Linda Gorman explains survival rates:
With funding from the Commonwealth Fund, Peter A. Muenning and Sherry A. Glied have produced a Health Affairs study of 15 year survival rates for men and women aged 45 and 65 in 13 countries for each year from 1975 to 2005.
A country’s survival rate is the percent of people of a given age who are still alive after 15 years. The authors ranked each country’s survival rate in each year. Because the U.S. relative ranking fell over the period while its per capita health spending rose, the authors conclude that the U.S. has a relatively inefficient health care system.
They blame the inefficiency on a rising number of people with “inadequate health insurance” and the reliance on “unregulated fee-for-service and specialty care” which they speculate may be “choking off public funding on more important life-saving programs.”
Little evidence is adduced to support any of these conclusions. In fact, the authors seem to jump through a myriad of speculative hoops to force the facts to conform to their preconceived views.
As is well known, age-adjusted survival rates are not by themselves a useful measure of the success or failure of a country’s health care system.
One reason that survival rates are not good measures of health system quality is that individual behavior has a large influence on health and, as a result, the health outcomes that produce survival rates. The authors do consider trans-national differences in smoking, obesity, and traffic accidents/homicide, three behavioral risk factors that receive a great deal of popular coverage. Unfortunately, their analysis of those factors is difficult to defend. At the same time, the authors ignore such factors as suicide, alcoholism, illegal drug use, poisoning, drowning, burns, and accidents other than homicide and traffic accidents.
Read Linda’s entire blog post here.
