No, Socialized Medicine Does Not Provide Superior Epidemic Planning

There have lately been a number of people using the COVID-19 epidemic as a justification for single-payer or socialized medicine. Particularly, Bernie Sanders has come out claiming that "it has never been more important to finally guarantee that health care as a human right by passing Medicare for All." Yesterday, I heard someone claim that the for-profit medical system we have in the US is less prepared than those of other countries, because its operators trim all non-exigent expenses down to average usage levels.

This of course is the purest nonsense, and anyone who has paid attention to the goings-on overseas would recognize this with just a little bit of research. Particularly, I wanted to look at one of the first things that will get used up in a real pandemic: intensive-care unit (ICU) beds. Eric Toner, M.D. and Richard Waldhorn, MD writing in Clinicians' Biosecurity News report an estimated 46,500 ICU beds in the United States versus low-case needs of 200,000 beds for a 1968 influenza breakout, and a high-end need of 2.9 million. Needless to say, the availability of ICU beds will become very stressed under epidemic conditions:

• The UK has 4,000 ICU beds, of which "about four-fifths are occupied" according to a recent BBC story. The UK's population is about 66 million, which translates to
  
  4,000 ICU beds / 66M = 6 ICU beds/100k
• Canadian ICU beds are broken down by hospital type, with occupancy rates of 86% for large urban facilities, and 90% for teaching hospitals, with rates as low as 50% for smaller/rural hospitals. I was unable to find an overall national occupancy rate, but it appears Canada has an occupancy rate at the very least comparable to the US if not greater. Canada's population is 38 million, over 3,715 ICU beds as of 2015, which means
  3,715 ICU beds / 38M = 8.3 ICU beds/100k
• The Society of Critical Care Management says that ICU occupancy in the US is 68% as of 2010, the last year figures were available. The US has 46,500 ICU beds distributed over a population of 331 million, so
  46,500 ICU beds/331M = 14 ICU beds/100k

In other words, the US has more beds, and more free capacity in the beds it does have, than two of the premier systems often touted as superior to the US. In fact, in general, the US's 14 ICU beds to 100,000 population ratio comes out looking positively rosy compared to most of the European systems (as of 2011):

(The figures above may actually overstate the ratios because the authors were unable to get standardized counts of critical versus acute care beds in many cases.) And it's not just ICU beds. As Noah Rothman points out in Commentary, public systems are struggling to cope with COVID-19. In Lombardy, Italy, the Italian Society of Anesthesia, Resuscitation, and Intensive Care has proposed an age limit for intensive care bed space. The UK's NHS has already run into ICU bed space problems and has inadequate ventilators, a situation that is "going to end in death". If there is a public system doing a better job (or capable of doing so) addressing COVID-19 planning, it hardly seems universal or even anything like a majority.

Update 2022-09-21: Google has seen fit to unpublish this on the grounds that it "violates Blogger Community Guidelines." This is pure political censorship.

Sunday Linkies

• The ACLU has come out in favor of M2F participation in biological women's sporting events, an announcement that was immediately panned by Martina Navratilova:

  I love you ACLU, but you are wrong on this. Unless you want to completely remake what Women’s Sports means, there can be no blanket inclusion rule. There is nothing stereotypical about this- it’s about fairness and it’s about science. Thank you.

  — Martina Navratilova (@Martina) March 13, 2019

  The ACLU's source for this claim is a data-free essay from ... Everyday Feminism.
• Reason ran a fine essay on sex differences in athletics that probably won't do much to change the current situation, larded as it is with loud advocates resting on spectral evidence that doesn't really address the differences between M2F transgender athletes and biological women. 
• A terrific thread from @FondOfBeetles showing how adolescent boys routinely break records set by the best women in track. Opening shot:

  In 2004, I was privileged to watch Kelly Holmes win the female Olympic 800m gold, in a run that kept everyone on tenterhooks until that final glorious sprint finish. Her finishing time was 1:56.38. 1/ pic.twitter.com/6EkVF5ZFxe

  — Dr FondOfBeetles (@FondOfBeetles) March 11, 2019

• A useful article from T Nation on the subject of transgender athletes:
  

  Most experts say that the average testosterone production for biological females ranges between 0.52 to 2.8 nmol/L. The Mayo Clinic put that range even lower (2). And while experts may vary in what they consider average among females, the consensus is almost always below 3 nanomoles/L.
  
  But remember, federations like the IOC require a male-born person to suppress and maintain testosterone production at 10 nanomoles/L.
  
  So even if a woman was genetically blessed with testosterone levels that reached 3 nmol/L, that would still be less than half of what a trans woman would be allowed to have during the competition. To look at it another way, her male-born competitor would have just over three times as much testosterone, even with hormone-altering drugs.

• Sex differences in the human brain show up before birth. The last refuge of the blank slate-ist is gone.
• Kirsten Gillibrand has zero endorsements. 
• Finland's government has collapsed following failed efforts to reform the country's healthcare delivery system.  This is interesting for a lot of reasons, not least because Finland has better per-capita spending on healthcare than France, which is often used as a model for US single-payer/M4A advocates (the light blue line below is Finland):