More on The Best Health Care System in the World ™ – Zombie Infant Mortality Explanation

Aaron Carroll, writing at the Incidental Economist has a post entitled The zombie infant mortality explanation. He takes the Wall Street Journal to task for trotting out a discredited chestnut apologizing for the abysmal ranking of the U.S. in infant mortality statistics.

This is of particular interest to me since I heard a lot of this explanation when we were discussing the necessity of health care reform on my blog in the lead up to the Obamacare legislation. The argument is that the infant mortality comparisons are apples to oranges. Our metrics are so much more sensitive, so of course we rank last – because we’re so damn good and try so hard to save babies, we report more deaths. Turns out, not so much.

Let me quote directly from the study (page 66-7):

The high rate of adverse birth outcomes in the United States does not appear to be a statistical artifact, such as a difference in coding practices for very small infants who die soon after birth (MacDorman and Mathews, 2009). Indeed, country rankings remained identical even when Palloni and Yonker (2012) recalculated the rates to exclude preterm births (less than 22 weeks of gestation).

There are lots of reasons why our infant mortality is terrible. This isn’t one of them. It’s a zombie idea.

Reminds me of a good “Usual Suspects” quote about Keyser Soze: “The greatest trick the Devil ever pulled was convincing the world he didn’t exist.” That’s what I think of sometimes when the discussion turns to problems we have that other countries are better at addressing. So often, there is an attempt to claim that either our condition isn’t really a problem or, if it is, it’s a problem that the other country never really had to deal with. Either the problem doesn’t exist or the solution doesn’t exist. That means we can keep on with the status quo.


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