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After Michael Moore threw his hissy fit on CNN the other day, he posted a response to CNN on his website under the unintentionally ironic heading “Sicko Truth Squad.” So let’s take a look at how the Sicko Truth Squad distorts the truth. Starting with the quote from the CNN report:
DR. SANJAY GUPTA, CNN: “(Moore says) the United States slipped to number 37 in the world’s health care systems. It’s true. … Moore brings a group of patients, including 9/11 workers, to Cuba and marvels at their free treatment and quality of care. But hold on – that WHO list puts Cuba’s health care system even lower than the United States, coming in at #39.”
Minor point: “Slipped” indicates that at one time the U.S. was ranked higher than 37 on a previous World Health Organization report. But there was no previous WHO report—the report Moore refers to was the first one the WHO ever conducted that ranked the health systems of the world.
Major point: The implicit assumption here is that the paper the WHO report (PDF) is printed on is worth anything more than the paper one uses after a bowel movement. One of the factors that the WHO report attempts to measure is health outcomes. Included in that factors are life expectancy and infant mortality, which tells us next to nothing about the effectiveness of a health care system (more on that in the next post). It uses data on illnesses like cancer, most of which comes from the OECD. But OECD data is notoriously unreliable. Indeed, the OECD, in conjunction with the Commonwealth Fund, concedes that that in most cases its data is not “internationally comparable” because “there is a lack of international agreement on the most promising indicators and many definitions of each indicator that could be adopted.”
What further makes the report, in the immortal word of Michael Moore on CNN, “crap” is that it uses factors that have nothing to do with how well a health-care system treats illness. One such factor is “fairness in financing.” As I wrote in the American Spectator over a year ago:
It is this factor that largely explains the U.S.’s low ranking on overall performance. On fairness in financing (see page 188 of the WHO report), the U.S. ranks 55th, behind “fairer” countries like Bangladesh, Tanzania, and Cuba.
The standards (PDF) that go into the fairness in financing measure include progressivity — i.e., whether the rich pay more into the health-care system (fair); whether some households incur catastrophic payments (unfair); and whether equivalent households make unequal health-care payments (unfair). Yet it’s questionable if such standards are really fair. For example, is it fair for two households with equivalent incomes to make equal payments if one household consumes more medical services?
It’s pretty clear that such standards were designed to bias an outcome in favor of government-run health-care systems. The WHO report states that in health care, “government remains the prime mover,” and its “key role is one of oversight and trusteeship — to follow the advice of ‘row less and steer more.’” We further learn that markets ration health care
by price, which means that who gets what goods and services depends not only on how much those goods and services are valued by people, but on who has the means to buy them. Priorities are not set by anyone but emerge from the play of the market. As indicated, this is almost the worst possible way to determine who gets which health services.
The WHO report was written based on socialist assumptions. Is it any wonder then that the U.S. health-care system, one of the least socialist among the developed world, does not fare so well in the WHO rankings?
By omitting any discussion of the assumptions of the report, Moore leaves his audience with the belief that the report is from an unbiased, objective government agency. Such a tactic is what is known as “appeal to authority.” That’s amusing, since Moore clearly fancies himself an iconoclast always challenging the powers that be.
+ May 2009
+ May 2008
+ May 2007