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June 23, 2009 05:55 PM UTC

Health Care: Post's Vincent Carroll Needs a Lesson in Logic

  • 53 Comments
  • by: dlof

( – promoted by Colorado Pols)

In today’s Denver Post, columnist Vincent Carroll uses some absurd logic to echo the fringe-right-wing’s argument that the American health care system isn’t broken.

I’ll start with this gem…

Admittedly, the United States does spend more on health care, at nearly 16 percent of its gross national product, than any other country. Even relatively big-spending Switzerland, France and Germany devote only 11 to 12 percent of GDP on health care.

On the other hand, we’re also wealthier than other countries. As people grow richer – here, in Europe and any place you care to name – they tend to devote more resources to their health. So in the natural course of affairs, we should be spending more than others, although probably not as much more as we do.

I’m not sure how Mr. Carroll’s world works, but as I have gotten wealthier (and that’s a pretty thin use of the term), I have devoted a smaller percentage to health care.  For example, I require insurance for a single person, which costs, say, $600/mo.  If I make $2,400/month, I’m spending 25% of my income.  As I grow wealthier, and make, say, $6,000/mo, that percentage drops to 10%.  I don’t spend more, proportionally, as I get richer.  That’s absurd.

Mr. Carroll goes on to argue that WHO rankings are meaningless using a strange variant of a red herring.

But what about the allegedly inferior results? Let’s first dispose of that 37th place ranking, since it’s become a staple of the indictment of U.S. health care at least since Michael Moore exploited it in his movie “Sicko.” To appreciate how strange the ranking is, you really have to ask yourself just one question: Would I prefer to be treated for a serious ailment or injury in Oman, Portugal, Greece, Colombia, Cyprus, Saudi Arabia, United Arab Emirates, Morocco, Chile, Dominica and Costa Rica as opposed to the United States?

If you answered no, along with most other sane people, you have begun to see the problem: All of those nations, some of them quite poor, appear above the U.S. in the oft-cited WHO ranking. Meaning the ranking must be flawed.

Call me a bit crazy, but that list does not contain the names of 36 nations (it’s incomplete).  It does, however, contain the names of two European nations, cloaked by four Middle Eastern countries (aren’t we experiencing some tension with various Arab/Middle Eastern countries), and four Central/South American countries (isn’t illegal immigration from Latin America another hot-button issue).  I’m impressed, because that’s a crazy-good red herring, soaked in the mercury of xenophobia.

The rest of the column is pretty much unreadable, but it includes several straw men, including an absurd argument about how the L.A. Lakers lost ground in a post-season survey because they had the resources to do better.  Applied to the U.S. health care system:

The rankings are also adjusted “to reflect a country’s performance relative to how well it theoretically could have performed.”

Call me crazy, but shouldn’t we get the best imaginable health care system if we’re going to throw 16% of the GDP of the richest nation on Earth at it?

Comments

53 thoughts on “Health Care: Post’s Vincent Carroll Needs a Lesson in Logic

  1. you don’t really have to read. Once you see what the subject is you can accurately predict pretty much everything the guy is going to say.  Ditto Rosen.  

  2. but at least with Vince you can kind of understand the logical progression, as wrong as his conclusions usually are.  With Rosen’s articles I’m left scratching my head wondering WTF?  Mike Rosen is the Gary Harmon of the Front Range…

      1. Meantime just received a Ken Gordon e-mail with a link to his blog and a handy list of all of our congressional delegation phone numbers, including toll frees for our senators.  I called everybody, even the no hopers, just to remind them that in a representative democracy three quarters of the population really ought to be able to get what they want out of their elected officials.

        Reminded Dems that the high tide of enthusiasm that brought them to power in the White House and both houses of congress is going to go pretty flat if they deny such a huge majority what they want.  We may not go for Rs but the turnout could be pretty anemic, especially among Dems and indies who voted for the first time because of Obama. Many will no doubt keep their own seats even if they piss us off but they may find themselves with a much smaller team post 2010, no matter how much money they get from the health and health insurance industries.  Here’s the list:

        Senator Bennet: Toll free 866-455-9866

        Senator Udall: Toll free 877-768-3255

        Rep. Degette: 303-844-4996

        Rep. Markey: 202-225-4676

        Rep. Lamborn: 202-225-4422

        Rep. Perlmutter: 202-225-2645

        Rep. Salazar: 202-225-4761

        Rep. Coffman: 202-225-7882

        Rep. Polis: 202-225-2161

  3. Seriously, I would like nothing more than to have someone try to defend this, because I have a hard time seeing how Mr. Carroll and his argument here are anything but a farce.

    1. .

      I’d like to focus just on the example of $600 being 25% and then 10%.

      The folks I know who gross $2,400 a month do not get $600 a month health care.  They settle for something less, with high deductibles for almost everything.  Many of them have only catastrophic coverage.  So they get less elective surgery and visit a Doctor less often.  

      The folks I know who gross over $20,000 per month see specialists for every little thing. They get liposuction and lasik and rhinoplasty.  

      I don’t question that what you’ve said applies to you, but it doesn’t mesh with my anecdotal experience.  

      Of course, the folks I know that consume the most health care are the ones who get it practically for free, those on Medicare.  Many of them have multiple appointments every week.  If the value of that care is factored in as part of their income, they are very wealthy, and that wealth is squandered on care that is, for the most part, not medically indicated.

      .  

      1. going to the doctor two or three times a week why aren’t they living longer than their peers in Germany, Switzerland and France (see below)?  Are the doctors killing them?  Last I heard Kevorkian was locked up in a Michigan jail…

      2. I really do appreciate people who something that seems indefensible and do it well.

        I think you raise a good point, and it does mesh with what I have observed. However it seems to me that the issue isn’t how often we use medical services, but how that changes with income. Like you said, it seems that the people who see the doctor the most tend to be either really wealthy or on Medicare/Medicaid. Yet for those who take in over $20,000 a month (to use your figure, I don’t actually know if that number matches with the data), even with all the liposuction and rhinoplasty, their medical expenses still do not make up much of their income, because by the time that they can afford such excessive procedures, they’re going to be very well off, with enough net worth that this is just a drop in the bucket. That’s why they get to have all the surgeries and so forth, it doesn’t cost them anything. So even though their usage is increasing, the percentage cost is dropping. That’s why (to me) Mr. Carroll’s argument seems bizarre. He is saying that it’s natural for health care costs to grow disproportionally with wealth, and while it seems correct to say that overall amount spent will grow as wealth grows, that doesn’t account for why it should grow faster than GDP.

      3. People on Medicare are older and generally have more health problems.  Before my dad went on Medicare, he rarely went to the doctor.  After he went on Medicare, he’s seen doctors for cataract surgery, bad back, bad knees, hearing loss, etc.  The increase in his doctor visits isn’t because he’s getting them for free, it’s because he’s got a lot more age-related health problems.

  4. argument, that as a richer nation we would spend more on our health care than poorer nations, it would stand to reason that we would see better results (afterall, a Lexus should run faster, ride more comfortably and last longer than a Yugo…if not, then why be an idiot and spend the extra money on it?).  So our life expectancy should be longer than Switzerland, France and Germany and our infant mortality rates should also be less than those three countries.  

    Right?

    Apparently not.

    Life expectancy for year 2008:

    France: 80.87 years

    Switzerland: 80.62

    Germany: 78.95

    USA: 78.06

    Infant Mortality Rates (Under age 5 mortality rate per 1000 live births):

    Switzerland: 5.1

    France: 5.2

    Germany: 5.4

    USA: 7.8

    So, Vince, what the hell are we doing paying Lexus rates for a health care system that is giving us Yugo-like performance in these two measures?

    1. have never used my high deductible health insurance (tied to an HSA) which I have had four years.

      In that time–although I have never used it once and have a $2,500 deductible–BCBS has raised my rates by 20%.

      I am afraid to use it, if I ever need to.  I’m sure at that point they’ll just cancel me.

    2. You are looking at the wrong statistics.  America has higher rates of homicide, suicide, etc.  We also have more drug abuse and inner city social ills than the other countries mentioned.  The resulting declines in life expectancy and increase in infant mortality aren’t a reflection on our medical system.

      Consider the simple facts: in Canada the mortality rate from cancern and heart disease is significantly higher than in America.  (I don’t have comparable stats for the other countries, just Canada.)

      That’s why Canadians come to America to get care they can’t receive in a timely manner in their own country.  

      1. Those countries have many more “socialistic” outreach programs which would account for their lower homicide, suicide, and drug and alcohol abuse stats. I’m betting you oppose those, in keeping with being a good little ‘pub.

          1. I was in India for only 4 weeks and I met 3 different groups of Americans who had flown over for routine treatment ranging from cataracts, to ACL surgery, knee surgery, and so forth. Certainly none of these people were seeking “experimental treatments,” as these are all things that we treat in the U.S. But health care is so costly here that it was more cost-effective for them to fly halfway around the world to India for treatment.

            While we’re on the subject involving real-world experience, travel to the northwest sometime, I went to college there, you’d be astounded by the number of people who I met that were actively seeking Canadian citizenship, just so they could get some decent, timely, inexpensive health care. People who didn’t want to fork over their entire paycheck to a private, price-gouging oligopoly of an insurance company.

            Open your eyes Kid, you could learn a lot.

          2. I think it’s a shame you didn’t do better in the front-page editor poll. I agree with Aristotle that you might be “blinded by ideology,” and I guess you might say the same for me. That said, I hope you keep writing here, because you do offer a coherent ideology in opposition to most of the writers here, which is refreshing. Even if I don’t believe most (if any) of it.

            1. I hope he continues to contribute as well, but the liklihood of any R’s posting seems small.

              Dems love to prove themselves here. Gotta prove they’re right! Even if one person posts disagreement with Kid or LB or Libertad, ten more replies are piled on as well reiterating counterpoints using arsenic laced with sarcasm.

              After about two or three I give up reading the ‘rebuttals’. Our Republican friends stop posting because it isn’t fun for anyone to be ganged up on again, and again, and again, and again and again…

              Too bad really, ’cause it is boring here listening to only Dems.  

              1. if you saved it for a time when the ‘pub in question wasn’t being such a jackass.

                I do agree, however, that people need to restrain themselves when some absurdity like KK’s comment already has two or three answers. We might be right but it won’t be taken as proof that we are.

                This site is not yet the “echo chamber” that many like to say or imply it is – check out Square State for a place deserving of that label.

              1. That’s easy for you to say.

                The reason I advocate for Libertad/KK/Laughing Boy or others to stay involved is they’re the only ones who present different opinions. Whether they should be promoted to editors is something for the group to decide.

                It would be wonderful if all we had here was high minded debate on the issues, but life being what it is, we don’t.

                Until then, I encourage Republicans to continue posting.

                1. My only point was that the reification of a polarized ideological debate does more to constrain discourse than to liberate it. In other words, that debate is “the box.” Focusing on it keeps us in that box.

                  If we really want to encourage a robust discourse generating a broad diversity of views, then we should be encouraging more discussion that is liberated from that very constricive view of how to conceptualize political discourse.

                  This isn’t just some abstract nonsense: For instance, I have entered into a very robust and interesting conversation with Rob Whitwer, a former Republican state legislator and current conservative columnist in South Jeffco. Instead of shouting empty ideological platitudes past each other, we are zeroing in on some very subtle and complex ideas, and are both benefiting from it. The problem with the superficial ideological debate is that it erases nuance and burries the truly essential questions.

                  These are just my thoughts on the matter. They’re a bit different from the normal discourse, but that’s exactly the point we’re discussing, isn’t it?

                2. You said: “they’re the only ones who present different opinions….”

                  No, they’re not. They’re the only ones who present different opinions along one well-worn pair of polarized positions. Some others, such as myself, present different opinions along all other axes, not just that one, and not just at the poles.

                  If you see the world in black-and-white, then a paucity of those representing “black” (or “white”) is of great concern. But if you see the world inclusive not only of shades-of-gray, but colors as well, your concern becomes more the obsessions with always emphasizing black and white.

                  Sure, we want “black” to contribute. But we want to recognize it for what it is: A very limited contribution to overall diversity of viewpoints. I don’t mind encouraging Republicans to participate; I just mind acting as if that is the road to a diversity of viewpoints. It is only the inclusion of one very small component of diversity. Failure to recognize that does more to constrain the dialogue than failure to retain conservative spokespeople on this site.

          3. but several states have begun reimporting pharmaceuticals that are manufactured by American based companies from Canada because they are cheaper there.  Further, people who live along border states with Canada often use Canadian health provider precisely because they can get the services for free.  Here are a couple of links to support my assertion….where are yours?

            http://www.nytimes.com/1993/12

            http://www.naturalnews.com/001

            http://www.encyclopedia.com/do

      2. The fact that we do poorly in homicide, suicide, drug use, as well as infant mortality and life expectancy compared to the rest of the civilized world is hardly a ringing endorsement of….well, anything, is it?  You forgot we also must have the most evil citizenry since we have the highest incarceration rate and that couldn’t possibly be because we’re doing anything wrong, either.  Way to defend your point, whatever that might be KK?  Were a mess and proud of it, perhaps?  

      3. I was not aware that suicide rates among four year olds was so high in the United States.  

        Further, the Crips and Bloods must have recently started a recruitment drive at day care centers since the homicide rate among 3 year olds is a driving force in our infant mortality rates….

        We need to get Fox News to do an expose….

        1. If you GET cancer in Canada, you are more likely to die.  That’s different from mortality rates.  Nice try, though.  You liberals sure have a lot of faith in government and big institutions.

          1. Because the work better than most private attempts to provide the same services.

            If you are more likely to die of cancer in Canada, it is because they will look at an 89 year old man and say, “No, we would rather spend the money elsewhere. Off to palliative care.”  And that’s what they should have done with my father two years ago.  Between AFLAK and Medicare, and our own out of pockets, our nation has spent close to $300,000 keeping this man with mild Alzheimer’s alive.  

            In the meantime, neither my brother nor I have health insurance.

            I’m sure you will agree that the government would have done better if we had the Canadian model.  BTW, that’s the way it is in most of those pesky EU countries.  

            If it’s so bad, why have none of these nations with universal health care canned theirs and adopted the American system?

            Huh?  Huh?  Huh?  

          2. You claimed (without any link, as always), among other things, that the cancer mortality rate is much higher in Canada than in the U.S. I debunked that falsehood by linking to an article in the Denver Post which cited specific statistics, including the following:

            “cancer mortality rate: [Canadian] 181.7. (U.S.] 197.”

            You then responded with some irrelevant distinction between death rate from contracting cancer in Canada, and their “mortality rate,” claiming that the former was the statistic I cited. But, wait, I have reproduced the actual statistic above, which, lo and behold! states the comparison of MORTALITY RATES from cancer!

            What THIS liberal has a lot of faith in is the combination of reason and good will applied to and informed by factual data, something obviously as foreign to you as the Baghavad Gita.

            1. if I recall correctly. And it is precisely the statistic you arbitrarily and without any basis claimed it wasn’t, because when a fact is inconvenient to your blind ideology, you just wish it away….

              1. it was a link to a random poster on a right-wing site who posted the empty claim that U.S. cancer survival rates are highest (without even including the referent), accompanied by a link to a U.K. Telegraph site which carried no information whatsoever that supported the claim (or was even relevant to it).

                The claim may or may not be correct, but as of now the only documented evidence that anyone has supplied suggests that it is incorrect.

                That’s the way it works, KK.

              2. Lies, damned lies, and statistics.

                I asked this the other day:  How come none of the national health care system in the rest of the world have decided to go the American way?

                Huh?  Huh?  Huh?  

                I know the answer, are you willing to admit it?  

          3. Steve demolishes whatever argument you might have had, but I honestly don’t know what you were trying to say.

            How do you HAVE cancer in Canada unless you GET cancer in Canada? Do Canadians come to America, catch cancer, and bring it back to Canada, and then get cured? Or is it the Mexicans?

            I should have known, it’s the Mexicans.

      4. I suspect that this issue is much more complicated than I’ve seen discussed here.

        For instance, KK asserts that the mortality/life expectancy statistics don’t account for social factors that affect them. I’ll buy that. But that’s not the end of the story.

        For example, the stats that Steve H cites include obesity. We’re a bunch of fatties next to our Canadian neighbors. That obviously affects the heart attack stats, and probably life expectancy. Score 1 for KK.

        On the other hand, I don’t see how heart disease and cancer are so directly related to “homicide, suicide, etc.  We also have more drug abuse and inner city social ills”. Score 1 for the libs.

        Before we tear each other limb from limb, I’d like to see how we spend our medical $ and compare that to how Canadians (for example) spend their health care dollars. People always talk about how much we spend on end-of-life care. How does that compare to Canadians? How about preventative care? How about life-saving care versus elective (or quality of life) care? [like them little blue pills that account for so much spam].

        And one last point: Nobody likes their taxes going up, not conservatives nor liberals. But we have a system now that effectively raises our health care taxes every year by double digits. We call it insurance, but it’s really just a tax. If this were truly a tax, then everybody would be absolutely outraged (cons and libs alike).

        Now, in the Canadian system, the govt budgets a certain dollar amount for health care each year. With that money, they can’t do everything that everybody wants. This affects health care decisions and some people claim it amounts to rationing.

        In our system of private insurance, we first define the benefits in terms of the types of health care we will cover, and then pay whatever is required to achieve that level of care. There’s no budget or cap on expenses. If there’s not enough money to achieve the level of care (+ profit), then insurance companies just charge more next year. It’s now wonder ins premiums increase by 10% every year in our system.

        So what to do? Personally, I don’t have faith that the magic of the marketplace will solve this problem all on its own. I think that a stripped down [no cosmetic surgery, no little blue pills] single-payer public option ought to be on the table. If you want more coverage or more care, buy it in the marketplace.

        To those who say it can’t be done, look at how successful UPS and Fedex have been competing with the subsidized post office.

        Apologies for the long, day-old post…

        1. Now if they could only devise a way to have you pay first and then refuse to send the shipment! That’s how good the health insurers have it in our system, and at our expense.

          I am sure there will be all sorts of pledges by private insurers to self regulate, which never works.  There’s just too much money involved.

  5. Why, if we had more money would we spend a higher percentage? What would the total resource pool have to do with allocations? Economics? math? Numbers? anything? I’d criticize the Carrol’s comment more, but I’d have to understand the logic and I suspect I would irreparably injure my brain if I did that.

    As to what Americans might actually want out of their health care there’s a great collection of polling data found here.

    http://www.researchamerica.org

    I grant you none of it involves the Lakers, but it’s still interesting.  

  6. but decided to engage in wars of choice that have started us on that downward spiral to fiscal doom.  If we bankrupt our economy maintaining the empire than it will be even more important to reduce the cost of medicine as a percentage of our GNP.

    1. that the wars are bringing this to a head now!

      I was counting on the American tradition of putting off our problems for our children’s generation to fix.

      Always so much easier, yet now, here we are trying to face up to big issues with little or no practice.  Tsk, Tsk…

  7. We are no longer the richest country, by a country mile, any more, per capita.

    It’s those fucking socialized ones like Finland and Norway.

      1. Except for us enlightened souls who can see through the cultural BS (Sorry, Craig), most Americans live in this Myth of America’s Innate Superiority in Everything.  I think winning WWII – conveniently forgetting the millions of Russian dying on the eastern front, for instance – set it off big time. And then when American science and business was virtually the only game in town, er, in the world, we were hyperventilating with our own successes….as we saw them.

        The older I get, the more that has happened especially post-Carter, the more unhappy I am about America.  I’m not saying it’s a pit, but we have strayed so far from the ideals I grew up with.  Anyone, anyone can read the statistics if they take the time and see that we are failing on so many fronts.  

      2. Except for us enlightened souls who can see through the cultural BS (Sorry, Craig), most Americans live in this Myth of America’s Innate Superiority in Everything.  I think winning WWII – conveniently forgetting the millions of Russian dying on the eastern front, for instance – set it off big time. And then when American science and business was virtually the only game in town, er, in the world, we were hyperventilating with our own successes….as we saw them.

        The older I get, the more that has happened especially post-Carter, the more unhappy I am about America.  I’m not saying it’s a pit, but we have strayed so far from the ideals I grew up with.  Anyone, anyone can read the statistics if they take the time and see that we are failing on so many fronts.  

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