Amazingly, the conclusion won’t be that the NHS is shit

“Life expectancy at birth” is a poor metric. Childbirth is messy, and an infant can be declared born-then-died, or merely stillborn, depending on local customs. “Life expectancy at age X” is a better metric.

PHE has chosen its statistics carefully from the many available. Here, we see there are 10 countries with a female LE between 81 and 82 years. The only countries doing substantially better are FR, SW, LX, IT, SP. We do better than Germany and Denmark. France does better because of all the smoking and high fat cheese eating. Spain and Italy do better bey being poor. In any case, following the “heart age” debacle, nobody believes a word PHE says.

Life expectancy at birth is higher in Cuba than in the USA. I doubt that Cuba’s healthcare system is better. It has to be a healthier environment. There may be such a thing as living too high on the hog.

‘My candle burns at both ends; it will not last the night; but ah, my foes, and oh, my friends – it gives a lovely light!’ – Edna St. Vincent Millay

Andrew C – perhaps compare Cuba to other similar small countries?
USA appears to have some self inflicted health problems. School shootings included.

Entirely off-topic, but there was a piece about Polly and the Laffer Curve on CT this morning. Now it’s gone, and I’m considered scum of the earth and forbidden to comment or communicate with CT.

Again.

“Life expectancy at birth is higher in Cuba than in the USA. ”

And in other news tractor production is UP again, for the 1032nd month in a row! All hail the tractor production collective, which now makes a tractor every 5 seconds………

@Martin – the thing about totalitarian states is that they’re not so keen on independent bodies coming in and actually measuring their own statistics.

Should we have believed Soviet agricultural and tractor production stats since there were no other sources?

Southerner

“Life expectancy at birth is higher in Cuba than in the USA. I doubt that Cuba’s healthcare system is better. It has to be a healthier environment. There may be such a thing as living too high on the hog.”

As other’s have pointed out there are many issues with the Cuban health care system, not least those metrics are actually targets and doctors go to prison if they miss them. This means that women can be forced to have an abortion if a fetus doesn’t look viable.

You can listen to one of the author’s of this paper being interviewed, and its worth a 50 minute listen:

This episode’s guest is Vincent Geloso, here to talk about his work on Cuban healthcare statistics. He recently released a working paper with coauthor Gilbert Berdine titled “The Paradox of Good Health and Poverty: Assessing Cuban Health Outcomes under Castro.” The abstract reads as follows:

In spite of being poor and lacking in economic opportunities, the population of Cuba enjoyed significant improvements in health outcomes under the Castro regime. Many have praised the ability of the regime to overcome the barriers of poverty and economic stagnation in order to improve health outcomes. Many have also argued that efficient features of Cuba’s health policy should be imported regardless of political considerations. In this paper, we argue that these improvements are probably overestimated, but that they are real nonetheless. We also argue that some of these improvements were an integral part of health policy and could only have been realized by the use of extremely coercive institutions. While efficient at fighting certain types of diseases, coercive institutions are generally unable to generate economic growth. On the other hand, the poverty such coercive institutions engender may have actually helped improve health outcomes, providing us with a false impression of the efficacy of the health care system in Cuba.

We have a wide-ranging discussion about Cuban health statistics, what they mean and don’t mean, how good health could be achieved by forcing people into healthy behaviors, and how well other Latin American countries have done in comparison to communist Cuba.

I’m sure, like Dominica, there must be two Cubas in the Caribbean. There’s the island my socialist friends in London have holidayed on. A marvellous place with a fantastic free healthcare system that’s the envy of the world. And the poverty stricken Cuba where, the Cuban guy services my car tells me, the clinic in his village has been closed & derelict for twenty years & the nearest healthcare is 30km away on an infrequent bus.

Superior health care is only one of the many reasons United States citizens have fled – by the thousands – from Florida to Cuba over the past 50 or so years.

And wasn’t it Fidel himself who expressed concern over the flood of New Jersey snowbirds that were overrunning large parts of Havana?

Yes, I think that answers it. The direction of flow of people is usually a very good indicator.

It’s also worth pointing out that as well as the stats being skewed by how death at/before/after birth are recorded the same is true at the other end of life. When you hear that so and so country has fewer deaths due to heart disease the proper response is one of scepticism. When autopsies are performed in this country in many cases the cause of death recorded by a doctor is found to be wrong. I actually met a doctor once who told me he wrote a wrong cause of death on some death certificates to spare the relatives from thinking their loved one had suffered. When you add all the different cultural practises, medical practises into the equation in different countries, making any meaningful comparisons is almost impossible.