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There's a few points that I forgot to bring up that I'll bring up and I promise I'll drop the subject. The first is the commonly referred to statistic that you hear everyone repeat verbatim and that I've read in almost every article about health care lately. The US Is ranked 37th in Health Care according to the World Health Organization rankings. The question to ask these people is, what metrics did the WHO use to determine these rankings. If they can't tell you, they don't think for themselves and they mindlessly repeat statistics they hear.
You're all poker players, you're aware that statistics don't necessarily tell the whole story. How many top players have given the advice, don't use a HUD? How many times have you seen a 57/40 and then instantly stacked off any pair to him postflop? Oh, did I mention that he folds to flop 80% of the time? Preflop stats don't give an accurate picture of how a player plays.
So what is the WHO using for metrics? Who is writing these reports and what are their motivations? I don't know all of them but here are the ones I'm aware of. There's subjective ones like:
1. How the cost burden is spread and how fairly it's spread out. A common theme you'll see in these ranking is an emphasis on how "fair" the system is rather than the quality of services and care provided. Think of a scale of 1-10. Let's say on average, the poorest people in Canada receive care that's ranked a 3. The richest people receive care that ranks a 4. In the US, the poorest people receive care that is ranked a 5 whereas the richest receive care that's ranked 8. Sure, poor people get worse care in relation. But is that really a worse scenario? The poorest people in our country get better care than the richest people in other countries.
2. How much of total GDP is spent on health care. If your GDP is larger, who cares if you spend a larger amount on health care? I'd be interested to find out how much of net worth Americans spend on housing, how much housing we get for that money. I bet it'd be higher than every other country in the world, but that's not really mentioned as a problem is it? When you have more money you spend more to buy more quality...bigger houses, better health care, faster cars. I'd rather drive my luxury car than those tiny 2 door pieces of crap they call cars in Europe.
Objective measures:
1. Age adjusted life expectancy. This is a combination of a variety of factors. A lot of this has to do with diet, amount of free time or money people have - for example, if your country has more money, more people have cars, more people drive, and more people die of car accidents. The #1 cause of death in the US is heart disease. This is a byproduct of having money to afford more unhealthy foods and larger quantities.
2. Responsiveness - This is a measure of available options, promptness of care, etc. We ranked #1 in this category. I call this category QUALITY.
The second misconception I'd like to clear up is that people always point to the # uninsured. A large percentage of people uninsured are in their 20's. This is a cost benefit analysis on their part. They're relatively healthy, they're deciding that it's -EV to buy insurance because they think they're not going to have health issues. The metric that people need to use is people who require care who don't have health insurance. This # is way lower than the 40% uninsured # you always hear people quote.
The third misconception is the difference between health care and medical care. Health care are things relating to your personal health. For example, your personal health can be determined by your diet, amount of exercise, etc. It can be influenced by medical care received, but they're generally two separate things. People assume that poor health is a reflection of medical care provided and that's inaccurate. It can be...but it's not necessarily so. If the US leads the world in heart disease deaths it must be because of the medical care received right? No, it probably has more to do with the fact that we can afford greasy, high fat foods. We can afford and have access to steaks night in and night out. We drive our cars everywhere instead of walk. Thus, general health of a population does not directly correlate to medical care provided.
The last misconception is that Medicare is better than private insurance and is run efficiently. Not only are Medicare costs skyrocketing out of control, but in general, the benefits are less rich than that of what you would get from an employer in the US. Also, you have fewer options.
A good metric would be people who go into medical care for a disease and survive. I'd like to see a study of percentage of people who survive cancer in the US as related to other countries. I'd love to see a study of availbility of treatments for rare diseases in the US as opposed to other countries.
You're all poker players, you're aware that statistics don't necessarily tell the whole story. How many top players have given the advice, don't use a HUD? How many times have you seen a 57/40 and then instantly stacked off any pair to him postflop? Oh, did I mention that he folds to flop 80% of the time? Preflop stats don't give an accurate picture of how a player plays.
So what is the WHO using for metrics? Who is writing these reports and what are their motivations? I don't know all of them but here are the ones I'm aware of. There's subjective ones like:
1. How the cost burden is spread and how fairly it's spread out. A common theme you'll see in these ranking is an emphasis on how "fair" the system is rather than the quality of services and care provided. Think of a scale of 1-10. Let's say on average, the poorest people in Canada receive care that's ranked a 3. The richest people receive care that ranks a 4. In the US, the poorest people receive care that is ranked a 5 whereas the richest receive care that's ranked 8. Sure, poor people get worse care in relation. But is that really a worse scenario? The poorest people in our country get better care than the richest people in other countries.
2. How much of total GDP is spent on health care. If your GDP is larger, who cares if you spend a larger amount on health care? I'd be interested to find out how much of net worth Americans spend on housing, how much housing we get for that money. I bet it'd be higher than every other country in the world, but that's not really mentioned as a problem is it? When you have more money you spend more to buy more quality...bigger houses, better health care, faster cars. I'd rather drive my luxury car than those tiny 2 door pieces of crap they call cars in Europe.
Objective measures:
1. Age adjusted life expectancy. This is a combination of a variety of factors. A lot of this has to do with diet, amount of free time or money people have - for example, if your country has more money, more people have cars, more people drive, and more people die of car accidents. The #1 cause of death in the US is heart disease. This is a byproduct of having money to afford more unhealthy foods and larger quantities.
2. Responsiveness - This is a measure of available options, promptness of care, etc. We ranked #1 in this category. I call this category QUALITY.
The second misconception I'd like to clear up is that people always point to the # uninsured. A large percentage of people uninsured are in their 20's. This is a cost benefit analysis on their part. They're relatively healthy, they're deciding that it's -EV to buy insurance because they think they're not going to have health issues. The metric that people need to use is people who require care who don't have health insurance. This # is way lower than the 40% uninsured # you always hear people quote.
The third misconception is the difference between health care and medical care. Health care are things relating to your personal health. For example, your personal health can be determined by your diet, amount of exercise, etc. It can be influenced by medical care received, but they're generally two separate things. People assume that poor health is a reflection of medical care provided and that's inaccurate. It can be...but it's not necessarily so. If the US leads the world in heart disease deaths it must be because of the medical care received right? No, it probably has more to do with the fact that we can afford greasy, high fat foods. We can afford and have access to steaks night in and night out. We drive our cars everywhere instead of walk. Thus, general health of a population does not directly correlate to medical care provided.
The last misconception is that Medicare is better than private insurance and is run efficiently. Not only are Medicare costs skyrocketing out of control, but in general, the benefits are less rich than that of what you would get from an employer in the US. Also, you have fewer options.
A good metric would be people who go into medical care for a disease and survive. I'd like to see a study of percentage of people who survive cancer in the US as related to other countries. I'd love to see a study of availbility of treatments for rare diseases in the US as opposed to other countries.