn must meet requirements of weight and height to not be considered stillborn, or are counted as stillborn if they are a certain time premature, even if they’re breathing or have beating hearts. They game the system, by declaring certain hard cases as stillbirths or miscarriages that the US considers live and expends effort on. In this catagory we are quite simply the best in the world at keeping premature and low birth-weight infants alive, despite what the statistic says.
Data collection is another issue. Britain lists pretty low rates of infectious disease, but it’s pretty common in Britain for hospitals to change the cause of death from an infection picked up in the hospital to something else in order to avoid being sued.
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