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Jewish World Review
June 12, 2009 / 20 Sivan 5769
Are We Scaremongers?
"This Time, We Won't Scare" boasts New York Times columnist
Nicholas Kristof, strapping on his armor for the coming joust. The health
care debate will be cheapened, he warns us, by scaremongers, just like those
who "spread rumors" during the campaign that Barack Obama was a "secret
Muslim conspiring to impose Sharia law on us." It will be subsidized, he
says, by "the same firm that orchestrated the 'Swift boat campaign' against
Senator John Kerry in 2004."
It's difficult to have an honest debate if your first move is to
attempt to delegitimize the other side. Many liberals seem to believe that
they never lose debates over policy; they are instead undone by
conspiracies, lies, and manipulation by dark forces (usually corporate) on
the right. To use the word "firm" regarding the Swift boat veterans is a
case in point. There was nothing corporate about the way the Swiftees got
together. It was the work of John O'Neill, who had debated John Kerry more
than 30 years before, and hadn't forgotten a thing. As for the suggestion
that opponents of nationalized health care are equivalent to those who
whispered about Obama's Muslim links during the campaign that is, or
ought to be, beneath the New York Times.
Kristof also raises, as other liberal outlets like Newsweek have
done as well, the old saw about infant mortality rates. We spend nearly
twice as much per person on health care as Canada, Kristof writes, "yet our
infant mortality rate is 40 percent higher." Advocates of single-payer
commonly cite infant mortality rates because the U.S. lags behind other
industrialized nations on this measure. But, as many studies have revealed,
these numbers are not reliable. In the first place, nations have different
standards about how to measure infant mortality. In some countries, a
severely premature infant is labeled a fetal death instead of an infant
death. Not in the U.S. In many nations, if a child dies within 24 hours of
birth, it is labeled a stillbirth. Not here. Social and cultural factors
including maternal drinking, drug use, and age are key to infant
mortality and have little to do with access to or quality of health care. In
America, infant mortality rates are sky high (five times the national
average) on Indian reservations (which have publicly financed health care by
the way through the Indian Health Service) and quite low in places like Utah
There are other international comparisons that are more useful.
Consider five-year survival rates after a cancer diagnosis. Unlike infant
mortality, which is confounded by definitional and cultural factors, cancer
survival rates are a pretty good measure of the quality of a health system.
These numbers aren't perfect either. They are affected by factors like the
uninsured in America (25 percent of whom are illegal immigrants) who tend
not to get early screening for cancer and have more advanced cases at the
time of diagnosis. The data that follow are accordingly all the stronger.
The journal Lancet Oncology has reported that American cancer
patients live longer than those anywhere else on the globe. Betsy McCaughey,
former Lieutenant Governor of New York and a health statistics numbers
cruncher, interprets the Lancet's (and other) findings as follows:
American women have a 63 percent chance of living at least five
years after a cancer diagnosis, compared with 56 percent of women in Europe.
For American men, the numbers are even more dramatic. Sixty-six percent of
American men live five years past a diagnosis of cancer, but only 47 percent
of European men do. Of cancers that affect only women, the survival rate for
uterine cancer is 5 percentage points higher in the U.S. than the European
average, and 14 percent higher for breast cancer. Among cancers that affect
only or primarily men, survival rates for prostate cancer are 28 percent
higher in the U.S., and for bladder cancer, 15 percent higher.
The British Health Service keeps costs down by rationing care
through long waiting lists for service. The Manhattan Institute's Dr. David
Gratzer reports that an estimated 20 percent of British lung cancer patients
considered curable when they were first placed on the waiting list for
chemotherapy or radiation were incurable by the time they obtained
An argument often advanced by single payer advocates is that
nationalized health care leads to more preventative care. But an analysis by
the Commonwealth Fund found that American women are more likely than those
in Australia, Canada, and New Zealand to get regular Pap tests and
mammograms. In Great Britain, men do not start getting screened for colon
cancer until age 75. In the U.S. men are urged to get their first
colonoscopy at 50.
We can certainly make improvements to our health care system
decoupling tax deductibility from employment would be a great first step.
But let's be clear: We have a lot to lose if we follow the example of Europe
and Canada. In fact, those countries are starting to move back toward more
market-grounded approaches. Let's not march backwards in the name of
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