Saturday, August 29, 2009
Mortality amenable to health care
I've already written a few posts advocating for an improved health care system in this country, but it's important and worth repeating. If you have scads of money, the system takes pretty good care of you, Glenn Beck's nightmare of early 2008 not withstanding. (I get the feeling Beck actually was given pretty good care and he's just a whiner who can't stand pain, which is sometimes unavoidable in the recuperation process.) But for people who don't have scads of money, the system doesn't work very well and it lets a lot of people down completely, even fatally.
Blog buddy Zoey & Me, author of the very pretty Cat In The Bag blog, did a post yesterday linking to data from The Commonwealth Fund, a private organization who state flat out in their charter that their goal is to improve health care access for the poor, minorities, children and the elderly in this country.
You know, commie fascist Muslim lesbian tree-huggers from Kenya.
Okay, now that I have the snark out of my system, let's look at the numbers. The observational study dealt with mortality amenable to health care, which they define as people dying before the age of 75 from stuff that a better health care system would be working towards preventing, like complications from diabetes, treatable cancers and cardiovascular diseases. They decided on a list of nineteen "industrialized" nations, the U.S., Canada, Japan, Australia, New Zealand and a cross-section of Europe that didn't live under Soviet rule during the Cold War. Left off the Western European list were Belgium, Switzerland and the postage stamp countries. Industrialized Asian nations like South Korea or Taiwan were not included.
They measured mortality amenable to health care in these countries in 1997-1998, then came back five years later to see if there was improvement.
There most certainly was improvement, across the board. The problem for Americans is that we improved least of all, and we fell from 15th of 19 on the list to dead last in those five years. Countries that were not doing well like the United Kingdom, Ireland, Portugal and Finland got their acts together in a big way and flew past us like we were standing still. We improved by 4.3% over those five years, but the next worst improvement was the Swedes, who did 6.8% better. This meant the Swedes fell from 5th place to 9th place. The weighted average of improvement for the other eighteen nations on the list was 15.0%, so in effect we were standing still.
What would it mean for us to go from dead last in our league to being in the top ten? What if instead of 110 deaths amenable to health care per 100,000, we could trim that down to 84 and tie with Greece for tenth place on this list? (Quick aside from an old coot: It's still strange for me to see Greece and Portugal counted as industrialized nations. When I was growing up, they were tourist destinations with nice weather that grew grapes and olives.)
Improving by 26 per 100,000 is the same proportion as 78,000 per 300,000,000. If the study is counting the whole population and we could do as well as the Greeks, 78,000 Americans that will die this year could be saved instead.
78,000 per year is like having a 9/11 sized attack every two weeks. It's not happening in one single place, there's no sexy image of a plane crashing into a building that can be repeated ad nauseum. The situation is that about 200 Americans a day dying before the age of 75 that would live instead if our health care system was as good as the Greek health care system. If we really got serious and tried keeping up with the Japanese or Aussies or the Spanish, we'd be saving about 300 people a day.
Part of the American problem is we still think we're the greatest country on earth. Nearly all of us have families that came from someplace else. Except for the people brought here as slaves, like the Africans centuries ago or the foreign girls that work in the massage parlors today, Americans share a story that our families came here to make a better life for themselves.
That story is still true to an extent, especially for the legal and illegal immigrants from other parts of our continent. Things are better here than they are in most of Mexico, or Honduras or Guatemala or El Salvador. But Europe and Japan, who trailed far behind the United States for decades after World War II as their much deeper wounds took time to heal, they don't look to America as the promised land anymore. America is the land of the greedy rich people and the fat poor people, and the only glue that holds the widening gap between rich and poor together is a strong tendency towards stupidity.
I have no illusions that stupidity will be eradicated in my lifetime. I have a sneaking suspicion that intelligence is a recessive gene, which means the stupid will always be with us. But even the dim can be motivated by pride, and national pride most of all. Do we really want to be worse than the Greeks and the Portuguese? Do we feel good when the Belgians kick our ass?
Things can turn around in this country, but we need a wake-up call for it to happen. If I may, let me use a sports analogy. When professionals were allowed to compete in the Olympic games basketball tournament in 1992, we sent a group of NBA players to represent the United States known as The Dream Team, and there was zero chance that team was going to lose. Less that ten years later, our professional all-star teams were losing to the rest of the world, not even getting a medal in the 2002 world championships and barely getting the bronze in Athens in 2004, winning five and losing three. Realizing the effort that was being put in was not enough, the U.S. men's basketball team returned to dominance, winning the world championship in 2006 in Japan and Olympic gold in Beijing in 2008.
So we can be the best in the world, then suck miserably, then return to prominence, but only if we know the situation. The big problem in this country is that we don't know had bad our ass is being kicked by the rest of the world when it comes to quality of life.
This is what happens when stupidity reaches a level so great, people can't even realize they are stupid.