Nonsense or no sense?

On Jan. 6, the six Republican candidates who sat on the debate stage in New Hampshire stated: “We have the best health-care system in the world.” Well, Ron Paul probably disagreed with that statement, but the others were unanimous in praising our health-care system.

Obviously they missed my letter in the Asheville Citizen-Times in late September, in which I documented that we have the most expensive health-care system in the world, but far from the best.

Using some of the standard metrics employed to measure the effectiveness of health care, we find that we rank [about] 36th in infant mortality. Some of the countries that best us are Cuba, Canada, Slovenia, Germany and France. But don’t worry; we are better than Zambia, Niger, Latvia and Belarus.

The United States ranks [around] 37th in life expectancy. A few countries that exceed us are Macau, Canada, Iceland, France and Germany. However, we best Libya, Fiji and Algeria, amongst others.

Another good index of health care is population older than 65. Here the United States comes in [at around] 40th. Besting us are Poland, Canada, France and 36 other countries. Fortunately, we beat Albania, Aruba, Peru and Brunei.

The above data are available on more than one Web site, so I trust them to be accurate. So is it that the Republican candidates are lying, are naive, are ignorant, are misinformed—or do they just need to hire better advisors? I personally think they are just ignorant and don’t care what nonsense they hand out to the public.

— Thomas M. Kelemen-Beatty
Asheville

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3 thoughts on “Nonsense or no sense?

  1. DebateTeam1

    Mr. Kelemen-Beatty raises good points. My concern is not for the political impact of his assertions but the factual basis of those assertions. I suggest that assigning fault to the quality or expense of the healthcare system is not warranted.
    I offer the following information from the March of Dimes website regarding infant mortality rates. This data can be found in context at the following website:

    http://www.marchofdimes.com/aboutus/15796_19840.asp

    “The March of Dimes “I Want My Nine Months” educational campaign aims to inform women and their doctors what they can do– even before pregnancy – to help give babies their full nine months of gestation.

    Women should avoid the dangers to the fetus of smoking, as maternal smoking is associated with higher infant mortality rates and increased risk of preterm and low birth weight births. The March of Dimes also urges women to take a multivitamin containing folic acid prior to and during early pregnancy to reduce the risk of serious birth defects; abstain from drinking alcohol during pregnancy and see their doctors to help manage chronic health conditions such as diabetes, hypertension and obesity.”

    Please note that the March of Dimes assigns a causal relationship between the mortality rate and low birth weight and/or premature births. In the above text the March of Dimes names the following items as causes of low birth weight (which is an indicator of mortality) and/or premature death:
    1. Smoking during pregnancy
    2. Drinking alcohol
    3. Failure to manage diabetes
    4. Failure to manage hypertension (high blood pressure)
    5. Failure to manage obesity

    I would note there are mothers with Type 1 diabetics that would constitute some percentage of the causes of death of the infants. Also, there are some congenital health conditions that lead to obesity such as hypothyroidism that would ultimately lead to some percentage of infant deaths.

    With exception of the instances just noted, the causes of infant death are due to a choice made by the mother. Those choices lead to premature births and the deaths of the infants.

    Common sense would dictate that if a mother is smoking, drinking, and overweight, it is her responsibility to change those behaviors and save her child’s life.

    I submit that the healthcare industry is not at fault for the high infant mortality rate. In fact, there is not treatment sufficient available by the healthcare industry in any country that would be able to overcome the risk factors introduced by the mothers.

    The most viable solution to the infant mortality problem is for mothers to stop smoking and drinking when pregnant and to lose weight to control or eliminate the “conditions” of obesity, high blood pressure, and Type 2 diabetes. No doctor in the world with all the available tools can prevent the inevitable.

    Let’s now turn to life expectancy figures. I would submit the following articles for examination from WebMD and a well documented piece by CNN:

    http://www.webmd.com/news/20050228/us-life-expectancy-best-ever-says-cdc

    http://www.cnn.com/2007/HEALTH/08/13/life.expectancy.ap/index.html

    The WebMD article indicates that heart disease and cancer are the two deadliest conditions in the US but are in decline. Unfortunately, Alzheimer’s and Parkinson’s disease are on the rise. So let’s look a little closer at the leading causes of death in the US. Please refer to the Center for Disease Control information for women and men at:
    http://www.cdc.gov/women/lcod.htm
    http://www.cdc.gov/men/lcod.htm

    Both sources indicate that of the top 6 causes, only accidental death is not an actual disease. Included in the top five are:

    1. Heart disease
    Primary Causes – High Cholesterol due to poor diet, diabetes due to obesity, smoking, and high blood pressure. Note that some heart disease is due to genetics and is not a result of environmental factors. Source

    2. Cancer
    Primary Cause – According to the American Cancer Society smoking and drinking alcohol are the primary causes of cancer. Source

    Note:  An article in the United Kingdom attributes 1 of 3 cancer causes to poor diet. Source

    3. Stroke
    Primary Cause – According to the National Institute of Health the primary risk factors of a stroke are High blood pressure, cigarette smoking, heart disease, and diabetes. Source

    4. Chronic lower respiratory disease
    Primary Cause – 80% due to cigarette smoking Source

    5. Diabetes
    Primary Cause – 90% of people with diabetes have Type 2 diabetes. Type 2 is diabetes that is treatable by losing weight and exercising.  80% of people with Type 2 diabetes are overweight. Source

    Once again, the causes of death are not attributable to the healthcare industry but to self induced conditions that are reversible.  Smoking, drinking too much alcohol, eating poorly, and not exercising are the causes of premature death. As with infant mortality, overall premature death is a result not of poor medical treatment but of patients actively participating in bringing about their early demise.

    It is not warranted to blame the healthcare industry because people smoke, or because people eat poorly, or drink too much, or sit around and watch TV instead of exercising.  Many reading this will either have witnessed first person or know someone in their family who has been to the doctor only to walk away with a prescription to treat these self induced diseases. But the doctor often offers another treatment that is usually rejected in favor or the pill – their alternative? – It is not a pill or an expensive treatment but a simple piece of advice – “You need to eat less, exercise more, but down on the booze, and stop smoking”.

    The amount of time energy and money spent in the US to try to treat and prolong the lives of people who are actively trying to harm themselves is astounding. If people would actively try as hard to save themselves as they do in trying to cause themselves harm, the astounding amount of resources spent trying to prolong their lives could be better spent working on the genetic causes of these diseases, not the man-made causes.

    Unfortunately, our society is sorely lacking in personal responsibility ethos. And it is personal responsibility that will solve these problems – not blaming an industry that is highly sought after by persons across the world that are in need of the best medical care available. I am not aware of any cases of citizens in the US seeking medical care overseas because they find insufficient treatment at Sloan Kettering, Mayo Clinic, Mount Sinai, St. Jude Medical Center, Johns Hopkins (and the list goes on). We have world class care, including our own local hospital. Let’s all stub out that smoke, put down that drink, go for a walk, and then eat a salad. 

    It doesn’t take a world class doctor to tell you that is the way to not only prolong life but to enhance the quality of the life that we have.

    In conclusion, rebuttal does not prove that the US has the best medical system in the world, but it does make a valid argument that the statistics cited by Mr. Kelemen-Beatty are meaningless taken out of context. In context, it is certainly understandable why the US is ranked where it is and that the cause can be attributed to the personal choice made by residents of this country. Do not expect this to change until we educate and train the children of the next generation to eat a more healthy diet and remove soda machines and snack machines in the schools.

    Thanks for reading…..

  2. Dr. Thomas M. Kelemen-Beatty,DD,BFHM

    Debate Team! makes a very persuasive argument, well supported by cites, that some of the metrics of health-care are, in fact, not the responsibility of the health-care system. However, I note that there is no evidence submitted that our just so-so system is not whelmingly the most expensive in the world. And they fail to address all of the negative metrics of our health system.
    I could not agree more that many, if not most, of our health-care related deaths are result of choices made by the individual. But is it not the responsibility of the health-care system and the public school system to educate the population on these matters? I do not think they do an acceptable job of it.
    Bottom line; thank you for a very well documented position. I just wish that more of the public could see the data you have presented. Perhaps you should consider an “Opinion” column for our local paper.
    Best regards, TomBeatty,DD,BFHM

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