Thursday, September 3, 2009

David Frum is a genius . . . oh, wait

In Four simple steps to health care reform, heard on Marketplace last night, David Frum makes the case that what we really need to do is reform individuals, not health care. He makes some good points, and also an excellent point he did not, I think intend. First the good points. Individual actions matter. He is a genius. That must be why he gets paid the big bucks. If people smoked less, ate less, exercised more, etc. blah-blah-blah. You already know all this, right? He does add some useful numbers about savings we could realize if people acted as if they really cared about their health, which I'm too lazy to fact check. Let's concede the point. All right?
Then we can move on to the excellent point:
Our infant morality statistics are awful, worse than Cuba's. It's these infant deaths that pull down American life expectancy overall. Once Americans reach 65, American life expectancy ranks a respectable 9th in the world.

Why so many infant deaths? The shockingly high American incidence of premature birth: about one baby in eight. And the most important causes of premature birth are controllable: smoking during pregnancy, drinking, drugs, maternal overweight, and sexually transmitted diseases.

We all want wider health access and a more rational health-care system. But a big obstacle to a better system is our expectation that doctors, hospitals, and machines will save us from the harms we do to ourselves.


Hmm, if we're so crappy at taking care of our health when we're younger, why do we do so well once we reach that magical age of 65? "Say, isn't that the age at which that socialized health system called Medicare kicks in?" I hear you ask (it's a fair question: not everyone gets this point). The answer of course, is yes, yes it is. Coincidence? Hah-ha. Maybe.

Naturally, correlation does not mean causation, and the fact that seniors do so well in the US, comparatively, could be due in part to other factors. Also, this isn't to say that taking better care of ourselves is a bad idea. I'm just sayin'. Medicare works.
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