Monday, August 04, 2008

Infant Mortality Comparisons.

That I'm not a fan of socialized medicine probably doesn't come as much of a surprise to the readers of this blog. While I don't want to get into a big debate about the pros and cons of government run health care per se (that's a post for another day) I did want to draw attention to this article that the wife emailed me last night.

One of the long standing arguments in favor of government run health care is that certain populations within a society gain access to medical services that they wouldn't get in a private model (I should mention as an aside that the United States emphatically does NOT have a private health care system but rather a mixed one of private and public providers each of whom service patients based on various criteria ranging from ability to pay to it's converse-need.). Whether that's really true or not is I think more open to debate than people realize. For every American twentysomething who didn't get health insurance and now finds themselves with a crippling illness there is a European who can't get a kidney transplant unless they fly to America for one and pay for it themselves. For fans of government run health care, this sort of thing tends to be rather embarrassing. So much for the government taking care of your health care needs in exchange for all those high taxes.

One thing that socialized medicine did do indisputably well though, was was combating infant mortality...or so it seemed. I vividly remember being taught as a child in the 1970's and 80's that countries with government run health care systems had much lower rates of infant mortality than the United States. Supposedly the difference was caused by greater foreign emphasis on low-cost prenatal care given away freely by the state as opposed to the more American approach of throwing lots of money at someone who was already sick. While one model might be better or worse for an individual depending on their circumstances, in the aggregate the statistics indicated that that the socialized medicine model was better for society.

The problem is that none of it is true.

Each country calculates infant mortality statistics their own way. As a result you're lucky if you wind up comparing things as similar as apples and oranges. In the United States we count babies as "live births" if they show any sign of life whatsoever (breathing, heartbeats, movement) and any subsequent deaths are counted. Not so elsewhere. Most other countries don't consider babies below a certain weight or size as viable (and thus outside the sample for infant mortality statistics). Not only does this distort comparisons of health care systems, but there is reason to believe that it undermines incentives to save premature infants.

Socialized medicine may have some strong arguments in it's favor, but quality of care isn't one of them. It defies reason to believe that the vast sums spent by this country account for nothing. Couple that with a healthy fear of screwing up thanks to America's tort lawyers and the notion that our doctors and nurses are being outperformed by a bunch of europeans who have an incentive structure for workplace excellence comparable to the one we see in action at the Department of Motor Vehicles becomes laughable.

Why Do So Many Not "Get" That We Are At War.

Westerners are in denial. And, the deniers are even more afraid of Jihad and terrorism than those of us who are crying out against it. Thus, like battered women, they seek to appease the violent offender; they also engage in self-blame in the misguided belief that if they do not “offend” their batterer that he will not batter them.

Aleksandr Solzhenitsyn Dead at 89.

He was one of the most important people of the the twentieth century. He understood the barbarity that underpinned communism for he had first hand experience with it. He "spoke truth to power" with a courage that critics of western democracy can only fantasize about. He was the real deal.

From time to time I'll meet a leftist who has nostalgia for the Soviet Union and the "achievements" of the communist world. I always recommend that they read The Gulag Archipelago or Darkness at Noon by Arthur Koestler. I doubt they ever do, but at least at that point their ignorance is willful rather than inadvertent.