Forget those cars and guns



It was a small episode in yesterday's Senate Finance Committee debate on health care. Nevertheless, it's worth a moment of scrutiny, because it spoke volumes about the intelligence-challenged mentality that has stymied reform in this country for lo these many decades.

Senator John Ensign, the Nevada Republican best known for having trysted with the wife of a top aide, strongly disputed all the health statistics which consistently show that the United States lags behind other western nations in terms of quality care. His protestations were entirely predictable; after all, most conservatives are incapable of accepting the notion that the United States lags behind anyone else on anything - because this is America, and America by definition is always number one.

Ensign and his brethren don't like to hear that America, despite spending more per capita on health care than anyone else, ranks 50th out of 224 nations in life expectancy (this, according to the CIA World Factbook); that the Commonwealth Fund, a private foundation that has tracked health care since 1918, consistently finds that when America is measured against five other western nations (Australia, Canada, Germany, New Zealand, United Kingdom) on five key health care metrics (quality, access, efficiency, equity, healthy lives), America ranks either last or next to last; and that, in a life-expectancy study conducted by the OECD (the Organization of Economic Cooperation and Development), America during the final two decades of the 20th century ranked only 19th of the 29 OECD member nations.

But what really ticked off Ensign was a Senate colleague's reference to international statistics which show that America has a higher preventable death rate than other western countries - that, in other words, America has the worst track record of losing people who could have been treated under a more efficient, accssible health care system.

This was the point when Ensign offered his sophistry:

"On preventative deaths, are you aware that if you take out gun accidents and auto accidents, the United States actually is better than those other countries?"

He continued: "On the preventable deaths, you take out auto accidents - because we drive our cars a lot more, (other western countries) do public transportation....If you take out accidental deaths due to car accidents, and you take out gun deaths - because we like our guns in the United States - you take out those two things, you adjust those, and we actually do better in terms of survival rates."

Wow. Where to begin...

1. "Taking out" the car and gun-related deaths in order to improve the death stats is akin to saying that the New York Mets would be winning the National League East if we simply take out the losses.

2. Ensign's sophistry is irrelevent, because the international statistics don't even deal with cars and guns. Instead, they compare apples to apples. In a 2008 study, the Commonwealth Fund focused solely on serious physical illnesses "such as treatable cancers, diabetes, and cardiovascular diseases...deaths from certain causes before age 75 that are potentially preventable with timely and effective health care." The Fund looked at 19 industrialized nations (14 in western Europe, plus Canada, Australia, New Zealand, Japan, and America), for the years 2002 and 2003...and, of all 19, America had the worst preventable death rate.

3. The OECD has written that, even if you factor in America's high death rate from all accidents and injuries, America improves its life-expectancy ranking by only two notches, from 19th of 29 member nations to 17th of 29.

4. Ensign was inadvertently suggesting that America would suffer far fewer premature deaths if we didn't love our cars so much, or love our guns so much. But Hades would freeze over before a conservative Republican would follow his own logic and conclude that we'd suffer far fewer preventable deaths by enhancing public transportation and curbing the love affair with guns. Naturally, Ensign said neither.

5. Forget the gun and car deaths for a moment. There are also three million car accident injuries each year in America, as well as 70,000 annual gun injuries. It's fair to assume that a hefty number of those injured people don't have access to any health insurance. Care to guess who picks up the tab?

Granted, Ensign and his fellow Republicans are largely a sideshow at this point; the real action is among the Democrats, particularly the Senate moderates who are balking at the creation of a government-run health plan that would compete with the insurance companies. The Finance Committee voted no on two such proposals, and Democrats are bound to struggle further if and when the idea reaches the Senate floor - and beyond, in House-Senate negotiations. But, even without a so-called "public option," the prospects for some kind of substantive reform remain bullish, and foes like Ensign seem increasingly tethered to fatuous arguments.

After all, according to Ensign's logic: If we simply "take out" the fact that his rich daddy paid off the cuckolded husband of the woman whom Ensign dallied with, then the senator of Nevada would have a squeaky clean rating.