The fraudulent health care metric underlying Obama Care

ObamaCare represents an effort to bring America in line with European and other socialized health care systems.  The sales pitch is now, and has always been, that “studies” show that the other, socialized, systems are “better” than the American system.  The crown jewel of these “studies” is a 2000 World Health Organization analysis ranking systems.  Intuitively, I knew it was wrong.  I’ve lived in a socialized medicine country and I have family and friends who also live under such systems.  The systems offer the bare minimum to everyone.  They fiddle with their infant mortality statistics.  If people have the money, they come to America for treatment.

In the recent edition of Commentary Magazine, Scott Atlas actually looks at that World Health Organization study and discovers precisely why these horrible systems got such high rankings:  WHO’s people weren’t interested in medical outcomes, they were only interested in the number of people who had access to something very loosely called “medical care.”  You have to read the article, which is now available for free.  If you read nothing else today, this week or even this year, read this article — and then send it to everyone you know, twice.

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  • kbterrier

    First of all, to take Ohsfeldt and Schneider’s numbers and simply remove GDP from the equation it would be impossible for the US to fall in rank unless Norway or Luxembourg surpassed the US.  Unless you are assuming that lower GDP per capita contributes to shorter life expectancy.  If that were the case Cuba and North Korea would have wonderfully high life expectancies.  And they are correct to adjust for GDP as there is a positive correlation between GDP and life expectancy.  For your assertion that excluding GDP drops the US to 17th to be true there would have to be a negative correlation.  Can you provide links to your study showing the US ranked 17th when adjusted as you say above?  Can you provide a link to support your assertion that Ohsfeldt and Schneider did not allow peer review?

  • kbterrier

    Z, Nevermind on the link.  I found it.  But again it is impossible to take out the impact of GDP and have the US rank fall unless you assume a negative correlation between GDP and life expectancy.  I’m not sure how the OECD came up with their calculation.  And if your assertion that Ohsfeldt and Schneider would not release their data for peer review were true, they couldn’t even if they wanted to.  So both of your statements cannot both be true.  Either their data was made available for peer review or the OECD did not adjust Ohsfeldt and Schneider’s calculation as purported.

  • http://zachriel.blogspot.com/2005/07/liberal-v-conservative.html Zachriel

    kbterrier: First of all, to take Ohsfeldt and Schneider’s numbers and simply remove GDP from the equation it would be impossible for the US to fall in rank unless Norway or Luxembourg surpassed the US. 

    Sigh. It’s actually hard to tell exactly what they are doing as they didn’t publish their results in detail. But they appear to use a variable that is not independent, but dependent on GDP, so it skews their numbers by circular reasoning. 
      
    kbterrierCan you provide links to your study showing the US ranked 17th when adjusted as you say above? 

    OECD economic surveys: United States 2008, pg 137.
    “The adjustment for the gap in injury death rates between the United States and the OECD average alone only increases life expectancy at birth marginally, from 19th among 29 countries on average over 1980-99 to 17th. Hence, the high ranking of adjusted life expectancy at birth mainly reflects high US GDP per capita, not the effects of unusually high death rates from accident [or] injury.”
    http://www.oecd.org/document/32/0,3343,en_2649_33733_41803296_1_1_1_1,00.html
     
    kbterrierCan you provide a link to support your assertion that Ohsfeldt and Schneider did not allow peer review?

    Did not allow? They have to submit to peer review, and that would probably require including much more detail on their methodology.

  • kbterrier

    Z said, “Ohsfeldt and Schneider didn’t submit their results to peer review…”
    Then
    Z said, “Did not allow? They have to submit to peer review, and that would probably require including much more detail on their methodology.”
    Which one is it?
     
    You then make this statement about the OECD’s calculation.  “It’s actually hard to tell exactly what they are doing as they didn’t publish their results in detail.”
    So, you are going to accept the OECD study that does not provide a calculation or methodology over Ohsfeldt and Schneider who did publish their calculation and methodology?  An OECD calculation that is absolutely impossible to have done what they say it did.  They had to have used a different calculation that they did not publish according to you.  It is absolutely impossible for the OECD to have simply used the Ohsfeldt and Schneider calculation minus the GDP correction and gotten the results they claim unless you assume a negative correlation between GDP and life expectancy.

  • http://zachriel.blogspot.com/2005/07/liberal-v-conservative.html Zachriel

    kbterrier: Which one is it?

    Not sure your question. They didn’t submit it to peer-review.
     
    kbterrier: You then make this statement about the OECD’s calculation.  “It’s actually hard to tell exactly what they are doing as they didn’t publish their results in detail.” So, you are going to accept the OECD study that does not provide a calculation or methodology over Ohsfeldt and Schneider who did publish their calculation and methodology? 

    Quite the contrary. We were referring to Ohsfeldt and Schneider’s calculation. The GDP term wasn’t that well-defined in their book, but it’s possible it was defined elsewhere. In any case, the OECD removed the GDP term. 
     
    kbterrier: It is absolutely impossible for the OECD to have simply used the Ohsfeldt and Schneider calculation minus the GDP correction and gotten the results they claim unless you assume a negative correlation between GDP and life expectancy.

    You have it backwards. If they assume a positive corelation between GDP and life expectancy, and build that correlation into their equation, then it’s not unexpected that their result tracked GDP. It looks that way from the equation.

    We could certainly be wrong on this point, as we are relying on secondary sources. If you can carefully define each of the figures, in particular GDPPCit, and show the calculations, we would be happy to take a look. 
     

  • http://zachriel.blogspot.com/2005/07/liberal-v-conservative.html Zachriel

    Consider this: Why the heck would they even include GDP? It’s irrelevant to calculating life expectancy. And it’s irrelevant for showing that removing instant deaths due to accidents and homicides change the ranking. It’s almost as if they want to find a particular result, and then work the regression until they have the result they want. They’ve admitted their calculation doesn’t actually re-calculate life expectancy, or that it was meant to be a precise analysis. They were just trying to show that a change in a few assumptions can change the rankings when the actual life expectancies are very close. 
     

  • kbterrier

    Not sure your question. They didn’t submit it to peer-review.

    I misunderstood your second statement as being an assertion that they did submit it for peer review.  My apologies.

    You have it backwards. If they assume a positive corelation between GDP and life expectancy, and build that correlation into their equation, then it’s not unexpected that their result tracked GDP. It looks that way from the equation.
    We could certainly be wrong on this point, as we are relying on secondary sources. If you can carefully define each of the figures, in particular GDPPCit, and show the calculations, we would be happy to take a look. 

    I can assure I do not have it backwards.  If there is a positive correlation between GDP and life expectancy and the US is adjusted to the standardized mean of all countries (which is what their calculation did) then it results in an adjustment down for the US.  If it is a country at the low end of GDP among the countries, then the adjustment would be up to the standardized mean.  Thus removing GDP per capita from the calculation results in an adjustment up for the US.  And since the US is in the top 3 or 4 of every GDP per capita calculation (behind Norway and Luxembourg in most and Kuwait (which is not in this data population) in some) it really doesn’t matter which listing of GDP per capita they used. 

  • kbterrier

    Consider this: Why the heck would they even include GDP? It’s irrelevant to calculating life expectancy. And it’s irrelevant for showing that removing instant deaths due to accidents and homicides change the ranking. It’s almost as if they want to find a particular result, and then work the regression until they have the result they want. They’ve admitted their calculation doesn’t actually re-calculate life expectancy, or that it was meant to be a precise analysis. They were just trying to show that a change in a few assumptions can change the rankings when the actual life expectancies are very close.

    They adjust for GDP per capita because they are trying to calculate a life expectancy that meaningfully reflects healthcare results.  GDP per capita has an impact on life expectancy that is not a reflection of healthcare outcomes.  They correctly adjust for it.  WHO took the unadulterated life expectancies as proof of the superiority of socialized medicine.  Ohsfeldt and Schneider were simply trying to adjust for factors that affect life expectancy that have nothing to do with healthcare quality.  If they were trying simply to manufacture a number that looked good for the US then they hurt themselves by correcting for GDP per capita.  Had they not corrected for GDP per capita, then the US life expectancy would look even better relative to the other countries except Norway.

    However, they do concede that life expectancies even when adjusted for variables independent of healthcare quality are not the best measure of healthcare quality.  They were simply forced to address life expectancy, because the Left had been so dishonestly portraying it as definitive proof of how horrible the US healthcare system is and how wonderful socialized medicine is for years.  Survival and cure rates for specific diseases and ailments are much better measures of healthcare quality and the US leads the world (by large margins in many cases) in cure and survival rates for the vast majority of diseases and ailments. 

  • http://zachriel.blogspot.com/2005/07/liberal-v-conservative.html Zachriel

    kbterrier: If there is a positive correlation between GDP and life expectancy and the US is adjusted to the standardized mean of all countries (which is what their calculation did) then it results in an adjustment down for the US. 

    Yes, your point is clear, but not if they embedded the results in the GDPPCit variable. In effect, they assumed their conclusion.
     
    kbterrier: Thus removing GDP per capita from the calculation results in an adjustment up for the US. 

    As we mentioned, there is no reason for Ohsfeldt and Schneider to have even included GDPPCit in their calculations. It’s a poorly defined fudge factor, and according to OECD, removing it drops the U.S. to seventeenth. Ohsfeldt and Schneider have admitted it was just a “little book project.” Unless you have some more detailed analysis, you’re reading far more into  Ohsfeldt and Schneider’s calculation than they themselves claim. “We’re not trying to say that these are the precisely correct life-expectancy estimates. We’re just trying to show that there are other factors that affect life-expectancy-at-birth estimates that people quote all the time.” Even with that qualifier, the results are considered flawed by other researchers. 
     

  • http://zachriel.blogspot.com/2005/07/liberal-v-conservative.html Zachriel

    kbterrier: They adjust for GDP per capita because they are trying to calculate a life expectancy that meaningfully reflects healthcare results. 

    We’re not getting anywhere with this. Even the authors admit it’s not an accurate calculation. If you want to press the point, you would have to clearly define the calculation and data, starting with GDPPCit. Otherwise, it’s just fudge.
     

  • kbterrier

    There is good reason to include a GDP correction as I explained in my last post.  And if the OECD removed the GDP factor from their calculation it is mathematically impossible for them to achieve the results they claim.  The OECD had to have used another calculation altogether. 

    Now I’m done arguing with a wall.

  • kbterrier

    Ok.  I’m not done yet. 

    Z said, “We’re not getting anywhere with this. Even the authors admit it’s not an accurate calculation. If you want to press the point, you would have to clearly define the calculation and data, starting with GDPPCit. Otherwise, it’s just fudge.” 


    Your repeated quote of the authors is by no means an admission of inaccuracy.  It is more an admission that there are so many variables to correct for that no one could possibly included all of them.  They took the most obvious and impactful ones and corrected for them.

    And you quickly declare GDP a fudge and at the same time accept without question the OECD calculation without having even seen it.  GDPPCit is GDP per capita and I have said before there is no legitimate GDP per capita listing that I am aware of that doesn’t have the US right up at the top.  Whether it is a listing that ranks the US in the top 3 or top 5 has very little if any impact on the calculation.  Any GDP per capita listing would result in having to bring the US down to the standardized mean.  You simply want an excuse to dismiss their findings so you can accept without question the findings from the OECD that you haven’t even seen.

  • http://zachriel.blogspot.com/2005/07/liberal-v-conservative.html Zachriel

    kbterrier: GDPPCit is GDP per capita and I have said before there is no legitimate GDP per capita listing that I am aware of that doesn’t have the US right up at the top. 

    Is this the formula to which you are referring?

    LifeExpit = 50.78 + 3.020 * log(GDPPCit) – 0.077 * [mean(Trans)]
    – 0.137 * [mean(Falls)] – 0.133 * [mean(Homicide)]
    – 0.0326 * [mean(Suicide)] + year-effectsit

  • kbterrier

    And in the end life expectancy is not even a good measure of healthcare quality anyway.  However, I do not expect you or any other Leftist to stop dishonestly using life expectancy as definitive proof of the superiority of socialized medicine.

  • kbterrier

    LOL.  You lied earlier when you said you hadn’t seen the review on Amazon.  You copied and pasted that formula from that review.  Maybe you should buy the book, check out the formula(s) and get back to me.

  • http://zachriel.blogspot.com/2005/07/liberal-v-conservative.html Zachriel

    kbterrier: However, I do not expect you or any other Leftist to stop dishonestly using life expectancy as definitive proof of the superiority of socialized medicine.

    That is precisely contrary to our position, which is that life expectancies are “reasonably comparable” in advanced countries. We’ve said that more than once on this thread. 
     
    kbterrier: You lied earlier when you said you hadn’t seen the review on Amazon.  You copied and pasted that formula from that review. 

    We looked at it after you pointed it out, of course. Isn’t that what you wanted us to do?

    Is this the formula to which you are referring, or isn’t it?

    LifeExpit = 50.78 + 3.020 * log(GDPPCit) – 0.077 * [mean(Trans)]
    – 0.137 * [mean(Falls)] – 0.133 * [mean(Homicide)]
    – 0.0326 * [mean(Suicide)] + year-effectsit

    We’ve already said we are unable to verify the calculations as we are relying on secondary sources. If you don’t know, then why would you expect anyone to accept what the authors admit are not “precisely correct life-expectancy estimates” at face value, without being able to double-check the calculations or some sort of scholarly review?