Stats justify proposed healthcare reform—Not!

By Christopher M. Smith, Ph.D

Most people (conservative and liberal alike) agree that there is a need to reform elements of our current healthcare system. I expect reforms to address fundamental issues and problems. This necessitates that we thoroughly study and critically analyze facts (including statistical data) to explicitly define the problems so we can construct solutions that explicitly address these problems.

The success of this analysis process is wholly dependent on the use of facts that are relevant to the discussion. Over the course of the past few months, we’ve heard and read “talking points” (supposed relevant facts) on both sides of the healthcare reform issue. One fact that I’ve heard battered about and was nationally opined by Andy Rooney in his closing CBS 60 Minutes segment (Oct. 25) was the implication that the U.S. healthcare system is a failure as exemplified by the low life expectancy of the average American (78.1 years, CIA World Factbook 2009) versus other countries. These statistical facts make for good “talking points” (to mislead and rile public opinion), but the casual implication is a bunch of croc! (“Bull manure” for most of us Ramona folks).

There is no direct, causal relationship between the life expectancy of all persons living in the United States and our healthcare system. Life expectancy refers to the average length of time a person will live or the average age at which a person will die. Life expectancy in the United States (and for many other countries) more accurately reflects the cultural characteristics and lifestyle choices of people, not access to or the quality of healthcare.

Americans have very diverse lifestyles, with various elements of our lifestyles presenting various degrees of “health” risk, from the sedentary coach potato to the extreme sport cliff jumper (very low altitude parachutists). In addition, elements of our culture, e.g., motorized vehicle and gun ownership and use, present other risks. Case in point, too many American drivers (auto/motorcycles) engage in extremely risky behaviors—driving under the influence of alcohol or drugs, driving at excessive speeds, driving without a seat belt, driving while text messaging, driving an improperly maintained vehicle, etc., all resulting in accidental death. And another segment of our society does not properly care for or improperly uses firearms, resulting in accidental fatalities (mostly children) and criminal homicides.

All these behaviors have a very significant impact on life expectancy, and are in no way directly related to healthcare. Furthering this point, the fifth and tenth leading causes of death for all Americans are accidents and septicemia, and amongst the top causes of death for children and young adults are accidents and homicides (principally involving automobiles and firearms), suicide and congenital abnormalities (CDC)—none of which are a direct result of an inadequate healthcare system.

And for the top four leading causes of American deaths—heart disease, cancer, stroke, and respiratory disease—a strong rational argument could be made that lifestyle choices (job/family stress, workplace/home environment, leisure activities, eating/drinking habits, etc.) are major contributors to the onset and severity of these diseases.

Although healthcare could be more effectively utilized to diagnose and combat these maladies, healthcare IS NOT responsible for creating them. You can reform healthcare to make the system more effective in helping those afflicted, but if you want to make significant, meaningful inroads at reducing or eliminating these diseases, we must reflect upon and change our culture—the mindset of our society. We can’t blame our personal and societal failings on the healthcare system NOR expect the healthcare system to be the panacea for all our societal and personal ills.

In closing, I’d like to add that I am very surprised that our life expectancy is so “high” given all the cultural and lifestyle choices contributing to death in America. Many crises that would have resulted in death elsewhere are averted in the U.S. because of our excellent (second-to-none) healthcare system and its capacity to effectively deal with both trauma (e.g., auto accidents) and chronic care (e.g., cancer).

Foreign students and patients do not come to the U.S. to train or take advantage of American healthcare in our medical institutions because we are behind the ball when it comes to medical expertise, technology, resources and care. They are here because we are at the leading edge of practically all medical fields.

And we are not at the leading edge because medicine is free. There is a cost, financial and societal. Universal access is possible (as some would like). It all depends on what you are willing to compromise! And far too many Americans are unwilling to compromise on the quality of their medical care for quantity (socialized health care).

Our humanity implores us to seek avenues to ensure that all people share some measure of quality of life. But we need to be realistic in our approach, critically analyze the facts, and make choices between what we want and what we can realistically afford. In this process, I wish advocates on both sides of the debate would be honest and forthright in presenting the issues to the general public. Misusing statistics to mislead the pubic does very little to help us find real solutions to the real problems.

Christopher M. Smith, Ph.D., is a Ramona resident.