Linda Gorman of the Independence Institute writes in an email:
I was finally catching up on my reading on Overlawyered.com and came across your Feb. 4 post on the possibility that Amber Taylor had a point when she noted that the IRS might give U.S. parents an incentive to count have a dead baby classified as a live birth.
This assumes that parents can affect the classification on the death certificate. U.S. parents do not typically fill out death certificates. She needs to provide evidence that parents affect classifications in meaningful numbers in the United States before anyone should take this speculation seriously.
The evidence that birthweight registration varies from country to country rests on statistical comparisons of the number of very low birthweight infants recorded. An early paper, which is very short, is here (PDF). These studies have been followed by a number of papers on birth registration in various European countries. At this point, the evidence suggests that what are counted as live births in the U.S. are often considered fetal deaths in other countries. They are thus not included in infant mortality statistics, and OECD has (finally) included a note to this effect in its international comparisons of infant mortality. It wouldn’t be a public policy issue if those who wanted to reduce the amount of privately provided medical care in the United States hadn’t used it as an indicator of the poor performance of the U.S. health care system. If you’d like more references, I’d be happy to provide them.
4 Comments
I don’t think Gorman says anything that contradicts Taylor’s point, and vice versa. Taylor merely pointed out the possibility of incentives to tabulate as live births what are classified as fetal deaths in other countries. While parents do not fill out death certificates, the doctors who do suffer no consequences for choosing a categorization that financially favors their patients.
See clarifying comment to that effect here.
Fantastic, I’ve been looking for this information to counter some fairly outrageous hand-wringing regarding the US’s apparantly horrible infant mortality rate.
The idea that a parent who lost an infant in a still birth would game the system to get a dependant tax credit…well, it’s just ludicrous. Have you ever met a parent who had a stillborn child? I can assure you that tax deductions are the last thing on their minds.