What Paris Hilton and the Commonwealth Fund Have in Common

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  • 08/13/2007
Paris Hilton told the media that her friend Nicole Ritchie, who will be heading to jail to serve 4 days for a DUI (this after a history of drug abuse) "will be the best mom ever."

The Commonwealth Fund tells us that single payer health systems provide the best health care to the happiest patients anywhere, according to the NY Times.

Except the next day we find out that the courts in the UK say it is just fine for NICE to keep on depriving patients dying of cancer and Alzheimer's access to new medicines. Yes indeed, that's an marker of excellent care.

And as if we needed another example of just how many intellectual underachiever clutter the field of health care policy we get 101 irrelevant and incorrect explanations about why the infant mortality rate in the US is higher than anywhere else. The NY Times citing Michael Moore (!) despaired about how crappy America's health care system is because we do such a lousy job of keeping babies alive -- which in turn drags down our life expectancy.

In fact, if we counted live births like other nations and simply withdrew care from low birth weight babies like the UK, Canada, Netherlands and other places our life expectancy would exceed everyone else. I guess that would make the folks over the Commonwealth Fund and the NY Times really happy which is more important than anything else in the whole wide world.

Let me spell it out: Moore/NYTimes/Commonwealth makes a big deal about how America’s infant mortality rates are lower than El Salvador’s. That is a lie. First, many countries such as France, Switzerland, El Salvador and others do not count the deaths of very small babies as live births which brings the total number of deaths down. Meanwhile American advances in medical treatment now make it possible to save babies who would have surely died only a few decades ago. Until recently, very low birth-weight babies - less than 3 pounds - almost always died. Now, some of these babies survive. While such vulnerable babies may live with advanced medical assistance and technology, low birth-weight babies (weighing less than 5.5 pounds) recently had an infant mortality rate 20 times higher than heavier babies, according to the very same World Health Organization.

The United States devotes about twice as much money keeping each infant alive as most other countries. In some Western countries, doctors do not tell parents when they are withholding care to a vulnerable infant. Still others, countries that offer the “free” universal healthcare such as Britain and Canada set a birth weight and gestational age below which no intensive care is offered. So our infant mortality rate is really a measure of how much we care and the lengths we go to keep vulnerable infants alive just as our cancer expenditures at the end of life are as well.

That applies with greater force to Cuba where infants who are born at less than 28 weeks, weighing less than 1,000 grams or measuring less than 35 centimeters are not counted as live births if they die within seven days. The communist system stressed the need to keep infant mortality low. And in Cuba today hospitals and medical staff face penalties (prison) if they reported increases. As a result, they sometimes report the deaths of babies in their care as miscarriages or stillbirths.

The rest of the Commonwealth Measures -- taken from survey data -- are process measures and highly subjective. Pure junk. Wonder why it ignored stuff like access to new drugs, cancer survival rates, mortality after by-pass surgery, treatment for high blood pressure, etc. Because those are meaningful clinical endpoints which reveal lousy performance in Europe relative to the US of A. Ditto, the comparative rates of increase in glucose and cholesterol levels in UK, France and the US. We are going down, they are going up for the most part. Medicine is doing something about disease either prevention or intervention.

Which is why when either Paris Hilton or the Commonwealth Fund weigh in on a serious subject you can expect a serious answer. Neither are serious. They are 24/7 publicity machines designed to advance one thing: themselves.

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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