Have you checked mortality rates for say….breast cancer in Canada? How about the formulary list for cancer fighting drugs in the UK?

Nice! Tally another vote for “take two aspirins and call me when your cancer is stage IV…” healthcare.

http://herceptin.dorothygriffiths-bcaf.org.uk/news-archive-apr06.html

In the UK, a person must (a) go only to the Family doctors serving your zip code — of which there may only be one, and (b) cannot see a specialist unless referred by your family doctor. So people cannot in any sense of the words “go anywhere they want” under the UK NHS.

Second, although the model is not one of claims and payments, treatments are approved by the NHS management (bureaucrats?) for use. There was a big stink recently because some UK regions did not allow the use of herceptin for breast cancer treatment, whereas others did (see: http://herceptin.dorothygriffiths-bcaf.org.uk/news-archive-apr06.html). This particular issue was resolved in 2006 when the NHS finally agreed to make herceptin available everywhere. This is functionally equivalent to a “denied claim” in the US.

Finally, my point is not whether the correlation exists. Often, correlation is easy to show statistically. My point is that correlation is not synonymous with causation; the observed correlation can be caused by factors not observed or even known about. For example, malaria is extremely highly correlated to a warm climate. Does malaria cause the climate to be warm? No. Does the warmth cause malaria? No (you can’t sit in a cold room to prevent or cure malaria). It took years of research (and the building of the Panama Canal) to establish that mosquitoes, which thrive in warm climates, transmit the parasites that cause malaria. To eradicate malaria from Panama, the US had to eradicate the specific variety of mosquito that carried it — typically by ensuring there were no standing pools of water for the mosquitoes to breed. So the correlation between warm climates and malaria is interesting, but not useful in isolation for the eradication of the disease.

Therefore, before taking action on anything you need to establish (a) correlation and (b) that you understand what causes the correlation to exist. Without that, taking any action will be a shot in the dark.

There are no denied treatments or claims under socialized medicine. Doctors choose the treatment – not “bureaucrats” as dishonest politicians like to claim. And they can see any provider they want. In fact there’s no concept of ‘switching’ providers. They can go anywhere they want.

As for the idea that there’s no correlation between care delivery and patient outcomes on a national level, I’m not quite sure what to say to that – that’s asinine. I suppose the tobacco companies are still denying correlation between lung cancer and smoking. And if that were the case, why bother to change it in any way whatsoever?

I was told there would be no math or statistics involved in tonight’s debate. – Paraphrase from SNL skit with Chevy Chase playing Gerald Ford. LOL.