Analyzing an article using the Toulmin method

For Monday’s blog (I realize I’m a little late considering it is early Wednesday morning), I was asked to do an analysis of the Toulmin method. Considering that I am juggling the idea of aspiring towards a career in the health industry, I chose to analyze a New York Times article entitled, “To Explain Longevity Gap, Look Past Health System.” After all, it seems that many people like to point their fingers at the health system and claim that it is the cause of all of America’s health misfortunes, rather than reflecting on what they could be doing to make the status of their health more favorable.

First, before even utilizing the Toulmin method to analyze the argument, I looked up the author (John Tierney) to verify his credibility. Although probably a fairly respectable reporter considering that he writes for the NY Times, it seems that Tierney writes about many different topics, and doesn’t specialize in health issues. The sources that he uses, Dr. Preston, a demographer at UPenn and his colleague Jessica Ho seem respectable, but they seem to be as the only experts on the issue in his article, with little other outside opinion.

Now, onto the Toulmin method. The first step in analyzing the claim is to find the claim, and in this case the claim is that Americans live shorter lives on average than those in other countries because of reasons other than the failure of the health care system. Although he qualifies that there are problems with the health care system such as lacking in preventative care, he states that the longevity gap is primary due to other reasons. Additionally, he admits that the American healthcare system is flawed in that it is expensive and requires unnecessary treatments, but it is also expensive because people get more thorough treatments and we get sick more often than other countries do.

Secondly, we must analyze the reasons behind Tierney’s claim. One reason that Tierney uses to justify his claim is that life expectancy in America is skewed to the left because there is a particularly high rate of sickness and death among middle-aged Americans. This seems like a legitimate claim assuming it is factual, and definitely supports the thesis. Additionally, Tierney claims that Americans are more ethnically diverse; unfortunately, perhaps I am missing something, but I don’t see how being ethnically diverse, meaning that we have more people from these other cultures with high life expectancies is what is lowering the U.S. life expectancy. However, he does point out the importance of poor lifestyle choices such as the growing trend towards obesity in the U.S. An argument that he depends more strongly on in his article is that Americans were heavy smokers for a long time, and this is also bringing down the life expectancy and is one way that our lifespan is decreased, but not necessarily due to medical care reasons.

Third, we need to analyze the evidence presented. Unfortunately, this is where it seems that Tierney is lacking. I think that it is obvious that obesity and the health complications associated with it don’t require too much evidence, but beyond saying that Americans are fat, Tierney doesn’t really explore this issue. In terms of the life expectancy being lowered by middle aged people with high death rates, one piece of evidence is that per-capita cigarette consumption was higher in the U.S. than anywhere in the developed world for four decades, a statistic that may have a huge impact on bringing down middle age expectancies. Additionally, he added that once American reach age 80, the longevity gap disappears and these people are likely to live longer than as in other countries; although this seems like a great fact, Tierney didn’t cite any source for this information, and one must question where he got this information from.

Finally, we have to ask whether the author examined possible refutations. This is one arena in which Tierney made a decent effort, much better than with factual evidence provided. Tierney says that Dr. Preston didn’t see any evidence for the “much quoted estimates that poor health care is responsible for more preventable deaths in the United States than in other developed countries,” but then again, although Preston didn’t find the evidence, it doesn’t mean that it doesn’t exist. Tierney also stated that some opponents of the U.S. healthcare system argue that the U.S. only has better cancer survival rates because cancer is detected early in the U.S., but this doesn’t show that we don’t treat cancer well, and in fact early detection is the best protection against the negative effects of cancer, so this complaint seems unworthy. Finally, many people argue that the health system fails in that it should prevent disease, not just be good at treating it. Tierney argues that this is true, but he’s not certain that other countries are doing any better at this (not that he provides any statistics to show this), therefore it is probably not significant. On a positive note, Americans are preventing disease in the U.S. has had the largest drop in cigarette consumption of all developed countries over the last 20 years, but I’m not sure that this is necessarily a merit of the healthcare system as much as it is a merit of changing American attitudes towards smoking.

Overall, the argument had a lot of good points, but there was a significant lack of evidence that makes one question whether there is more evidence than just the facts that Americans used to smoke a lot and are obese or if Tierney’s arguments are just the result of an active mind.