Stanley Feld M.D.,FACP,MACE
I love it! These are the type of comments I wanted to stimulate. My comment is below the quoted article.
Stan
Think about this too.
Richard
Many "people" are stupid and this is why a system depending on them making the choice is unacceptable.
You need to note the most recent article on health care comparisons, published recently by Mike Stobbe of the Associated Press. The article follows.
Survey
Canadians report better health
by Mike Stobbe
Associated Press
Atlanta -- You can add Canadians to the list of foreigners who are healthier than Americans.
Americans are 42 percent more likely than Canadians to have diabetes, 32 percent more likely to have high blood pressure, and 12 percent more likely to have arthritis, Harvard Medical School researchers found.
Comparing Conditions
Problem Americans Canadians
________________________________________
Diabetes 6.7% 4.7%
High blood pressure 18.3% 13.9%
Arthritis 17.9% 16.0%
Obesity 21.0% 15.0%
Sedentary lifestyle 13.5% 6.5%
Smoker 17.0% 19.0%
That is according to a phone survey in which American and Canadian adults were asked about their health. Less than a month ago, other researchers reported middle-aged, white Americans are much sicker than their British counterparts.
"We're really falling behind other nations," said Dr. Steffie Woolhandler, a co-author of the Canadian study.
Canada's national health insurance program is at least part of the reason for the differences found in the study, Woolhandler said. Universal coverage makes it easier for more Canadians to get disease-preventing health services, she said.
James Smith, a Rand Corp. researcher who co-authored the American-English study, disagreed. His research found that England's national health insurance program did not explain the difference in disease rates, because even Americans with insurance were in worse health.
Woolhandler said her findings were different in at least one important respect: In the Canadian study, insured Americans and Canadians had about the same rates of disease. The uninsured Americans made the overall U.S. figures worse, she said.
The study, released Tuesday, is being published in the American Journal of Public Health. It is based on a telephone survey of about 3,500 Canadians and 5,200 U.S. residents, all 18 or older, in 2002-2003.
The results are based on what those surveyed said about their health. The researchers in the American-English study surveyed participants and also examined people and conducted lab tests on them.
I just finished a book call Fooled by Randomness by Nassim Nicholas Talas
It is a book on how to judge stock trading statistics. The subtitle is “The Hidden Role of Chance in Life and in the Markets . Telephone surveys have a gigantic selection bias. The selection bias does not flatten out with large sampling. The conclusions if forceful enough or impact full enough become the eventually become the truth in decision making. However, the evidence in this article, in reality, is observational and not randomly controlled scientific evidence.
This data would be classified at Level 4 data. It suggests a difference in health but does not prove a thing. How many Hispanics and Blacks were in the American survey as opposed to the Canadian survey? Is the survey reproducible with the same number of participants, and a controlled mix of patients? These are just a couple of the many questions that must be answered.
People are not stupid when they have enough accurate information. The challenge to our healthcare system is to provide accurate and transparent information. The patient can then make a wise choice. We must work our way through all the noise presented daily.
People also become very smart when they have some skin in the game. My goal is to teach physicians and patients how to demand both so that the facilitator stakeholders feel they have to produce to satisfy the will of the major stakeholders, the patients and the physicians.
Stanley Feld M.D.,FACP,MACE
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