The Perils of Sloganeering (healthcare edition)

There’s so much political stupidity on Facebook that I have to just ignore 99% of it. But yesterday I noticed a very conservative friend — known for his opposition to universal healthcare in any form — quip that “the city of Pittsburgh has more MRI machines then [sic] all of Canada…”

I took a particular interest in this bumper-sticker fact not just because I’ve previously spent a lot of time researching universal healthcare, but also because the claim seemed to be doing more intellectual work for these conservatives than it was doing for me. That is, I didn’t think such an isolated statistic was so thoroughly devastating to the case for universal healthcare… there had to be more to the story, right?

In looking into it I discovered that this quip — “Pittsburgh has more MRI machines than Canada” — has been turned into an endlessly quoted slogan that is rarely cited or examined. But here’s where things get funny: the origin of this phrase lies in a 2008 Forbes article by David Whelan in which this statistic is mentioned to show precisely what’s wrong with the U.S. healthcare system (oh, the irony!). Whelan’s point was that spending was out of control, and that advanced imaging machines (both MRI & CT) purchases were above and beyond what was necessary. What was a throwaway line by one journalist to point out the weaknesses of the U.S. system is now being brandished by right-wingers to point out the supposed superiority of the U.S. system.

Note, however, that Whelan doesn’t actually cite where he got this statistic. My best guess is that he was relying on a 2005 Pittsburgh Tribune-Review article. The piece paraphrases Vic Panza — V.P. of National Imaging Associates and a man with a vested interest in high sales of MRI machines — as saying that Western Pennsylvania (not just Pittsburgh) has 160 total machines. However, according to the O.E.C.D., in 2005 Canada had some 183 MRI machines (and some 250+ by this year). So even if you trust Panza’s estimate, the whole statistic seems fairly suspect to me.

Frankly that entire question is pretty misleading in the first place. Even if the slogan were true (and this is now pretty doubtful) it wouldn’t be surprising or very informative: per million people, the United States has 3x as many MRI units as the average among the 30 OECD nations (25.9 vs 8.4). This data comes from the 2009 OECD Health Data report, which is an incredible compilation of statistics comparing each of these advanced economies, all of whom have some form of universal healthcare (mostly single-payer). However, when it comes to healthcare they consistently outperform us (Canada’s system is also pretty middling compared to the others). On average, OECD nations have more doctors than us, more hospital beds, more acute care beds (including longer stays in those beds), lower infant mortality rates (ours is comparable with Slovakia), and a higher life expectancy. All this, despite the fact that we spend 120% more per capita; this works out to be 16% of our total GDP spending (compared to a 9.1% OECD average).

So if we’re spending more on healthcare and getting less for it than other industrialized nations, what exactly is the point of bragging about owning more MRI & CT units than everybody else? Rather than a strength, it looks like Whelan’s thesis holds: spending on advanced imaging machines is not doing us a whole lot of good. The spate of these devices is probably more attributable to the profit motive (on the sellers part) and fear of malpractice lawsuits (on the buyers part). The OECD data demonstrates that a superior healthcare system is not — sorry Facebook neocons — dependent on owning a gazillion more $2M gadgets than the other guys.

Leave a Reply

Your email address will not be published. Required fields are marked *