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pan6467 · 12-01-2005, 11:27 AM

I don't know how well this will come out as there are charts and I suck at ccping charts....

Here's the link: http://www.eriposte.com/health/other/healthcare_US.htm

It compares our healthcare spending to 23 other "civilized nations" and how we finish last in just about every category. We spend more of our GDP on healthcare than any other nation and we get less results. And yet these 23 other nations have some form of Universal Healthcare.....

so 23 - 1 and we show worst...... which system works best???????

Quote:

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).

I. REFERENCES

II. DATA

III. EXCLUSIONS

IV. RESULTS

IV-A. INFANT MORTALITY

IV-B. LIFE EXPECTANCY

IV-C. PRACTICING PHYSICIANS

IV-D. HEALTHCARE SPENDING

V. TENTATIVE CONCLUSIONS

VI. AFTERWORD

--------------------------------------------------------------------------------

I. REFERENCES

The main references for the data/charts shown below are the following:
[1] Brian Weatherson, Crooked Timber, 11/20/03
[2] Kieran Healy, Crooked Timber, 7/14/04 - via Kevin Drum (Political Animal)
[3] Kevin Drum, Political Animal, 5/20/04

II. DATA

Brian [1] provides much of the data I use for the charts in this page. Here is the crux of what Brian found:

For amusement I was traipsing through the OECD health stats for various countries, and I was stunned by one of the things that springs out of the data - health care systems that are government run or funded tend to be cheaper despite being just as effective in every respect, and more effective in some respects. I'm sure someone somewhere has analysed the data properly, but even a crude analysis suggests the empirical case for having a government run or funded health care system is quite strong.

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.

III. EXCLUSIONS

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).
(a) Countries that have only recently become capitalistic ("New Europe" as opposed to "Old Europe") or those that are not part of the traditionally wealthy, capitalistic economies (Mexico, Turkey) should not be compared one-to-one with the richer, capitalistic economies of the West.
(b) Even if the exclusion seems arbitrary (which I don't believe it is), my goal is to compare the wealthier, capitalistic nations amongst each other, to see how the U.S. fares in comparison. In itself, this is a justifiable comparison. There is no specific requirement that the system in the U.S. has to be compared with every country possible for the objective of this study is to understand whether a more efficient and effective system is possible, not to quantitatively judge every system that exists.

IV. RESULTS

Brain [1] already summarized the results in brief. I show the same results in chart form to highlight some key points.

IV-A. INFANT MORTALITY

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.

IV-B. LIFE EXPECTANCY

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.

IV-C. PRACTICING PHYSICIANS

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.

IV-D. HEALTHCARE 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).

CHART FROM REFERENCE [2]

V. TENTATIVE CONCLUSIONS

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:
(a) The data being limited,
(b) The error bars on the data not being known
(c) Potential nuances in the collection and interpretation of the data.
(d) The types of health issues that dominate in one country compared to the other (which in turn depends on the culture, lifestyle, environment, etc.)

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.

VI. AFTERWORD

Kevin's words [3] are appropriate:

FRENCH HEALTHCARE....The Economist provides a capsule summary of healthcare in France:

Its hospitals gleam. Waiting-lists are non-existent. Doctors still make home visits. Life expectancy is two years longer than average for the western world.

....For the patient, the French health system is still a joy. Same-day appointments can be made easily; if one doctor's advice displeases, you can consult another, a habit known as nomadisme médical. Individual hospital rooms are the norm. Specialists can be consulted without referral. And while the patient pays up front, almost all the money is reimbursed, either through the public insurance system or a top-up private policy.

For family doctors too, liberty prevails. They are self-employed, can set up a practice where they like, prescribe what they like, and are paid per consultation. As the health ministry's own diagnosis put it recently: “The French system offers more freedom than any other in the world.”

And despite the Economist's scary headline, which proclaims that "crisis looms," the French system provides this service to everyone in the country and does it for less than half the cost per person of the U.S. Even if they decide to raise taxes to cover a growing deficit in their healthcare fund (the subject of the Economist's article) their costs will still be less than half ours per person.

Now, there are undoubtedly drawbacks to the French system. They probably have fewer high-tech machines than we do, and the comparative cost figures may be skewed by the American love of elective procedures. Still, there would have to be a lot of drawbacks to make their system less attractive than ours.

So why not adopt it? Well, that would be socialized medicine. Can't have that, can we? After all, everyone knows that when you socialize something it automatically declines slowly into anarchy and uselessness. Right?

Sorry the charts didn't come out.... perhaps a Mod can help.... if not simply click the link.