We Spend More On Healthcare Than…..Bug or Feature?

The arguments have been going on as long as we’ve had modern healthcare.  On one side we have those that claim the United States spends more on healthcare, with worse results, than any other industrial nation on earth.  Therefore our system is broken.

The other side claims that the ability to spend more on healthcare may be an indicator than our system is the BEST in the world.

To be sure, no one wants to have to spend $550.00 a month on medication when we could craft a system that delivered the life saving pills at a tenth of the price.  Spending money for money’s sake is silly.  But our levels of expenditure are elevated because the medical care system is, quite simply and without debate, the best in the world.

Just ask Mr. and Mrs. Baker.

There is a couple in Seattle who have tried for the better part of a decade to have children.  Nothing is working.  Finally they agreed to explore a surrogate:

Misty and Brian Baker had tried for ten years to have a child through in vitro fertilization. The couple then reached out to their friends Brian and Amber Pluckebaum in Indiana.

They introduced the Bakers to Dr. William Gentry of the Advanced Fertility Group in Indianapolis, who last October suggested implanting embryos into not just Amber, but Misty as well.

“Why not both of you try? I mean, who knows?” Gentry told RTV6. “I think her thought was, ‘Sure, why not? But it’s not going to work with me. It never works.’”

So first of all, we have a couple suffering from the tragedy of not being able to have children.  This condition ruins marriages and lives.  Couples, in their quest to have kids, often times spend every last blessed dollar they have.  The fact that America can deliver this service is a miracle in and of itself.  And the fact that we are such a wealthy nation that we can afford it is yet another miracle.

The cost of medical care, in some cases, may in fact, be a feature.

11 responses to “We Spend More On Healthcare Than…..Bug or Feature?

  1. Your argument is supported by your example. You’d have to show: a) that people in other advanced industrialized states don’t have access to these things; b) if we have more of this, then you’d have to quantify what the value gained is; and c) you’d have to compare that to the fact we pay nearly 17% of GDP for medical care, other countries are between 6% and 10% (the Swiss a bit higher), the cost of having 50 million uninsured, many not seeking help when needed, getting substandard help or going to expensive ERs, the cost to families of medical bankruptcies – the majority of our bankruptcies are from medical expenses. I find it highly unlikely that Americans have better access to fertility technology by a significant amount (if any), but if they did, I can’t see the benefits outweighing the drawbacks.

    • You’d have to show
      A.
      B.
      C.

      Fair enough.

      the cost of having 50 million uninsured,

      I’ve been over this, but you may not yet have been a visitor. On my list to review.

      • Yeah, as Scott points out, you have quite a bit more work to do here. This is like posting, “The Yankees spend almost $110 million more on salary than the Mariners, but the Mariners beat the Yankees yesterday! This proves that money doesn’t matter in baseball.”

        Now, this isn’t my favorite chart in the whole world, because as we’ve discussed, life expectancy alone doesn’t give us a sound overall measure of a system’s effectiveness. Still, this shows just how far out of whack our health care spending is: http://blogs.ngm.com/.a/6a00e0098226918833012876a6070f970c-800wi

        And remember, we have a more free-market oriented system, with lower proportion of gov spending on health care, than anyone else in the OECD.

        Now, you’ve linked in the past to info about how maybe we lost more people than average to violent deaths in the 1990s. Which is something, but every single comprehensive study I’ve come across, that looks at more than just life expectancy, has found that we’re underperforming, even aside from the fact that we spend about 2.5 times the OECD average per capita.

        The problem is that the US is overspending for less-than-great results, not that everything about the US system sucks. It’s like we’re spending $200,000 on a Honda Accord. It’s no indictment of the Accord to say call that purchase less than ideal.

        • The Yankees spend almost $110 million more on salary than the Mariners, but the Mariners beat the Yankees yesterday! This proves that money doesn’t matter in baseball.

          It might be late, but I think that’s backwards.

          It’s the left that says that other countries, the Mariners, spend less and beat the Yankees. When it turns out that spending more is a feature and results in World Series ring.

          because as we’ve discussed, life expectancy alone doesn’t give us a sound overall measure of a system’s effectiveness.

          Yeah, that’s a bad graph.

          The problem is that the US is overspending for less-than-great results

          See, I disagree. When life expectancy and infant mortality rate is normalized, we’re number 1, or very close to it.

          • The Mariners won one game. Mr. & Mrs. Baker had one successful outcome. The US overall gets so-so outcomes. The US is spending $200,000 on an Accord, or paying $130 million on payroll for the 2010, sub-.500 Mets.

            The chart is useful by showing our out-of-whack spending. Here are some graphs you might like more: http://seekingalpha.com/article/146992-comparing-u-s-healthcare-spending-with-other-oecd-countries They’re about spending, not about life expectancy.

            When life expectancy and infant mortality rate is normalized, we’re number 1, or very close to it.

            First off, “number 1” how? The studies I’ve been linking are comprehensive studies of a whole range of aspects of our health care system, not just about life expectancy.

            What’s more, why would we “normalize”, rather than simply counting Americans as Americans? How does normalizing work? How would we normalize other countries’ experiences?

  2. I don’t think there’s any argument as to the high level of care and expertise you can receive in America. “Best” and “worst” are such relative terms when discussing health.

    In comparison/contrast, here’s an article below that discusses a similar situation but up in Canada Perhaps the couple mentioned in the article below didn’t get as top-quality a doctor or clinic as the one discussed above? Curious also as to what the price was.

    http://www.cbc.ca/news/health/story/2010/05/20/calgary-ivf-may-hanck-funding.html

    Is the amount America spends on healthcare a bug or a feature? I think that’s a question too difficult to answer until people can agree on the metrics. My personal opinion is that America can do more with less spending, but I don’t agree that they should abandon a private model completely. The problem I know in Canada (especially a province as rich in oil revenues as Alberta) is that those who can pay and want to pay for highly-specialized services aren’t allowed to pay (or more specifically, clinics aren’t allowed to serve them in the way they want to pay for.)

  3. They’re about spending, not about life expectancy.

    Look, I agree, there are places where we simply waste money in the healthcare space. In that regard, you and are are sympatico, at least I think we are. However, you have to admit that spending money on braces is a positive, not a negative. Same for lasic, liposuction and IVF. These are costs that we take on because our system freakin rocks.

    First off, “number 1″ how?

    That life expectancy in the US is the best in the world.

    The studies I’ve been linking are comprehensive studies of a whole range of aspects of our health care system, not just about life expectancy.

    Virtually every study quoted that shows the US lagging uses some combination of

    1. Cost
    2. Life expectancy
    3. Infant mortality
    4 Access to care

    What’s more, why would we “normalize”, rather than simply counting Americans as Americans? How does normalizing work? How would we normalize other countries’ experiences?

    Because I don’t think one gang banger executing another gang banger is an example of how well our medical care delivery system works. So if we have enough gang land style deaths, our numbers are skewed.

    Similarly, I don’t think that DOA car accidents are indicative of our medical care delivery system for the same reason. Therefore if we have more DOA auto accidents, the numbers are skewed.

    I think that for whatever reason, African American mothers tend to have different health outcomes during child birth than non African American mothers. And if there is a nation that is dramatically more homogenous, think Nordic nations, that should be taken into account. Further, if we have massively higher number of at risk pregnancies , single moms, incarcerated dads, high blood pressure moms, obese moms than other nations, THAT should be taken into account. Last, the biggest contributor to infant mortality rate is premature babies. And we make lots of premature babies. We either do this on purpose, see caesarean births, or because moms want to have kids when they otherwise couldn’t, see IVF.

    The truth is that America is far and away the world’s leader when it comes to saving preemie babies. But you wouldn’t know it.

    • And America deserves kudos for being able to keep all those overly-obese people alive and functional! 😉 Wonder how those will skew the numbers in 10-15 years.

    • Re: the studies discussed at this link: the one that put us 7th out of 7 examined quality, access, efficiency, equity, productive lives, and expenditures; we never did better than 4th in any category. The study that said we got a failing grade examined health outcomes, access, equity, quality and efficiency. The study that put us 37th, that the WSJ article said should have put us 15th, examined responsiveness, fairness of financial contribution, overall level of health, distribution of health in the population, and distribution of financing.

      There are, so far as I am aware and you have been able to produce, zero studies anywhere concluding that we’re getting better results in exchange for spending 2.5 times the level of other OECD countries.

      But Republicans aren’t interested in facts; they’re interested in digging up one or two anecdotes that confirm their biases.

      You heard somewhere that African American health outcomes are worse than those for whites, so you want to find a way to minimize the importance of health care for black people in order to justify your unshakable, baseless “USA NUMBER ONE!!!!1!!” claim.

      For your approach to make sense, we’d have to ask whether it would make sense to compare, say, me to people living in Europe today (I grew up in a different context, three-plus generations removed, and am about 80% Irish; should I be compared to people in Europe, or just Ireland?); whether, say, any different outcomes for Americans of Polish or Vietnamese descent in the US in the 1970s, when those countries were in bad shape, were due to some innate Foreignness or due to differing conditions; whether societies and subpopulations that were comparable at one time have remained so over time; and any number of other factors. But why bother with work, when there’s already a simple conclusion at hand, by reference to something you think you may have heard from a guy who read something somewhere one. “Black people have worse health outcomes, so our health care system is actually awesome. We should spend 4 times the amount the rest of the world spends! It’s a bargain!”

      VR Kaine throws out the word “obesity”. “Ha ha, stupid Americans! You spend 2.5 times as much as any other country in the world for so-so results because you deserve it because you’re too fat!” In real life, though, “The Lancet released a thoughtful issue on obesity, including estimates that obesity-related health costs in the US will reach $28 billion in 2020.” Not great, but somewhere around one percent of US health care spending. Doesn’t account for why we spend 2.5 times what other wealthy countries do, for not-so-awesome results.

      But those are facts, which are irrelevant to Republicans.

  4. My tongue-in-cheek comment on obesity was to say that perhaps even if #1 (which I disagree with), it would unlikely be #1 for long if child/parent obesity is increasing at such a rapid rate as we’re hearing.

    “But those are facts, which are irrelevant to Republicans.”
    I’m not a Republican, but I think that goes a little too far if trying to facilitate a discussion. “Facts” in this case come from top-level studies that are far too vague (in my opinion) to really get at the nuts and bolts of this issue of where the system needs fixing.

    The problem as I see it being a Canadian in the U.S. having direct experience with both systems, is that it’s being held strictly as an ideological argument or debate rather than a practical one.

    Personally, I don’t give a shit about rankings. They ignore the family members I have who have been kicked off coverage, wiped out because of treatments, or too afraid to even get treatment for fear of them getting thrown into the hospital again for another $100,000 bill. Even if America was #1, I still have two upper middle class relatives are now on social assistance because of their medical bills and there’s tens or even hundreds of thousands of other stories out there like theirs. While my one relative was sick, had someone shoved a “yeah but when you consider everything we’re still #1 in care” in my face I would have decked them! 🙂

    As an entrepreneur and business owner I’m as capitalist as they come, but to me BASIC health isn’t something that should have a profit motive embedded into it that forces costs up exponentially beyond inflation year after year, especially around something that is as guaranteed as getting sick is. And it affects my business, too – I just lost a contractor because I can’t afford to put him on a family insurance plan to cover his over $2,500 a month in prescription costs.

  5. Pingback: Life Expectancy In The United States: We’re Number 1 | Tarheel Red

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