Jun
21
So says Greg Mankiw:
There is another, flawed argument floating around that also needs debunking–that Americans pay more for healthcare but don’t get anything for it, as measured by, for example, life expectancy. The problem with such international comparisons is that there are a lot of differences among nations beyond their health systems. To make comparisons in health outcomes, you need to control for other variables.
He then goes on to quote Gary Becker:
the American system has sometimes been found wanting simply because life expectancies in the United States are at best no better than those in France, Sweden, Japan, Germany, and other countries that spend considerably less on health care, both absolutely and relative to their GDPs….
Gary Becker then goes on to say that this is an invalid comparison because other factors influence life expectancy. Smoking and obesity are just two factors that strongly influence life expectancy but bear little relation to the quality of a healthcare system. Yes, a debate about preventative medicine could be had here, but obesity, for which the U.S.A. is unfortunately renowned is a social issue more than a medical one.
A better way to judge the quality of a healthcare system is to judge it by it’s success in dealing with illness, after all, that is it’s purpose. And here, America performs very well. Compared to the E.U. and the U.K., the chances of a person diagnosed with cancer living five years from the time of diagnosis is significantly higher in the U.S.
For example, amongst men, 66% of Americans are likely to survive five years compared to 47% of E.U. men and 45% of British men. Amongst women, the rates are 63% U.S., 56% E.U. and 53% U.K. It should also be noted that these statistics include all Americans, not just those with private insurance. So if you are diagnosed with cancer, it is much better for you to be living in America than in Europe or the U.K.
Gary Becker then goes on to state that it is not just cancer sufferers who benefit from an American health system:
Several measures of the quality of life also favor the US. For example, hip and knee replacements, and cataract surgery, are far more readily available in the US than in Europe.
Those cancer figures aren’t a very good advert for the British national health system, lower survival rates than in America or the E.U. The state does not necessarily provide!
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21 Responses to “Healthcare: Don’t Rely On Life Expectancy As A Guide”
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Okay Iv’e heard it all now – We should discount life expectancy as important metric in the healthcare debate. Next I suppose we should be discounting sex in the teen pregnancy debate!
Could that argument being put forward by the right because America is the bottom of the league of Western countries for life expectancy- I wonder!
Call me a cynic but I bet it would be an important positive factor in those arguing for the staus quo if America was near the top of the life expectancy tables.
Nobody doubts that US medicine is world leading but you ain’t seeing it without insurance.
THX
If it’s used as a metric to solely comment on healthcare, then yes we should. There are so many other factors involved in life expectancy. Smoking causes cancer, why is that a healthcare issue? Obesity causes diabetes and heart disease. Both those are responsible for lower life expectancy but say nothing about the healthcare system. What matters is how the healthcare system fixes you, and as I showed, America performs very well there even taking into account the uninsured.
And no, it’s nothing like sex in the teen pregnancy debate – sex is a direct cause, I’m sure someone’s explained the causality there to you
Ok if I give you life expectancy (for this debate only) what about infant mortality rates a key OECD health metric which the US is right at the bottom of the pile. Please don’t tell me tell me that doesn’t count either as dying before your one is just more life expectancy and therefore by your logic should be discounted.
Babies haven’t had a chance to start smoking and drinking too much or eating shit food.
You’re right my sex analogy wasn’t my strongest.
Conservative Cabbie, one other point that drives socialists, in other words, adherents of a toxic belief system, to vituperative comment is, the American healthcare system is private – in the main.
This does not mean, as the socialists sneer, that people who have no medical insurance are not treated.
First, regarding anyone who has an accident, heart attack or similar, ambulances are required, by law, to take the patient to the closest medical facility, be it a fancy private facility or a county facility. That hospital is required to accept that patient without asking for proof of ability to pay.
That hospital is also required by law to swing its full efforts into stabilising that patient. Only after the patient is stabilised can they ask the name of his/her insurance company.
If he/she does not have private insurance, they will not be thrown out on the street to die. In fact, visitors to the United States must be frequently unnerved at the lack of the suffering and the dying in the streets. Most visitors, indeed, have never been required to step over a dead body even once.
Once stable, those without insurance are taken to a county hospital. These are taxpayer supported and run along the lines, although much more efficiently, obviously, of the NHS.
When the patient has been treated and can be released, he will be given a payment schedule requiring him to pay very modest amounts each week/month if he is in employment. If he is employed, he will be chased for these modest payments and failure to keep them up will affect his credit record. If he is not, it will normally be written off.
In any area, capitalism and free enterprise always trump state dependency in outcomes. Obviously, there should always be a safety net for those unable to pay, but it should be as exceptions, not the norm.
Having written the above, I’d like to add the proviso that medical care in France is so exceptionally successful because, although paid for by taxpayers, the whole thing is run as private enterprise is run, proving that capitalism works best.
When I lived in France, I was most impressed by it.
If your doctor thinks you should have an exray, for example, he doesn’t tell you that his office will make an appointment for you and you will hear back later.
He simply hands you a prescription for an exray. You are free to take it to any exray clinic you fancy. You choose the one most recommended by your friends, so the competition is fiercely capitalistic in that sense.
The clinics are spruce and friendly, appointments are kept on time, technicians and doctors are friendly … because, although being paid by the government, they are aware that they have to attract patients to get funding. And that means recommendations.
When you take your xray back to your doctor, he decides whether you need further treatment. And hand the xray back to you to take home. It’s yours. If you decide to seek a second opinion, you have it to take with you.
The British system is the worst of all worlds and caters to the nastiest British characteristic: bossiness.
THX,
It seems you only want to preach to your far-left choir of Israel and Hayward…are you even bothering to read the other comments from me, shockwaver or Cabbie?
How many times do I have to say that EVERYONE receives healthcare in the US…all you have to do is walk into a hospital. If you go in by ambulance, they will ask if you have healthcare, if not, they take you to a state sponsored hospital…the UNM Hospital in my community is first rate and and on par with the other two private hospitals.
Obama’s plan is not about giving healthcare to those who don’t want it…it is about lowering the cost of government Medicare and Medicaid by some $500,000,000,000 over a number of years. It will lower the quality of healthcare for everyone, especially the elderly…and they won’t allow people who can afford it, pay for better care…the arrogant bastards…of course, that won’t include the Congress and the President…they’ll still get the best of private care…they’re special!
When I had surgery ten years ago…there was a woman in the next bed that had been diagnosed with a tumor in her liver…she was receiving the best of care and her doctor was scheduling her for surgery for a biopsy in this private run hospital…even though she did not have health insurance…
The estimated number of Americans without health insurance is distorted because the liberals need it to be exagerated…many of the uninsured are young who can afford insurance but perfer to spend their money elsewhere, knowing if something does go wrong, they’ll still be taken care of.
The large majority of those without health insurance can afford it but chose instead to buy new cars every year or so…they know the rest of us will foot the bill for them. Many of these people are experts at gaming the system.
What I really resent is that lifelong- responsible Americans will be paying much more for much poorer health care under Obama…he wants to even out the playing field, good socialist that he is…so we can all have poorer health care like Canada…whose citizens, by the way, come to the US for surgery at the tune of 35,000 per year.
Obama’s new healthcare plan says that I can’t pay for the better care or medicines I may need if the new health program refuses to provide for it…I say screw Obama and the horse he rode in on…I’ll go to India or wherever…
I can’t tell you how angry it makes me to have politicians like Obama and Chris Dodd deciding my health and fate…
Verity…
So very nice to hear from you. Thank your accurate description of US health insurance.
It’s so nice to have someone of your mental acuity join us…we’re drowning in liberal nonsense here.
Verity,
I was so excited to see you appear after all these many months…I meant to say ‘Thank you for… your accurate description of US health insurance’.
Hope you are here to stay…
An American,
I have stayed out of this debate, apart from giving some indication of the the health system in the Commonwealth of Australia.
The reason is I tend not to comment on areas of which I judge myself to have very little knowledge.
So I do not know why you had to mention me in your spray at THX 1138
Verity
Welcome, it’s very nice to have you here, your comments are always worthwhile. Your comment about British “bossiness” is absolutely spot on. Why do politicians and civil servants who can’t write an expense form without cheating, lose laptops on trains and haven’t had a private sector job in years, think that they are able to tell us how to lead our lives? And this bossiness is so pervasive. I used to be a Police Officer. I had so much respect for the police. But they have morphed from an outfit who’s responsibility was to fight crime into an outfit whose responsibility is to enforce government’s will.
A question for you. Your input on what happens to an uninsured American hurt in an accident was very informative. But what happens if they have a long term illness like diabetes or cancer? What happens if they have a serious childhood illness? What is their interaction with the health system then? An American and Shockwaver, please feel free to chip in, as should you THX, has mini-THX told you anything about this?
An American I repeat my question from earlier. If everything in the US healthcare system is wonderful why do you and other people “waste” your money buying health insurance?
Cabbie I will ask my brother about your point’ although has had told me that in his cardiac unit they do the minimum required by law and then people are just basically thrown into the street.
Hi Verity
If I may digress for a moment, largely becuse I suffer from ADD when it comes to healthcare and other important practical matters.
I agree 100% with your point about British bossiness. It is absolutely insufferable but there it is, everywhere you turn in Britain. I travel a lot and its the first thing I notice every time I get home.
An American FYI I’m not the far left perhaps only by comparison to you , my political allegiance is “soft” centre right and in the election in the UK I be will voting for the centre right Conservative party.
So Cabbie On Verity
“your comments are always worthwhile.”
How about this from last weeks Coffee House Wall.
“Derek June 19th, 2009 9:35pm
Mr. Vulture states that “Any act of unprovoked thuggish violence against a group containing the elderly and infants is repulsive and needs to be utterly condemned”. As Coffee Housers are trained to scrutinize the statements of Our Dear Leader, I hope that I will be excused if I say that I hope that Vulture does not intend to defend PROVOKED acts of thuggish violence against such a group nor to support unprovoked acts of thuggish violence against a group that does NOT contain the elderly and infants…? Even more illuminating might be to know when he thought thuggish violence did not need to be condemned.”
[...]
“Verity June 20th, 2009 4:10am
Derek, I think we need to define “thuggish” violence here. Frankly, I am not opposed to unthuggish violence under these circumstances.”
So according Verity violence is acceptable do you still think her comments are worthwhile?
THX
I think its OK, and easier, to discuss Verity’s comments with Verity and it’s no bad thing to have that opportunity.
Who knows, she may even learn to relax and forget about getting her retaliation in first in a less febrile environment.
An American … you are right when you point to the fact that many of these tragically uninsured Americans are uninsured by choice because they are buoyed up by the optimism of hope. When you are young, you are invincible. All my friends who worked for corporations had insurance because it was part of the bennies package. Two or three who were freelancers, didn’t have insurance, by choice, wanting their money for clothes and neat cars.
As people grow older, they grow more cautious and most take out insurance or go and work for a company that offers it. I say “most”. I have researched this in another context, and an astonishing number of the uninsured so lamented by the Left are middle aged and older people who don’t want for a dollar or two. They prefer to invest their money, getting a return on it, rather than draining it away to pay for insurance. When they need treatment, they have the funds. So there are even two sides to this aspect of the tale.
It is prudent to have health insurance, but if you don’t have it, you will not want for skilled treatment. The notion that people are dying on the streets in the US is a deliberate lie put about by British socialists working for the toxic BBC, Guardian and other usual suspects.
Verity,
Agreed…I have nothing against helping the truly needy. But US uninsured numbers have been distorted on purpose.
And what really irks me is those of us who have paid more than or share of taxes over the years and have paid for more than our share into the health insurance business are going to be punished by Obama and his cronies who plan to give us more inferior healthcare like socialist countries while taxing us more for it…They want us to stand in line and wait in waiting rooms for hours on end to be told we’re too old, too fat, smoke, eat too many sweets, don’t exercise enough, etc. etc. for the best of treatment by too few overworked, governmen controlled doctors.
And all these trillion more they plan on spending to insure the uninsured will only help pay for 30% of those uninsured…that’s because that’s the correct number of uninsured…and they know it.
Obama’s arrogance is over-whelming.
Meanwhile he has a ‘Father’s Day’ ice cream photo op…gotta take advantage of the moment… while Iranians are dying in the streets fighting for their freedom to choose a leader…although. I beleive for most of them that it is something much bigger…a yearning for true Democracy.
THX
“An American, I repeat my question from earlier. If everything in the US healthcare system is wonderful why do you and other people “waste” your money buying health insurance?”
THX,
Because I know the difference between right and wrong. I’m an independent, moral American who believes in paying my way..I don’t take advantage and steal from the pockets of other Americans…like most uninsured do.
You are unclear on the concept.
Everything that the US government runs is failing…the economy, our education, our social security, our healthcare, our infrastructure, post office, etc., etc…why in the world would I want Obama and his hoods to have control of my healthcare…my very well-being?
Hayward,
American,
“So I do not know why you had to mention me in your spray at THX 1138.”
Hayward, Hope you will accept my apology…I probably should have addressed it to Israel and THX…
An American,
Apology accepted.
By the way do you base your nom du blog on “An American” who was writing all those interesting observations in the lead up to the Revolution.
verity
i like your spunk.