I copied this table from a Wikipedia entry. Hopefully the formatting isn’t too awful. In any case, two things I have heard frequently in the health care debate are “the U.S. has the best health care in the world,” and “Universal health care is too expensive.” Both propositions appear to be demonstrably false. The table compares Australia, France, Germany, Japan, Sweden, the UK, and the U.S. Compared to these other six countries, the U.S. spends far more on health care and fares worse on key indicators of the effectiveness of a country’s health care: infant mortality rates and life expectancy.
| Country | Life expectancy | Infant mortality rate | Physicians per 1000 people | Nurses per 1000 people | Per capita expenditure on health (USD) | Healthcare costs as a percent of GDP | % of government revenue spent on health | % of health costs paid by government |
|---|---|---|---|---|---|---|---|---|
| Australia | 81.1 | 4.7 | 2.8 | 9.7 | 2,999 | 8.8 | 17.7 | 67.0 |
| Canada | 80.4 | 5.4 | 2.1 | 8.8 | 3,678 | 10.1 | 16.7 | 70.0 |
| France | 80.9 | 4.0 | 3.4 | 7.6 | 3,449 | 11.1 | 14.2 | 79.7 |
| Germany | 79.8 | 3.8 | 3.5 | 9.8 | 3,371 | 10.6 | 17.6 | 77.0 |
| Japan | 82.4 | 2.8 | 2.1 | 9.3 | 2,474 | 8.2 | 16.8 | 82.7 |
| Sweden | 80.8 | 2.8 | 3.5 | 10.7 | 3,202 | 9.2 | 13.6 | 81.7 |
| UK | 79.1 | 5.0 | 2.5 | 11.9 | 2,760 | 8.4 | 15.8 | 87.0 |
| US | 77.8 | 6.9 | 2.4 | 10.5 | 7,290 | 16.0 | 18.5 | 46.0 |
The U.S. spends at least 2x per capita what these other countries do on health care. We spend 16% of our considerable GDP on health care. And, despite spending considerably more, we have the highest infant mortality rate of these countries — 6.9 per thousand versus less than half that in Japan & Sweden. We also have the lowest life expectancy of these countries as well — 77.8 years versus 82.4 in Japan and 81.1 in Australia.
We’re Americans. We’re supposed to be the most practical people on earth — not getting too wrapped up in pure theory or ideology; always looking for a way to build a better mouse trap. There is clear evidence that the system we have doesn’t work and that other systems work better. Why are we so attached to ours?
I do not pretend to even understand all the ramifications of the health care issue (here and elsewhere in the world) and do not know what is the correct route for the U.S., but the games being played with the “truth” by both sides (and the middle) have confused things to point of little chance of a consensus. In too many situations there is too much polization on issues without any attempt (it seems) to even hear the other side(s) of an issue. Example: coming up this week—do not let your children hear the “sociolistic” President of the United States speak about getting an education. Sharing of thinking is out and name calling is in and as commented on by another writer elsewhere is that IF something bad happens to the President now there will be an explosion of emotion that will rip the country a part.
Actually, the infant mortality rate in the US IS much lower than the other countries. Other countries basically ignore premature births in the statistics they produce:
http://pajamasmedia.com/blog/the-doctor-is-in-infant-mortality-comparisons-a-statistical-miscarriage/
That happens to be the only relevant statistic in your chart.
Doctors per 1000 people is irrelevant, unless you somehow believe that a government takeover of health care will result in there being more doctor per capita in the US. If you do, I’d like to know on what you base such a strange belief.
I’ll give you life expectancy, but health care is not the only thing responsible for life expectancy, as I’m sure you know. Lifestyle, population density, and countless other factors. It’s a useful metric, but only when more detail is provided.
And, again, it doesn’t matter how much we spend on health care, unless you have actual evidence to back the claim that a government takeover will mean that we will spend less. There, all the evidence is against you.
“We” aren’t. The people who don’t want a better system are the people who profit off the current one and they’re using those profits to buy congresspeople and scare Americans with false claims.
I’d like to see some manner of study about the costs associated with interventive care. I think of it because my wife, a certified nurse midwife, is regularly complaining about the urge to go straight to c-section, not because it’s necessarily better care, but because it results in fewer lawsuits. It’s definitely more expensive, and is therefore self-serving in two ways to the hospital.
C-sections are also more convenient for the medical staff to schedule. No pesky waiting around for the vagaries of vaginal birth. I don’t know if that’s an actual concern – but in terms of perception, I’ve heard mutterings about how the doctor has a tee time to catch.
“claim that a government takeover will mean that we will spend less. There, all the evidence is against you.”
Well, no. The other countries where the government has “taken over” spend much, much less than we do.
Chris of Rights makes the important statistical points. Then, there’s the likelihood of false-cause fallacy in terms of the logic.
Doug makes the easy and correct observation that our system is messed up. But whether it is better to extend or reduce government’s significant reach into health care/insurance– I suppose that’s an open question. As long as you recognize that govt is heavily involved today, and you can’t connect our problems somehow to that involvement, then I suppose one can believe that more govt will help.
In any case, those who believe that other countries have better health care “systems” should want to experiment at the state-level with those systems. Canada is a lot closer– in terms of population size and diversity– to Oregon, than to the U.S. as a whole. (We ably covered this point already on this blog.)
Once again, Chris offers no real evidence but just throws out conjecture and purely sourced information.
First off, PajamasMedia is hardly an unbiased, credible source. Second, the article doesn’t quantify any of their claims. It merely states that countries use different standards, but makes no effort to quantify the impact of those standards, so the whole thing is meaningless.
On the final point – that the government would spend less is a useless metric. The problem is that people are not treated. That millions of people have no access to health care. Spending less is a completely useless metric, because if placed in an optimization function, the answer would always be, “insure no one.”
I first read the premature birth point from Bernadine Healy– hardly an ideologue. The point stands– although Marc asks a good and important question about the quantitative impact. I don’t know of any work that addresses the question but would be quite interested if someone has anything on that. In any case, if people are using apples and oranges for classifications, then wielding the stats as if it’s apples and apples is somewhere between ignorance and demagoguery.
There’s a lot of conflation between those who have no health insurance and those who receive no care.
As I asked on the other thread, the two relevant questions are: 1.) will even more govt help (beyond the huge amount we have now); and 2.) if so, why risk a single, grand, federal experiment on a complex issue vs. 50 states giving it a shot?
Eric – point taken. I will see if I can dig up the necessary figures to compute the same index on multiple countries. I am not holding out much hope – we would need some classifications that I doubt they track, but later this week I will see what I can come up with.
Marc