Barack Obama says he wants to make reforming health care one of his administration’s top priorities. Change in health care is certainly needed. There is a danger, though, that the new president will be unduly influenced by political advocates peddling the same tired myths that have dogged the health care debate since the Clinton years. These myths are founded on selective data, doubtful sources and faulty science. For anyone with an open mind and a passion for accuracy, they are easily dispelled.
First, we hear a lot about how terrible the infant mortality rate is in the United States, supposedly the worst in the civilized world. Is this true? Not really. U.S. health officials count all live births, while many other countries only count full-term births or infants who live at least 28 days. Obviously, premature infants, who are counted in the U.S. but not in other countries, have a much higher risk of mortality.
Second, we are told people in the U.S. don’t live as long as people in other countries. However, deaths from homicide and accidents distort the picture. When the data is adjusted for these categories, life expectancy in the U.S. is as high as in other countries. Homicide and violent trauma certainly reflect a country’s social problems, but they tell us little about its health care system.
Third, we are told that each year in the U.S. there are nearly 100,000 unnecessary hospital deaths. A panel of doctors reviewed the hospital data and found the great majority of these deaths occur at the end of the patient’s natural life, when the outcome would have been the same regardless of what hospital staff did or did not do. In other countries, these older, desperately ill people often are not even sent to a hospital, dying at home instead, and are not included in national medical statistics.
A comparable, population-adjusted study in Canada found 200,000 “unnecessary” hospital deaths, even though political activists regularly push Canadian-style health care as the model for the U.S.
Fourth, we hear many people have to declare bankruptcy because of medical bills. It turns out advocates count any bankruptcy case involving even a single medical bill, whether or not health costs had anything to do with the person’s financial problems.
People ages 55 to 65, who have more personal control over their health coverage, are less likely to declare bankruptcy, while people over 65, who are on government-run Medicare, have seen a doubling of their bankruptcy rate. Tax-funded health care has not reduced bankruptcies for elderly Americans.
Fifth, we are told 45 million Americans are uninsured. Who are the uninsured? Is cost really the reason they do not have coverage? It turns out political advocates count anyone who was without health coverage at any time during a calendar year. Half of those counted as uninsured were in transition to a new job, and one-third could sign up for a government program (like Medicare, Medicaid or state-subsidized care) but choose not to.
Only about eight million people, less than 5 percent of Americans, are chronically uninsured. This is a serious problem, but hardly a reason to revolutionize health coverage for 95 percent of the population.
Sixth, we are told the U.S. ranks a dismal 37th in health care worldwide. The figure comes from the U.N.’s World Health Organization. Three of the five criteria used to rate nations were biased in a favor of nationalized, single-payer systems, and U.N. officials admit they have an 80 percent uncertainty level in their data. Amazingly, none of the five criteria included actual health outcomes, such as cancer or heart attack survival rates. The U.S. tops all countries in favorable health outcomes.
Besides, any health study that ranks Greece (#14) and Morocco (#29) ahead of the U.S. clearly has methodological problems.
The national debate about how to improve health care needs honest research honestly presented, not skewed data or false comparisons with other countries. The six myths about U.S. health care only serve to shift our focus away from the real problem – overregulation and artificially high costs. Only when public policy reconnects patients with their own health care dollars, and when decisions about care are made by doctors talking with patients, not by government program managers, will our nation be in a position to control costs and extend coverage to the chronically uninsured.
Dr. Roger Stark is a health care policy analyst at Washington Policy Center, a non-partisan independent policy research organization in Seattle and Olympia. For more information contact WPC at 206-937-9691 or washingtonpolicy.org.