I ask because it’s seen as such by many in Europe. If it is valid, then there seems some good quality data that informs the current US debate. For example:
I assume the comparison has to be with like, so you would compare developed-industrialised countries and discard countries at different stages of development. So:
USA: 15.3% moving towards 19.5%
France: 11%
Germany: 10.4%
UK: 8.4%
On the face of it, universal healthcare wins. What are the flaws in the case?
Hang on… increases in health care costs are mostly driven by increases in the cost of care of the elderly. In the U.S., health care for the elderly IS universal care, funded by the government. So the sharp rise in costs could just as easily be spun as a flaw of public health insurance.
One problem with the GDP measure, however, is that it doesn’t control for relative wealth. As nations become wealthier, they have more disposable income to spend on things other than basics like food and shelter. Yes, Americans spend more than anyone else on health care. They also spend more than anyone else on pet toys, games, speedboats, lawn care, and a host of other discretionary expenditures, because they are wealthier and have more disposable income.
That’s why I don’t like aggregate measures like this. They really don’t tell you much, other than perhaps “something’s wrong”, and maybe not even that. The same is true for using life expectancy as a surrogate measure of health care quality. There are just too many confounding variables to make it a reasonable way to measure health care.
The proper way to analyze the cost of health care is to drill into it and follow the money. Do Americans pay more for an X-ray? Do they pay more for a routine checkup? What are the emergency room costs per patient, and how do those compare against measures of quality of emergency room care, such as the rate of hospital infections, death rates for various critical injuries and conditions once admitted to the emergency room, etc.
You also have to assign a cost to waiting lists. The ability to treat anyone on short notice means you need to maintain a higher staffing ratio of doctors and nurses, and you need to have a larger supply of equipment to handle the busy times. This costs more money. What is the value of not having to wait three months for a diagnostic test? Shouldn’t we assign some sort of cost equivalent to the waiting lists in other countries?
Then you have to look at the overall health of the population. Do Americans do more dangerous jobs? Do they get injured more often? Are they fatter than other people? Do they smoke and drink? What’s the incidence rate of expensive conditions like diabetes, and is it higher than in other countries?
That’s really the only way to really figure out what’s wrong with health care and what needs to be done to fix it. I can give you one example of a major difference between the U.S. and many other countries - it’s much more common in the U.S. for a doctor to order an MRI or PET scan for a patient admitted through the emergency room. Those are expensive. Is it good medicine, though? Or are they just covering their butts for liability purposes?
The devil is always in the details. You learn nothing by looking at a few gross metrics from 20,000 ft.
I would have thought this might have related to Obama’s international competitiveness argument.