Rabid Sanity Tackles Health Care

In an exchange I had with Steve at Rabid Sanity regarding health care, he referred me to two articles that take issue with the current low ranking by World Health Organization of the United States’ health care system against other industrialized countries. We’re 37th. The two articles dispute the rankings, saying they are biased in favor or state-run systems. Our system is not “perfect” one admits, but is probably the best in the world.

The first article is How surveys twist rankings on health care, by Glen Whitman. The problem is, he says, the objectives of the study.

The most obvious bias is that 62.5 percent of their weighting concerns not quality of service but equality. In other words, the rankings are less concerned with the ability of a health system to make sick people better than with the political consideration of achieving equal access and state-controlled funding.

This, he says, is a flaw in the study. The United States is very good at making sick people better – not all sick people, but that’s not the point. A health care system should be measured by its abilities, and not its delivery capacity. That 47 million of us are without insurance? Not an issue. Bias.

The rankings include measures for “health level” and “responsiveness.” “Health level” is their way of saying life expectancy, while “responsiveness” refers to a survey based on “respect for persons” and elements such as speed of service, convenience and choice — yet even in these cases half the overall weighting is determined by considerations of equality. Thus, a country with a poor level of “responsiveness” throughout the population will score higher than a country with a good level in some parts and an excellent level in others.

It’s in the eye of the beholder, I guess. Whitman is a professor of economics, and is not concerned about equality. And he is right: If you only measure the people we actually take care of in this country, we’re the toast of the town.

The second article, Ranking the U.S. Health-Care System, by Jim Peron (for whom it gives no credentials), says pretty much the same thing, but from a doctrinal standpoint. Peron starts off by using the word “socialist” as a pejorative, so it’s not hard to see where he’s going. Referring to a study by the Commonwealth Fund that also ranked the U.S. very low, he says

The Commonwealth Fund marked down the United States partly because “All other major industrialized nations provide universal health coverage, and most of them have comprehensive benefits packages with no cost-sharing by the patients.” Again the American system loses points because it doesn’t provide socialized medicine. And the Times neglected to note that “no cost-sharing” means the people have paid through taxes whether they receive the care or not.

This is a curiosity. The concept of insurance is based on shared risk, no different than coverage of people’s health care through taxation, also a shared-risk system. But Peron presumes that private insurance is a superior model because it is not based on taxation. That’s nothing more than personal bias.

This is priceless:

This issue is not unknown to the Commonwealth Fund. In 1999 it
published The Elderly’s Experiences with Health Care in Five Nations, which found significant delays for “serious surgery.” Only 4 percent of the American seniors reported long waits for serious surgery. The rate was 11 percent in Canada and 13 percent in Britain. For non-serious surgery the differences were more obvious: 7 percent in the United States, 40 percent in Canada, and 51 percent in Britain.

He’s talking about seniors. He doesn’t seem to realize it, but he’s comparing our Medicare, or government-sponsored system that is supported by taxes, with other countries. I’m happy that Medicare is doing well in that regard. It’s a well-run system.

In other areas, Peron simply offers up weak, made-up-on-the-spot excuses.

The United States also lost credit because fewer Americans report having a regular doctor for five years or more. But Americans are more mobile than many other people.CNN reports that Americans move every five years on average.

He does that in other areas as well, as in emergent care wait periods, lack of centralized medical records, and the number of patient complaints. (“But different cultures have different attitudes toward complaining.”)

It’s all illuminating, but not of the relative merits of health care systems. In terms of equality and delivery of care, the U.S. lags far behind other countries. But these articles, and Steve’s post to begin with, shine a light not on study biases, but rather on right wing biases. Yes, we don’t offer care to everyone. We don’t intend to! Yes, our care for the wealthy and well-insured is excellent. Those are the people the system is meant to serve.

The system works as it is intended to work, delivering excellent care to insiders, and poor or no care to outsiders. When we debate conservatives like Steve on this issue, that is the subtext, and the issue we need to highlight. Conservatives are far too caught up in rewarding the financially well-off. In health care, that’s a poor objective. Even if they attain it, they have failed us.

For that reason, they need to step aside and let us “socialists” fix our health care system. It’s long overdue. We have real answers while they offer nothing other than a curtsy to Ayn Rand.

Bicyclist Assaulted by New York’s Finest

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Incredibly, the bicyclist, who was part of a Critical Mass protest, was arrested and charged with assaulting a police officer. The officer in question claims that the cyclist was aiming at him and that he was only defending himself.

In 1968, he would have gotten away with it.

The Moons of Jupiter

This is pretty neat if you like looking at stars and stuff. The brightest object in the southern sky these nights is the planet Jupiter. Last night, using ordinary binoculars, we were able to see it well enough that three of its moons were visible. Two were on the right, one on the left.

I needed to steady the binoculars to see the moons, so I crouched way down and braced them on the back of a lawn chair. After the binocs were steadied, the moons appeared as if by magic.

Too Close For Comfort

Three separate studies predict that Barack Obama will win the coming election with between 52 and 55 percent of the vote. The studies, highlighted in this Raw Story article, predict election outcomes based on our economic condition, and have been right in almost every postwar U.S. election.

Problem: Exit polls in 2004 showed John Kerry winning the popular vote in that election by three percentage points. Yet on the Wednesday morning following the election, George W. Bush was on top by 2.5%. Something was amiss. There was a 2.75% flip. (There was a similar flip in 2006, but the Democratic victory was so large that the exit poll discrepancy has largely been pooh-poohed.)

Exit polls, a powerful tool used by the Carter Center and the United Nations to judge the fairness of elections throughout the world, have been pretty much dead on in the United States – up until about 1998. Then they went haywire. What changed?

This study, from the National Election Day Archive Project, pretty well demolishes all of the arguments used to explain the disparities between the exit polls and the vote count in 2004. It boils down to vote-counting irregularities, which in almost all cases favored George W. Bush. In other words, enough of the vote was flipped to him, usually by unauditable electronic voting machines that count the votes in secret (using proprietary software), to swing the election in his favor.

So the problem with the Raw Data article that predicts an Obama victory is that it puts the winning margin within the ‘flippable’ range – if Barack Obama secures 53% of the vote, the final tally will show him with 49.9%, losing a squeaker.

Democrats are weak on this issue, as on almost every other important issue of the day. I do not understand why. John Kerry privately admitted to Mark Crispin Miller in 2004 that he suspected the 2004 election was stolen, but publicly has been submissive and denies saying so.

Subtle Racism from McCain

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We speak in code. Hillary Clinton and John McCain are millionaires many times over, McCain by way of marriage to an heiress. They are aristocrats, and usually our elections are a choice among such people.

Why are we now told that a man from a common background who doesn’t have a lot of money, who made it on smarts and guile, is all the things that are really more like Clinton and McCain? Why are they using words like “arrogant” and “pompous” and “elitist” against Obama now? It’s easy to understand once you break the code. Barack Obama is

uppity

There’s even more going on with the McCain ad above, and thanks to Rachel Maddow for pointing this out last night on Race to the White House on MSNBC. (Her comments elicited exasperated sighs from her colleagues). Why did the McCain people use Britney Spears and Paris Hilton in the ad, juxtaposed with Obama? Why not Ophra Winfrey, with whom he really has a relationship? She’s famous. She’s a really big star.

It’s not hard to see once pointed out – it’s “Harold, Call Me” all over again. It’s a black guy with white chicks. White guys hate that. It’s an archetype, something embedded deep in our minds. Advertising is a science that persuades by subtle manipulation of the senses, and not by reason. There’s latent racism in all of us – McCain needs to nurture it and exploit it. But he’s got to be careful to avoid a backfire. Our outer, or public selves reject racism, but our inner selves, which is where advertising is aimed, harbor it.

It’s starting now. I thought they’d wait until Labor Day, because as Andrew Card reminded us, you don’t introduce a new product in August. It’s going to be a long campaign. And there’s really very little that Obama can do about it. How do you defend yourselves from advertising professionals?

There are two defenses against a professionally done smear campaign: Engage them on their own turf, or stay above the fray. Neither works.

Daniel Ellsberg on Obama and FISA

Daniel Ellsburg on Barack Obama and FISA:

I think when people go to the polls in November, and especially in light of the fact that even Barack Obama (whom I certainly support – it’s essential, necessary that he be elected), with his support of this FISA Amendment Act, has indicated very clearly that it is not his intention to roll back this usurpation of presidential powers. He’s accepting the powers that Bush and the Congress are going to bequeath him. So I think the people will be choosing between two… not presidents in the sense of the constitution … but two kings, two people with dictatorial powers.

Conservative Assumptions

According to Richard Viguerie,, Chairman of ConservativeHQ.com, the actual Bush deficit for the coming fiscal year is not the $482 billion announced by the White House, but rather $789 billion. The former number does not include $227 billion that will be borrowed from the Social Security Trust Fund (taken from the middle and working classes), and $80 billion to fund the ongoing wars in Iraq and Afghanistan.

Estimated expenditures are over $3 trillion, counting the wars, so that we are borrowing about $.26 cents for every dollar we spend at the federal level.

Viguerie is against this sort of spending. We probably don’t agree on where spending should be cut, but it is refreshing to hear from him, to know that there are some fiscal conservatives living and breathing out there. As with everything else he touches, Bush has made a joke of an honorable philosophy.