For its facts and figures, the Times largely relies on â€œthe highly regarded Commonwealth Fundâ€ that has â€œpioneeredâ€ comparative studies with other advanced nations.
Letâ€™s pause for a moment and shed a little light on the Commonwealth Fund and their most recent (heavily touted) comparative study of national healthcare systems.
The â€œhighly regardedâ€ Commonwealth Fund is also the same â€œhighly Liberalâ€ Commonwealth Fund that has been consistently lobbying for a U.S. single-payor healthcare system. Itâ€™s also important to note that the â€œpioneeringâ€ comparative study the Times refers to failed to sample in rural areas internationally where health and access disparities show up. And even then, Americans did as well or better than less diverse and urbanized countries in getting prompt care.
Why didnâ€™t the Times mention this? At over 1290 words it certainly wasnâ€™t because of space constraints. Itâ€™s worth repeating the old maxim that â€œresearch is like a bikini â€“ what it shows you is interesting, but what it conceals is essential.â€
There are so many variables when it comes to healthcare. The Times mentions only the ones that fits its thesis. For our national newspaper of record (and on a Sunday, no less) itâ€™s amazingly simplistic. According to the editorial, our system is bad and single payor systems are good. Almost like a print version of SiCKO penned by Paul Krugman on an off-day.
One point of discussion, conspicuous by its absence, is that Americans are the ones paying for global medical innovation. Indeed, what would survival rates for any number of diseases look like if a nation could only use medicines they helped pay to develop? This "disparity" is unfair to the American consumer and not sustainable. The rest of the world must accept its fair share of the burden for healthcarer R&D. Zero discussion of this by Andy Rosenthal and his associates.
Another issue absent from the Times editorial is the general state of healthcare record keeping from country to country. Perhaps the most polite way to address this issue is to say that it is uneven. And to allow the findings of the Commonwealth Foundation to drive the debate, while ignoring other, more detailed European-based research findings (such as those by Populus and the pan-European Stockholm Network) which point to significant dissatisfaction among EU citizens of single-payor nations on a wide swath of healthcare delivery issues is, well, curious.
But, most importantly, itâ€™s crucial that we not allow slanted studies by folks at the Commonwealth Foundation or ill-considered propaganda like SiCKO to sucker us into believing that there is some universal â€œbestâ€ model for the delivery of healthcare â€“ when what we really need to be debating is how to construct a healthcare system that provides the right care for the right patient at the right time. â€œComparingâ€ various national healthcare systems through poor research is as dangerous and fruitless as â€œcomparingâ€ the relative effectiveness of medicines using large scale population studies that werenâ€™t designed for that purpose.
Unless, of course, you only want to use research that tells you what you want to hear.