Friday, July 31, 2009

The Fallacy of Measuring Healthcare Quality

One of the most often cited reasons for supporting government-run healthcare for all, besides the fact that it will be “free”, is that places like Canada have a longer life expectancy than the United States.  I have heard that argument made over and over again and I think it originated from that Michael Moore film that nobody watched, but some elitist columnist may have written an article that predates it.  I am sure that Michael Moore, though possibly entertaining, is probably not all that original in his ideas and thinking.

The problem with citing life expectancy as a measurement of a good healthcare system is that life expectancy is probably one of the most unpredictable things when you look at groups as a whole.  In Canada, I am almost certain that you are less likely to contract some kind of disease because of the cold, dry air up there.  There are probably a lot less disease carrying insects, for example, unlike warmer, wetter areas to the south.  As someone who has had to take anti-Malaria drugs in order to travel to Uganda, I can attest that the people there have a much shorter life expectancy because of such diseases (although AIDS prominent in the media, it is other diseases that do people in over there).  Other there, they get it like many children here in the United States used to get Chicken Pox, although Malaria tends to stay with you until you die and never really goes away.  That is if you are not killed by it when you are first infected.

Life expectancy is largely a genetic factor as well.  Some people are prone to living a much longer life than others by simple virtue of their genes.  When you break it down by race, for example, you might conclude that heart disease is a racist disease.  Someone like me is genetically more likely to have higher cholesterol than other people and I may end up taking drugs and getting frequent screenings later on in my life.  Cancer also seems to have genetic component as some people are more likely to acquire certain forms of cancer than others.  Tony Snow’s family had a history of colon cancer and, unfortunately, it took him when he was in his fifties.

In Biblical times many prominent prophets lived long lives.  Moses was roughly 120 years old when he traveled to the top of a mountain to die.  Abraham, Isaac, and Jacob were all full of years, as the saying goes.  In those days, there was no such thing as quality health care, so if we are to believe the accounts, which I do, it certainly flies in the face of the life expectancy argument.

Healthcare quality cannot be measured by life expectancy.  The most accurate measurement to use for the quality of healthcare are the options available to the consumer and the quality of service.  Certainly the best system of health care in the world right now is found here in the United States, in spite of it enjoying some level of economic freedom from the government.

Life expectancy is not a good argument for or against creating a government-run healthcare system.  The main problem is that we are all predestined to die from the moment of our conception.  While I think we should do everything we can to avoid death, it is inevitable and eventually there will be nothing more for a doctor to do for us besides “make us comfortable.”  While new technologies may be advanced to create us unnaturally long lives in the future, in comparison to our average life spans now, death will eventually come for us.  While the general goal of any healthcare system is to prolong our lives, there are still many things that can just as easily kill us that have no cure, of which some groups of people tend to be more prone to than others.  Life expectancy ultimately has no bearing on the quality of care that people receive.