Friday, June 29, 2012

Where can you get Universal Health Care?

Its been a while since I posted anything but a recent CNN health article titled "Where in the world can you get universal health care?" gave me the need to post again.  This CNN article talks about some of the countries that have universal health care but by using the simple rhetorical trick of omitting facts the article makes it appear that universal health care is not widely used in the first world when in fact it is the most common health care system in the first world.  The health care debate in the U.S. is at a peak right now after the recent supreme court ruling upholding the new health care bill.  Thus, this CNN article discussing the countries where universal health care exists is timely.  However, the article is also highly misleading due to its rather absurd omissions.

First a little background.  Nearly every first world country has some form of universal or socialized health care but the United States has been one of the few hold outs refusing to obtain universal health care.  Now before you get excited and think that our lack of universal health care is a good thing lets look at the facts.  The united states ranks 37th worldwide in health care and most of the countries ahead of the US are countries with universal healthcare.  But it gets worse.  Not only are we 37th in healthcare, we also pay way more on health care than any other nation but end up with worse results than most nations that have universal health care.  Obviously we are doing something wrong and our system needs fixing.  The solution seems easy  since we have plenty of examples of countries with universal health care who are doing way better than us like Germany, France, Japan, and Norway.

Now lets get back to the CNN article and see what is so misleading about the article.  The article starts off pointing out that America doesn't have universal health coverage but it also says "neither do most other countries."  Right out of the gate the article hits us with a misleading statement by omission.  The article should have stated: "neither do most third world countries, but in the first world America is the glaring exception to the general trend of countries utilizing universal health care."  The article is of course technically correct that most countries do not have universal health care but it is highly misleading because it makes it appear that the US is one among many that lack universal healthcare.

This introduction becomes even more dishonest with what follows.  The article proceeds to casually mention that the UK and Canada have universal Health care but then goes on to give other examples of countries with universal healthcare, under bold headings, including: Brazil, Rwanda, Thailand, South Korea, Moldova, Kuwait, Chile, and China.  Out of the eight counties listed only Chile is ranked higher than the US in health care with Chile ranked 33 to the US ranking of 37.  Looking at the ratings for other countries we see that China is rated 144 and Rwanda is rated 172.  It seems bizarre that the article wouldn't list more prominent examples of universal health care like France (ranked 1 in health care), Italy (ranked 2), or Spain (ranked 7).  But it isn't so odd if the article is trying to be misleading.

The general expectation that we as readers have when reading an article is that prominent examples of countries with universal health care would be listed first.  Thus, when we read CNN's list including Brazil, Rwanda, and Thailand we incorrectly assume this means more prominent countries like France and Germany probably don't have universal healthcare.  This wrong assumption is especially likely after we were just told that most countries don't have universal healthcare.  This misleading set up creates the false image that universal health care isn't used in most other first world countries because if it was we would have expected the article to list more familiar countries like France, Germany, or Spain.

This story is a perfect example of how leaving out facts and framing the issue can give a distorted picture of reality. Imagine if we saw this same sort of article in a different context like sports. Imagine you go to a school with a track team that performs fairly poorly and its fastest runners generally place near last. You pick up a copy of the school newspaper and see an article titled "Our school has faster track times than other schools." You start reading about the race times of your track team and see that your track team has faster times than the runners listed from other schools with better track teams. However, what you don't know is that your school newspaper only listed the slowest runners from the other schools and didn't list the times of any fast runners from other schools. Our usual assumption is that the newspaper would list the fastest runners from each school and thus we wrongly assume that the runners at our school are the fastest runners. This is the same sort of misleading use of facts that the CNN article is using. CNN has listed the slow runners in Universal Healthcare rather than the fastest runners and thus misleads us into believing that other first world countries don't have universal healthcare.

I of course cannot say why CNN chose to present the countries that have universal health care in such a misleading way. What I can say is that the structure of the article is likely to give a misleading view of the prevalence of universal health care in first world nations. CNN should be more careful in its writing in the future.

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