Tuesday, August 28, 2007

How to judge a healthcare system

Was the recent shooting of a child in Liverpool a healthcare issue? According to the WHO it was. Cafe Hayek reprinted part of a column by John Stossel, in which he looks at why the USA did so badly in the WHO and Commonwealth Fund country surveys. They take life expectancy into account, which of course includes gun fatalities and traffic accidents - on both of which counts the USA does badly. But here's the best bit:

Another reason the U.S. didn't score high in the WHO rankings is that we are less socialistic than other nations. What has that got to do with the quality of health care? For the authors of the study, it's crucial. The WHO judged countries not on the absolute quality of health care, but on how "fairly" health care of any quality is "distributed." The problem here is obvious. By that criterion, a country with high-quality care overall but "unequal distribution" would rank below a country with lower quality care but equal distribution.

It's when this so-called "fairness," a highly subjective standard, is factored in that the U.S. scores go south.

The U.S. ranking is influenced heavily by the number of people — 45 million — without medical insurance. As I reported in previous columns, our government aggravates that problem by making insurance artificially expensive with, for example, mandates for coverage that many people would not choose and forbidding us to buy policies from companies in another state.

Even with these interventions, the 45 million figure is misleading. Thirty-seven percent of that group live in households making more than $50,000 a year, says the U.S. Census Bureau. Nineteen percent are in households making more than $75,000 a year; 20 percent are not citizens, and 33 percent are eligible for existing government programs but are not enrolled.

1 comment:

Anonymous said...

Two of our closest friends (she and I were in the PhD program together decades ago) are illustrative. She was disgusted by nasty university politics, and when she finished her PhD, she and her husband bought a farm, sheep and goats. She did what she loved most: weaving. He is a handyman, and a very good one. They have two children, live below the poverty line, and don't accept a cent of government assistance. Somehow, they manage to buy medical insurance.

There's plenty of insurance policies available here, and just about anyone who wants insurance can afford to buy it.