Investor’s Business Daily is in some hotwater… the blogosphere is a buzz is with a discussion of the IBD’s blunder that range from describing the quote as “Dumbass” to accusing the IBD of ‘lying‘. The original quote taken from the IBD read:
People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.
The editorial has subsequently been ‘corrected’ and now contains the following disclaimer above:
Editor’s Note: This version corrects the original editorial which implied that physicist Stephen Hawking, a professor at the University of Cambridge, did not live in the UK.
I must admit that this is not entirely honest. The take-home message of this editorial was not that Hawking lived in England, but that he is a poster child against nationalized healthcare. As it turns, Hawking was born and raised in the UK, and has in fact come out in support of the UK’s National Health Service.
‘I wouldn’t be here today if it were not for the NHS,’ he told the Guardian. I have received a large amount of high-quality treatment without which I would not have survived.’
Though the IBD has handled the correction improperly, Hawking was not a good example to have chosen… and not because the UK’s NHS has superior healthcare.
Firstly, a little background about amyotrophic lateral sclerosis (ALS) and Hawking’s experience with the disease, also known as Lou Gehrig’s Disease, and the cause of his disabilities. In general the disease is relatively late onset, Hawking’s ALS began to develop when he was 21 years old, ca. 1962. The disease is a neurological disorder; it attacks neurons that control the movement of voluntary muscles. As the disease progresses it causes a loss of muscular coordination which eventually leads to death, usually via respiratory failure. In general, those afflicted with ALS succumb to respiratory failure within 5 years of symptom onset. However, up to 20% of ALS-affected individuals survive for at least 10 years; Hawking, having lived more than 40 years, is an extremely rare occurrence of ALS.
In my opinion, Hawking is a poster child against genetic testing and subsequent selection of ‘superior’ embryos based on DNA sequence (there is a genetic marker for the disease); genetic testing and subsequent counseling could, and likely would, lead to abortion of a fetus such as Hawking. However, Hawking should not be held up as an example of the inferior nature of the UK’s NHS.
There are at least a couple of reasons for this: Firstly, Hawking’s case of ALS is extremely atypical; it progresses much more slowly when compared to the typical ALS sufferer. Secondly, Hawking is an atypical individual; his disease didn’t progress to the point of being debilitating until he was well into his graduate studies. Perhaps he wasn’t recognized as the brilliant theoretical physicist that he is back then, but it’s extremely likely that his brilliance was recognized by that point. Hawking lost the ability to feed himself around 1974, the same year he was elected as as one of the youngest Fellows of the Royal Society; clearly he had distinguished himself in his field by the time his disease progressed to the point where he was significantly impaired.
None of this is meant to belittle Dr. Hawking’s accomplishment’s, especially given that he does suffer from this disease; I’ve no doubt that his struggle has been remarkable and hard won.
IBD’s choice of topic, and their position were not wrong; they just utilized an extremely poor example. Indeed, waiting lists, and rationing are better examples, but they don’t illustrate the truly superior nature of US healthcare. Let’s move past the statistics regarding life expectancy in the US, as I’ve dealt with them in a previous blog entry. For the sake of completeness, I’ll re-post a portion of my statements here:
The problem with this type of evidence is that life expectancy in any country is not necessarily indicative of the state of healthcare in that country. A wide variety of factors that cause premature death are completely unrelated to the state of a nation’s healthcare. For example, here in the US we have many more fatal traffic accidents when compared to other countries. Additionally, our homicide rate is off the charts relative other nations: 10 times higher than in the U.K., eight times higher than in France, and five times greater than in Canada. None of these are healthcare related issues, but all contribute to life expectancy statistics. Though I’ve not done the calculations, nor could I find them done anywhere, when factors such as these are accounted for it’s entirely likely that U.S. life expectancy is similar to, or possibly higher when compared to other industrialized nations.
What indicators – besides Stephen Hawking’s subjective experience – might actually suggest which healthcare system is superior? In my opinion, a good indicator is the relative survival rates for specific diseases in each respective country. Let’s take for example survival rates for various cancers in Europe vs. the USA (Source). Statistics from the USA are much more positive than those from Europe. Compare for example the 5-year survival rates (adjusted for age) for all cancers: In Europe the rates are 47.3% for men and 55.8% for women, significantly lower than 66.3% for men and 62.9% for women achieved in the USA.
In fact survival rates for all cancers were significantly higher in the United States with the exception of soft-tissue, stomach and testicular cancers; survival rates in Europe and the USA are comparable in these instances. The most striking differences were observed in colon and rectum (56.2% in Europe vs 65.5% in the United States), breast (79.0% vs 90.1%), and prostate (77.5% vs 99.3%) cancers.
Nevermind speculation about rationing, waiting lists, “death panels”, government bureaucracy, and all of the other issues surrounding healthcare reform; not that they aren’t important, they simply lack any firm, quantifiable, or measurable impact. In short, those issues are still speculative.
Cancer survival statistics are quantifiable, tangible, and provide a viable mechanism by which one might be able to discern which healthcare system is superior. When we compare apples to apples, that is survival rates for the same disease as a function of different healthcare systems, the data presented here clearly indicate that the healthcare system in the United States – despite its many flaws – is far superior to those in Europe.
If these cancer survival statistics don’t indicate this, then what do they say about each respective system?
Perhaps Stephen Hawking is satisfied with the NHS in the UK; I’ve no doubt that the NHS has in fact, saved Hawking’s life. However, as the cancer data clearly indicate, one simply has a better chance of surviving a life-threatening disease in the United States. That is the ultimate measure of the efficacy of any given healthcare system: what statistically measurable effect does it have on a population. Anecdotes – even when they are about Stephen Hawking – are not data, and tell us nothing about the larger system.
In the future, I would encourage the IBD to rely on data, not anecdotes, to make their entirely valid point.
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I’m so glad I found this site…Keep up the good work