Saturday, November 16, 2013

US health outcomes

The whole "US pays more for worse health outcomes" always sounded too bad to be true, and doesn't jibe with all those accounts from Britain and other single-payer systems about having to wait months and months for urgent care. And based on this table from this presentation, which shocked me despite my prior expectation that health care is probably in fact better in the US than other places held up as models by single-payer advocates, it sure looks to me like that rhetoric is greatly exaggerated...


By the way, the most frequent statistics I hear quoted as part of that silly meme are related to life expectancy, and that presentation also shows that when you adjust those figures (as you obviously should) to remove fatal accidents, the US jumps from 19th to 1st in the OECD and Japan falls from 1st to 9th.

None of this, of course, has much to do with cost efficiency, and I'm guessing the US is pretty bad on that front, perhaps largely because it's richer and therefore spends more on healthcare and marginal benefit is decreasing. I'm not going to ignorantly speculate further, but wanted to at least point out I'm not making claims on that dimension.

[stolen from MR]

4 comments:

  1. The bloggers at The Incidental Economist have written a lot about this topic. I highly recommend their posts if you haven't seen them, e.g. this discussion of a (possibly related) Health Affairs paper by someone from AEI, and follow-up, and an older discussion of the problem of looking at survival rates. I think their overall argument is that looking at survival rates for cancer presents a very misleading picture of the efficacy of the US health system (even not accounting for cost, though especially accounting for it).

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  2. These statistics are nearly 30 years old...

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  3. obviously there is more screening for cancer in the US. So, cancer is diagnosed quicker.
    Let's put that differently: screening for breast cancer has been shown not to decrease the number of deaths caused by breast cancer, but it does detect breast cancer much more often. So, the cases that are found by screening are types of 'cancer' that disappear by themselves.
    These cases are not found in Europe, but they are found in the US, which then shows up in the statistics as the US having a better survival rate after cancer diagnosis.
    So, because cancer (even forms that disappear by themselves) is much more often diagnosed in the US than anywhere else, survival rate after cancer diagnosis are bound to be higher.

    The picture is actually quite simple. US is underperforming on all the hard statistics: life expectancy, obesity, road kills, murder rate, education level, homelessness, social mobility, increase in median wages (since 1980). Reagan started a social experiment, and the data is in. The US is much worse off, compared to the rest of the western world, than they were before Reagan. However, US will not change course, so we can all watch how the US is taking itself down.

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