Americans rate Canada’s health care better than health care in the US, and a working paper proposes that the SES-health gradient difference between Canada and US citizens decreases at age 65, miraculously the same age Americans get Medicare.
This is a medical weblog--a collection of thoughts about medicine, medical training, and health policy--written by a fifth-year medical student.
I recently stopped blogging, as I graduated from medical school and I'm now a physician in my residency training in New York City. But feel free to read and enjoy!
(To get rid of this thing, just wave your mouse over it. Ta da!
Yay for Canada :)
Q
The Harris Poll you cite refers to a cross-section of adults who were weighted/adjusted for age, sex, race, education, and household income. But the methodology section of the poll does not mention whether any of the responders had ever received any medical care in Canada or knew anyone who had ever been treated in Canada; or, even what the “health care” in Canada is like.
It just asked how people “feel” about health care in the two places.
It is no surprise then, with this subjective goal, that the pollsters don’t bother to define “health care” neither for those polled nor for the reader.
To what use shall we put these data?
The NBER study you link is also of dubious use. The synopsis is moderately dense mumbo-jumbo (usually a tip-off that wobbly social scientists are at work) and contains an interesting bait-and-switch methodological tactic when defining their assessment of the enrollees “health” status.
When describing their methods they tag a disclaimer onto “health”:
“the size of the income gradient in self-reported health in the US and Canada.”
And then when dazzling us with their conclusions they drop the mitigating appellation:
“We find that being below median income raises the likelihood that a middle aged person is in poor or fair health by about 15 percentage points in the U.S., compared to less than 8 percentage points in Canada.”
So we went from people feeling they had poor health to people being in poor health. If the health assessments are indeed self-reported, what exactly should we do with conclusions drawn from these data?
Nothing. Which is good, and what is deserved.
Notice both of these studies are centered around “feelings.” The bear tracks of the social scientist!
I tried to purchase the study for the five dollar fee, but it was unavailable!
Please respond to me.
I always read your blog and I admire your intellectual honesty and I think that these references and your blog entry were misleading.
What do you think?
Don’t you think I am right?
Israel– Thanks for posting. I think the former is still very interesting–even with all the negative media and smearing of Canadian health care in the media, people’s opinion of it is *still* better than that of the US.
The latter I agree can be tough to analyze–anything self-reported is. I read the basics of the study to be that health differences tied to income decreased (and became more similar to Canada’s) once people got Medicare (or something else magical happened at 65), and that Medicare was something of an equalizer.
It’s a working paper, and I didn’t have time to read the paper, and I still don’t–that’s why I just posted them as “interesting,” not as sources for an argument I was making. Sorry if you assumed they were anything more than that, I just wanted to let people know about them and get their opinions, like you gave me. Thanks!