Single-Payer Misinformation


Get ready for the misinformation coming soon. The 2020 Presidential Election Campaign will kick-off soon and the likely Democratic candidates have one thing in common.

Senators Bernie Sanders, Kamala Harris, Elizabeth Warren, Corrie Booker, and former Vice-President Joe Biden are all considered possible Democratic candidates for president in 2020. All have expressed interest in single-payer healthcare with enthusiasm that ranges from interested believers to passionate evangelist when describing Sanders.

When these Democrats begin their campaigns, be prepared to listen to their talking points. One of those talking points will be to compare the U.S. healthcare system statistics to other countries. Their favorite statistic is infant mortality.

The Organization for Economic Cooperation and Development (OECD) is comprised of 35 countries. It lists the U.S. as 32nd among these countries when it comes to infant mortality. Do you believe for one minute there is anywhere in the world better to have your baby than in the United States?

Dr. Scott W. Atlas, senior fellow at Stanford University’s Hoover Institution, says the reason for this low ranking is a matter of statistical definitions. Unlike many countries, the U.S. strictly adheres to the World Health Organization’s definition, recording as a live birth any baby, “irrespective of the duration of the pregnancy,” who “breathes or shows any other evidence of life.”

By contrast, WHO noted in a 2008 report, it is “common practice” in several western European countries to register as live births only those infants who survived for a specified period. Infants who don’t survive are “completely ignored for registration purposes.” A British Journal of Obstetrics and Gynecology study of Western Europe found that terminology alone cause up to 40% variation and 17% false reductions in infant mortality.

There are other misleading issues to consider. Partly because of harmful behavior during pregnancy and socioeconomic factors, premature births – the main risk factor for infant death – are far more common in the U.S. than in any other developed country. The U.S. prematurity rate is 65% higher than in Britain and more than double that of Ireland and Finland.

A Centers for Disease Control study found that standardizing for gestational age eliminated 68% of the difference in infant mortality between Sweden and the U.S. The CDC concluded, “the primary reason for the United States’ higher infant mortality rate when compared with Europe is the United States’ much higher percentage of preterm births.”

When it comes to premature births, the U.S. ranks third behind only Sweden and Norway in survival rates. This is due to greater technology and more experienced neonatologists. Heroic efforts to save such babies are commonplace in the U.S. while in Europe physicians are limited by inferior technology and training. When such babies die they aren’t even counted in their official statistics.

Sweden and Norway benefit from more homogeneous populations than the United States. America has a population heterogeneity that is four to eight times as high as in countries like Sweden, Norway, France and the United Kingdom. Countries with more homogeneous populations have lower infant mortality, but that doesn’t reflect better healthcare quality.

U.S. life expectancy is also adversely affected by personal lifestyle choices – especially smoking and obesity, but also nutrition, risk-taking, exercise and sexual practices. International differences in violence, urbanization, marriage and economic inequality also have an effect on averages.

The U.S. has a substantially higher obesity rate than any other developed nation. This is a positive reflection of prosperity in the U.S. but has a negative impact on our healthcare outcome statistics. It is not a reflection of inferior medical care. According to the OECD health statistics for 2018,

  • 40% of the U.S. population is obese
  • 17% in France
  • 13% in Sweden
  • 3% in Switzerland
  • 8% in Italy
  • 2% in Japan (longest life expectancy)

Obesity alone accounts for approximately 40% or more of the differences in life expectancy between the U.S. and almost every other country.

A more accurate way to measure the quality of healthcare is to consider access to medical care for those illnesses that cause the most deaths and the common chronic disease that lead to the most disability and death.

Dr. Atlas says, “The world’s leading medical journals report the U.S. has superior results, including for cancer, heart disease, high blood pressure, diabetes, and high cholesterol; the quickest access to life-changing surgeries that permit pain-free mobility and restore vision; superior screening rates for cancer; the earliest access to new drugs; and broad access to safer, more accurate diagnostic technology that forms the crux of modern health care. Even for the lowest-priority care, U.S. wait times are far shorter than for seriously ill patients in peer countries like Canada and the U.K.”

Remember, “statistics don’t lie but you can lie with statistics.” The United States healthcare system is the best in the world and all the speeches about the virtues of single-payer healthcare won’t change that. Why else do so many people from Canada and Europe come to the U.S. for healthcare when they can get “free healthcare” at home in their own country?