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HEALTH - OTHER
HEALTHCARE IN THE UNITED STATES: PART I MYTHS VS. REALITIES IN HEALTHCARE SPENDING and HEALTH METRICS - UNITED STATES v. OTHER WEALTHY CAPITALIST COUNTRIES Healthcare costs have been soaring in the United States for some time now. In that context, I came across some data published by some bloggers on healthcare spending in the U.S. vs. health metrics and how it compares to data from a bunch of other wealthy capitalist countries. The data is limited, but at face value it shows interesting trends which appear to contradict what is commonly stated by some conservatives - namely that public spending on healthcare is to be avoided because it is less efficient and less effective. Indeed, the data suggests that the opposite could be true in some cases. (In Part II, I highlight myths versus realities on prescription drug costs (for brand-name drugs) in the United States). The main references for the data/charts
shown below are the following: Brian [1] provides much of the data I use for the charts in this page. Here is the crux of what Brian found:
Brian shows a table with a wealth of useful information - I am not reproducing the table here. What I have done is import his data (mostly from 1999, taken from the OECD - Organization for Economic Cooperation and Development) and chart it into relevant graphs. Although the data is not up-to-date, it is quite acceptable for this preliminary analysis. Brian provides data for 30 countries - mostly from Europe and North America. What I did was to reduce the country list to 24 - Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Japan, Korea, Luxembourg, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom, United States. I excluded the following countries -
Czech Republic, Hungary, Mexico, Poland, Slovak Republic and Turkey. I believe there are good reasons why these countries
could be excluded for this preliminary "analysis" (for lack of
a better word). Brain [1] already summarized the results in brief. I show the same results in chart form to highlight some key points. The U.S. had about the worst infant mortality compared to the 23 other wealthy capitalist countries, even though healthcare spending as a percentage of GDP was highest in the U.S. Note, though, that total healthcare spending as a percentage of GDP was not a very good predictor of infant mortality as a whole. Also, the U.S. had almost the lowest amount of public healthcare spending among these countries. Interestingly, higher public spending on healthcare seems to have a slight (positive) correlation to better infant mortality, but only slight.
The U.S. had close to the lowest male and female life expectancies at birth compared to the 23 other wealthy capitalist countries, even though healthcare spending as a percentage of GDP was highest in the U.S. and public healthcare spending as a percentage of total healthcare spending was almost the lowest in the U.S. Higher public spending on healthcare (as a percentage of total healthcare spending) and higher healthcare spending as a percentage of GDP were more generally associated with better life expectancies - but there are exceptions.
Although higher healthcare spending as a percentage of GDP in the 24 wealthy capitalist countries was more generally associated with more practicing physicians per 1000 population, the U.S. was again an exception - there were significantly fewer practicing physicians in the U.S. per 1000 population when compared to the amount of healthcare spending/GDP. Note that physician count was not very strongly dependent, however, on the percentage of total healthcare spending that was public spending.
Even though the U.S. had nearly the least amount of public healthcare spending, the per capita healthcare expenses in the U.S. and the total healthcare spending as a percentage of GDP in the U.S. were the highest among the 24 countries examined. The former was true even when data in the timeframe of 1990-2001 was charted (last chart below). Now, I am more than
willing to acknowledge that it is hard to draw definitive conclusions
from the data above, for several reasons, including such factors like: But, having said that, at the minimum there are some interesting trends here. The trends appear to suggest that there are inefficiencies in healthcare system in the U.S., to the point that the ideological reliance on private spending/plans over public/spending plans is NOT so easily justifiable. Indeed, if the trends above are real, then it is quite possible that more public spending on healthcare could indeed be a more efficient use of money and might get more effective results - if well managed. I would say that this data calls for more systematic analysis of healthcare costs in the U.S. and a real debate on this - that involves not just ideological biases but lots more data and reality. Thanks to Brian Weatherson, Kieran Healy and Kevin Drum for educating us! NOTE: In Part II, I highlight some key points on the myths vs. realities of high prescription drug costs (for brand-name drugs) in the U.S. Kevin's words [3] are appropriate:
Last updated: 7/15/04
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