WHO World Health Report 2000:A chance for the WHO to advance its own agenda

The BBQ Pit
#1

Not to be redundant here with the health care threads; however, I wish to be the first to critisize the WHO’s new World Health Report for 2000.

Most importantly, the WHO unfairly places more emphasis on the distribution of care and what it calls fair than the level or effectiveness of care. To quote the report most directly, “Goodness and fairness:both level and distribution matter.” Thw WHO claims that this report is intended to help people improve their health care systems, yet it seems more important to them that everbody gets the exact same coverage. Consider the five factors that govern a nation’s standing,
“WHO’s assessment system was based on five indicators: overall level of population health; health inequalities (or disparities) within the population; overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts); distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system); and the distribution of the health system’s financial burden within the population (who pays the costs).”

The fundamental flaw here is the assumption that the overall level of health system responsiveness and general population health is best achieved through a socialist health system. Never mind if a capitalist system ACTUALLY DELIVERS BETTER CARE, IT IS MORE IMPORTANT THAT EVERYONE SUFFER THE SAME BAD HEALTH CARE. The WHO gladly acknowledges that the US has essentially the best health care response available, the most direct measure of actual health system performance, we still come in well behind of France, Spain, Italy, and Oman even though our life spans beat out all of these countries.

P.S. In the WHO’s statistic on Usefull Life Span, people with major dissabilities such as parapalegics are relavantly dead to the WHO. It does not matter if you work as a mechanical engineer with a Ph.D. and then go flash 5.10s on El Cap over the weekend, your life must be useless, according to the WHO.

#2

I’ve worked with the WHO in South Africa, dealing with malaria, yellow fever and bilharzia parasites. You have badly misconstrued their mission. I suggest you check their website for a clearer insight.

#3

Oh, but that’s their website. It’s obviously full of lies promulgated by the evil anti-capitalist one-worlders. Can’t find any good infor there. :rolleyes:

#4

The WHO website, that IS where I got all of my information from. I did not just pull this information out of my ass or something.

#5

I’m sorry, I just don’t see what’s wrong with this.

#6

Freak, I gotta disagree. What’s the good of evenly distributed care if it’s a low level of care? Or worse, if it’s ineffective?

–Tim

#7

I’ve been thinking about your post this afternoon. I haven’t read the report in its entirety [basically I’ve been looking at the data first] so I won’t be able to respond to your points about the physically disabled as yet. I’ll come back to that issue in a separate posting.

I’ll start off with stating that I do not agree with your conclusions. Basically, I think you have not taken into account what this year’s report is about, but rather you have jumped to conclusions based on your political leanings.

This year’s WHO report is on improving health systems performance. I grant you that this is not a heartstopping and fastpaced Grisham novel, but for WHO to make this type of analysis should be applauded. WHO has long been under the influence of Me Docs [physicians] who have had little understanding of health economics and public admin.

So WHO has chosen to focus on the measurment and evaluation of how well the various health care systems worldwide are responding to their peoples health care needs in an effective manner without runaway health care costs. This doesn’t mean just your neighborhood physician or the nearest hospital. Health care systems cover: primary, secondary, tertiary care, health care financing, health care or biomedical research, public health, training professionals, health education, public policy, infant/child mortality rates, maternal mortality rates, disease prevention to cover the biggies.

The US is a clear leader in health care, biomedical research, and public health. We could learn a bit more and improve how we train professionals [need interns and residents work 36 hours straight?] and health education [why are so many Americans obese?]. How we finance health care has been an ongoing political debate since the 60s which we still have not been able to solve. Some African countries have better national immunization rates that our major metropolitan areas.

Several countries, such as France and Oman, have public health policies which promote more equitable access to high tech care than the US. At this particular time, I don’t know specifically why Spain and Italy are noted as “ahead” of the US - I’ll have to go back and look again. France and Oman have both made the political choice to spend more public dollars on health care than the US. They have made their systems more equitable by not measuring access to health care based on your insurance carrier or your ability to pay. One might ask the question of whether it is good public policy to have enough money to give every citizen the latest in high tech care [transplant this or that, bypass here or there]. Our system, because our elected politicians, has decided not to do so. In terms of public health response, the US has outpaced everyone since we “invented” public health [epidemic response].

Sidebar: the development of public health as a field started in the South with folks wanting to provide health care services to Blacks who were not receiving adequate, equitable quality care from a predominately white system.
Ditto the Indian Health Service. This is an example of a past problem where an ethnic group did not have access or receive equitable and quality health care… hhhmmmm, it’s debateable whether they still do…

I think your analysis is offbase, however I would be willing to listen further if you would provide evidence for your opinion.

#8

I guess I should add a couple of fuck this and that, here’s a motherfucker for you, and piss on that as well… there you go.

#9

Kiffa said this a million times, better, but redundancy and mediocrity has never stopped me from authoring a post before!!

I suspect that WHO’s working from the reality that health care resources are not unlimited. Maybe developing countries should focus less on having the best success rate against acute myeloid leukemia or the most heart-lung replacements and instead focus on making sure that everyone gets a checkup once in a while. Or that the underpriveleged don’t die or go blind from things that could be cured with a 15-cent dose of medicine.

Actually, the public health problems in a country like the U.S.–a developed nation which kicks ass when it comes to complicated diseases – are absolutely staggering. We might be able to provide the best care possible to some people, but others get pretty piss-poor care, or none at all.

Don’t get me wrong, when my son spent a week in the NICU, I was grateful as hell that we had all that medical expertise to throw at him. I just realize that when we crow about how damn great our “system” can be against these challenges, we’re ignoring the fact that we’re not spending resources on a lot of people who have slipped through the very wide cracks. The $100,000 we spend on a marrow transplant, or the $1 million we spend on saving a baby born too early, comes with an opportunity cost.

#10

Okay, I am going to go ahead and conceed this thread after punching some numbers.

Apparently, our health care is not as effective as I thought, by life period alone, we come in 27th, well behind France, Spain, Italy, et al.

#11

Thanks for your posting anyway. I enjoyed thinking about this stuff and my response. Looking forward to anything else you might want to talk about - for example: check out the eliminating syphilis article in New Yorker’s Talk of the Twon… your insights could be interesting. Also, how about posting in GQ or GD rather than the Pit where I feel obligated to add some fucks, shit, crap, goddamns in the appropriate spirit.