Single Payer’s Misleading Statistics

Mediocre U.S. rankings in infant mortality and life expectancy have little to do with health-care quality.

By Scott W. Atlas. Excerpts:

"America’s rate of infant mortality—death within the first year after birth—was 5.9 per 1,000 live births in the latest statistics, 32nd among 35 developed countries, according to the Organization for Economic Cooperation and Development. But these aren’t apples-to-apples comparisons. Unlike many other 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 Gynaecology study of Western Europe found that terminology alone caused up to 40% variation and 17% false reductions in infant mortality."

"A Centers for Disease Controlstudy 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.”

American physicians consistently make heroic efforts to save extremely premature infants—unlike their European counterparts, who limit necessary technology and then don’t even count such babies when they die. Official data from the U.S. National Center for Health Statistics and the European Perinatal Health Report show that when it comes to newborns who need medical care and have the highest risk of dying, the U.S. has the world’s third-best infant-mortality rate—trailing only Sweden and Norway."

"Throughout the developed world, racial and ethnic minorities have double the infant mortality of the majority—including in countries with government-run medical systems like Canada and England. U.S. population heterogeneity is four to eight times as high as in countries like France, Norway, Sweden and the U.K. Countries with more homogeneous populations have lower infant mortality, but that doesn’t necessarily reflect better health-care quality."

"The U.S. has a substantially higher obesity rate than any other developed nation—again, a problem, but not one of inferior medical care. According to the Organization for Economic Cooperation and Development’s Health Statistics 2018, 40% of the U.S. population is obese, compared with 17% in France, 13% in Sweden, 10.3% in Switzerland, 9.8% in Italy and 4.2% in Japan, the country with the longest life expectancy. Based on the estimated 6.5 years of lost 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."

"Two-thirds of deaths among Americans between 1 and 24 are not from illness, and so are more than 40% of deaths from 25 to 44. For men between 20 and 24, accidents and homicides account for 84% of the gap in mortality rates between Canada and the U.S."

"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."