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Monday, October 24, 2005
Is Infant Mortality a Good Measure of the Quality of Health-care Systems?
From Brian Ferguson at Canadian Econoview:
Canadians are used to hearing comparisons between infant mortality rates here and in the US used as an argument for the superiority of our state-run health care system. For example, in 1998, the overall infant mortality rate for the US was 7.2 per thousand live births, compared with 5.4 per thousand in Canada...
Infant mortality comparisons are tricky things. For example, mortality risk is closely linked to birthweight: low birthweight means high mortality risk. With that in mind, let's look at some detailed figures from the same periods as those averages were calculated for. In these figures, "g" is grams, and 2500g and up would be normal birthweight.
Deaths/1000 live births in Canada vs. the U.S. (by weight class):
1500 - 1999g: 28.7 in Canada, 29.0 in the U.S.
2000 - 2499g: 12.4 in Canada, 12.5 in the U.S.
>2500g: 2.3 in Canada, 2.6 in the U.S.
The infant mortality rates in the U.S. are slightly higher than those in Canada in these weight ranges, but the difference is VERY slight (what statisticians would call statistically insignificant). The data presented by Brian Ferguson show that the differences go the other way for babies born with very low birth weights: the infant mortality rate is higher in Canada in the U.S.
There are many more data available at his site, along with his usual pithy discussion and analysis; please read the whole thing before dashing off a comment here. While there are many possible explanations for the differences, one conclusion that emerges is that rough comparisons of infant mortality rates are probably not a good indication of the overall quality of medical care.
Posted by EclectEcon on October 24, 2005 | Permalink
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Comments
I agree with you - I think that the statistics between the two countries, using both deaths per 1,000 live births and life expectancy, are too close to be statisically significant.
In Norway, for example, which has a mixed (private and public) health care system, the infant mortality rate of 3.7 is lower than Canada's 4.75 - and the life expectancy is statistically the same. So- we can't conclude that Canada's refusal to permit private health care is the key to health. It isn't - and we are finding, as we struggle to maintain its costs, that it will be an economic disaster.
We can compare economic robustness, for example. Canada has grievously erred in setting up its economy to piggy-back on the US economy. That is, we aren't really a world market economy; we set up branch plants of the US here - and are employed as its workers and managers. And, we rely almost completely on the US to purchase our goods.
For example - Canada's exports are:
USA- 85.2% (!!!!)
Japan - 2.1%
UK- 1.6%
Imports:
US: 58.9%
China- 6.8%
Mexico- 3.8%
That has set us up in quite a dependent relation. We are so dependent that we spend a great deal of time rejecting this actual dependency by self-defining ourselves as 'good' and the Americans as 'bad'.
Compare with the US:
Imports
From Canada Canada: 17% (Canada imports from US- 58.9 and exports 85.2%))
China: 13.8%
Mexico: 10.3%
Japan: 8.7%
Germany: 5.2%
Exports:
To Canada: 23%
Mexico: 13.6
Japan 6.7
UK 4.4
China 4.3
See what Canada has done? It has set up its economy to interact with only one other country!
So- Canada refuses to admit that it subsidizes its foresters via their cutting their wood on public land with low stumpage fees..versus the American foresters who must invest capital to purchase land...and Canada INSISTS that the US purchase its softwood!! Insists!
And Quebec INSISTS that Wal-Mart set up a store there, and hire its employees - at wages set by Quebec unions. INSISTS! Takes them to court! The US must, must, set up stores in Canada so that Canadians will have jobs.
That's the type of economy Canada has set up.
Using the same Norway example (no reason)..you can see that Norway has diversified its imports and exports - just like the US. For example, Norway exports:
UK - 22.4
Germany - 12.9
Netherlands - 9.9
France - 9.6
US - 8.4
Sweden - 6.7
Only Canada has set itself up in an economic infrastructure, a lazy, lazy structure - where it exports its goods to primarily only one country. It doesn't have to enter into the world market; doesn't have to compete. Lazy, lazy. And - then, gets into the situation where it is so dependent - that it INSISTS that the other country ignore market value..and purchase Canadian goods. Because otherwise, Canadians don't have jobs.
Incredible.
(All data - CIA world factbook).
Posted by: ET | 2005-10-25 10:38:04 AM
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