We spend more per capita, both in total and in tax dollars, on health care than other major industrialized countries, according to the latest figures from the Organization for Economic Cooperation and Development. But all that extra money doesn’t buy us extra-large helpings of doctor or hospital care.
(If you want to dig into the OECD data yourself, you can download it here.)
The goal of health care, of course, is better health. Does our huge monetary outlay at least buy us this? That’s a trickier question to answer than you might think, but let’s take a stab at it.*
Start with the most basic comparisons, such as infant mortality. Among the eight wealthy, industrialized countries in our comparison group, ours is the highest (that’s bad).
Our life expectancy at birth, on the other hand, is the lowest (also bad).
Not looking good so far. But let’s dig deeper. Some critics of health reform have warned that if we switch to “European-style” universal health care, we’ll end up denying seniors the treatments they need to live to a ripe old age. The OECD statistics show life expectancy after age 65 and at least we’re not at the absolute bottom of this list. But I do wonder if a better placement on this list is connected to the fact that Americans over 65 are the only ones who have universal health care, aka Medicare.
As you’ll recall from the previous blog in this series, we devote a lot of resources to expensive technologies and treatments for serious conditions like heart disease. And, indeed, that spending does seem to help (remembering, again, that many people who die of these diseases do so after 65, while covered by “government-run” health care). We are in the middle of the pack in death rates for heart attacks…
…cancer…
and strokes.
But we rank at or near the bottom in deaths from respiratory disease…
….and diabetes.
So, all in all, these numbers don’t suggest that our big spending is buying us proportionally more health and longer lives. But our health depends on more than medical care alone. For instance, Americans are much fatter than inhabitants of the other seven countries, and excess weight is a risk factor for diabetes, heart disease, and other ills.
On the other hand, our rate of smoking—another big risk factor—is the lowest.
So maybe our national weight problem counteracts some of the benefits of our health care. But then again, our low smoking rates might cancel out some of the ill effects of the overweight rates. (I told you this question was harder to answer than you might think.)
To recap, what we can see in the OECD data is that despite outspending other rich industrialized countries, we don’t have an unusually generous supply of health care, and we don’t seem to be healthier in ways that we can easily measure.
In the next and final installation of this series, I’ll talk about a clever, though complicated, approach to comparing the performance of different countries’ health care systems that, at least as far as I’m concerned, is as good a way as any now known to figure out what we’re getting for our money.
—Nancy Metcalf, Senior Program Editor
*All charts represent latest OECD data available for individual countries, ranging from 2004 – 2008.
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