How to convince me about health care (or anything else)
I think that countries with socialized medicine seem to do a much better job than we do. I think it's really important for us to reform things the right way which means I've gone looking for people who don't think my way is the right way. I want to make sure that they don't know something that I should know. No matter which side of this debate you're on, here are some tips for how to convince someone that your side is better.
Zeroth, we need to find some sort of compatible standard of evidence. If I think that the World Health Statistics Report is a decent source for information and you think that it's an ACORN-staffed propaganda machine of Obama's secret puppetmasters then there's nowhere that we can really go with that. If I'm trying to tell you why dragons aren't real and the only book you consider authoritative is the Dungeons & Dragons Monster Manual then there's not much more I can say on the subject.
First, anecdotes aren't evidence. You might know a Canadian who came to America for health care he couldn't get in Canada. I happen to know a Canadian living in America who went back to Canada for health care he couldn't get here. We can trade stories but real numbers are more convincing.
Second, make sure you're comparing marginal benefit. Don't just say "this is an apple"; compare apples to apples. Several people might be suing the Canadian health care system to recover the out-of-pocket costs of buying health care in America, but quite a few Americans are also suing their own HMOs to recover their out-of-pocket costs. Which system produces more lawsuits? Which system has more out of pocket expenses or more lawsuits per capita? How many people in Canada are coming to America for health care vs. people in America going to Canada for health care? Is that just because more Canadians live in America than vice-versa? The British NHS denies thousands of patients Mucagen for macular degeneration which is sad and tragic, yes. How many Americans denied that drug by their HMOs? What's the out-of-pocket cost difference for people who end up paying for it themselves?
Finally, make sure to avoid cherry picking. Ask yourself "is this example typical of the general case?" If Lucentis is scarce in Britain but everything else is quite nice rational people might still, on the whole, choose to live in Britain and only come to America in the rare cases where they needed the one thing that Britain doesn't have.
This is what I've been trying to do with the NHS Tax Cut spreadsheet. The source seems reliable, the numbers seem better than any I can find, I'm comparing countries to countries and apples to apples, and I'm trying to get enough countries on the sheet to show that it's not just one or two that do better than us, it's pretty much everyone. This evidence convinces me, and hopefully it convinces you too.
This process also works against me. Recently I was talking to someone about health care reform and they mentioned that tort reform was also necessary. I didn't have a very favorable opinion about tort reform so I asked them to explain. They mentioned that even though the costs of insurance are around 0.5%-2% of total health care costs, defensive medicine contributes 2 to 9%, and that prosecuting medical malpractice actions is more difficult in Canada than in many United States and United Kingdom jurisdictions. This doesn't seem like nearly as big a win as saving 18% of government expenditures and 80% out of pocket but fine, I'm convinced that it has the potential to help a little. If other countries have done tort reform and it works OK there we can do similar things here too.
Zeroth, we need to find some sort of compatible standard of evidence. If I think that the World Health Statistics Report is a decent source for information and you think that it's an ACORN-staffed propaganda machine of Obama's secret puppetmasters then there's nowhere that we can really go with that. If I'm trying to tell you why dragons aren't real and the only book you consider authoritative is the Dungeons & Dragons Monster Manual then there's not much more I can say on the subject.
First, anecdotes aren't evidence. You might know a Canadian who came to America for health care he couldn't get in Canada. I happen to know a Canadian living in America who went back to Canada for health care he couldn't get here. We can trade stories but real numbers are more convincing.
Second, make sure you're comparing marginal benefit. Don't just say "this is an apple"; compare apples to apples. Several people might be suing the Canadian health care system to recover the out-of-pocket costs of buying health care in America, but quite a few Americans are also suing their own HMOs to recover their out-of-pocket costs. Which system produces more lawsuits? Which system has more out of pocket expenses or more lawsuits per capita? How many people in Canada are coming to America for health care vs. people in America going to Canada for health care? Is that just because more Canadians live in America than vice-versa? The British NHS denies thousands of patients Mucagen for macular degeneration which is sad and tragic, yes. How many Americans denied that drug by their HMOs? What's the out-of-pocket cost difference for people who end up paying for it themselves?
Finally, make sure to avoid cherry picking. Ask yourself "is this example typical of the general case?" If Lucentis is scarce in Britain but everything else is quite nice rational people might still, on the whole, choose to live in Britain and only come to America in the rare cases where they needed the one thing that Britain doesn't have.
This is what I've been trying to do with the NHS Tax Cut spreadsheet. The source seems reliable, the numbers seem better than any I can find, I'm comparing countries to countries and apples to apples, and I'm trying to get enough countries on the sheet to show that it's not just one or two that do better than us, it's pretty much everyone. This evidence convinces me, and hopefully it convinces you too.
This process also works against me. Recently I was talking to someone about health care reform and they mentioned that tort reform was also necessary. I didn't have a very favorable opinion about tort reform so I asked them to explain. They mentioned that even though the costs of insurance are around 0.5%-2% of total health care costs, defensive medicine contributes 2 to 9%, and that prosecuting medical malpractice actions is more difficult in Canada than in many United States and United Kingdom jurisdictions. This doesn't seem like nearly as big a win as saving 18% of government expenditures and 80% out of pocket but fine, I'm convinced that it has the potential to help a little. If other countries have done tort reform and it works OK there we can do similar things here too.