At Billy Rubin central, we like snark just as much as the next guy or gal, but our amusement is dependent in part upon the wit used in the creation of said snark. And "duh" doesn't seem to rely on a great deal of wit--especially when written in all caps. To wit:
a. Though we don't share his political views, we're a fan of retired doc. Retired has been haranguing against the health care act for some time, and of late he has been pointing out what he believes is the erroneous use of data from the Dartmouth Atlas in forming public health policy. (Quick version: the atlas uses Medicare data to look at the distribution of medical resources across the country, and takes the editorial point of view that more care is not necessarily better care.) One of his blog posts tries to make the point that sometimes spending more on health care brings better outcomes, and then finishes off the title of the post with those piercing three letters d, u, and h.
Of course, it's the qualifiers that are critical: noting that more care is not necessarily better implies that it depends upon the comparisons. Health care in the US is undoubtedly better than Botswana (or, say, Cuba, a topic we've covered previously here) and the US spends much more as well. But within the US, regions that have a higher concentration of docs, facilities, and technology do not appear to benefit disproportionally on the whole. Even a cursory reading of the Dartmouth Atlas makes this clear.
As for whether sometimes spending more on health care brings better outcomes, one might as well say that sometimes it rains. I rather doubt that the researchers who put together the Dartmouth Atlas would quake in their boots at the evidence gathered in this post. As of now, the sole commenter on this post points out, "[it] shows that people don't read the caveats". We agree.
If one really needs to search for facts about health care which might be met with the chorus of "duh", one might simply look at our per capita expenditure on health care--which is twice that of any other nation of similar size in the world. We are most certainly not twice as healthy as other industrialized countries. We simply can't afford more care whether we want it or not. What's the difference between our health care system and those of comparable nations? The answer is nationalized health insurance (which, lest anyone misunderstand, is not the same as nationalized health care, for which the only comparison is Great Britain).
b. The clever folk at Gun Owners of America are circulating a cartoon on Facebook describing the "as yet unlearned lesson of 9-11-01". The lesson, helpfully illustrated by Ben Franklin, states that "disarming innocent people does not protect innocent people", with Ben usefully chiming in that "We Founders call this 'the theory of DUH'." Surely Trayvon Martin, innocent and unarmed as he was, would have appreciated this sentiment, were he not shot through the chest by a very much armed George Zimmerman. Though perhaps GOA believes that wearing a hoodie and being a black teenager disqualifies one from being 'innocent'. Stand your ground, Gun Owners of America!
(One also wonders why this is a lesson from 9/11. Does GOA believe that allowing passengers to carry firearms aboard flights is a good idea? It would seem that the hijackers would have been delighted by such a policy, but perhaps I'm too stupid to appreciate the subtleties of their point.)
The "duh" that forms the rider on these expressions serves only to indicate that no real dialogue is taking place. If one must say "duh" to make a point, it means that the truth of the point is so obvious that anyone not in agreement with said point is self-evidently an idiot. So why bother? The chuckle can be had among the elect, as they already know what's what and don't need to deal with the trivial details of constructing a plausible argument.
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