American Exceptionalism Strikes Again
This chart from National Geographic combines several data sets which require a little bit of puzzling out, but which come together in one whopper of an illustration.
The parameters are:
Cost per capita – lefthand scale, and lifespan — righthand scale, which together give a sloped line for each nation showing dollars per year of lifespan.
Thickness of each nation’s line indicates number of doctor’s visits per year.
Line colour indicates whether the nation has universal health coverage (blue) or not (red.) There are only two red lines — Mexico and the USA.
Looking at these, you would hope to achieve a low lefthand starting point (low cost), a high righthand point (high longevity), and a thick line (lots of doctor visits.)
The USA line looks like it was drawn by someone who got the instructions backwards — a very high lefthand starting point (huge cost), a mediocre righthand point (middlin’ longevity), and a hairlike line thickness (scanty doctor visits, less than 4 per year.)
Who gets the healthcare bargain on this chart? Japan is the most striking, with the highest lifespan (almost 83 years), and a visit a month or more to the doctor, at a cost of about $2,600 per capita — one-third the US cost.
Fifteen of the 21 nations shown achieve longer lifespans than the USA, at roughly half the US price.
Nuts, just nuts.
h/t to “fatster” in the comments over on Emptywheel.
busted link “National Geographic” due to extra “http//” at beginning
Noni,
Are we at least better than Africa? Where is Burkina Faso on you chart? I bet we could beat them.
Just for the record. We have universal coverage in the United States. Everyone gets treated regardless of their ability to pay. Apparantly Americans want all the services they get given their willingness to pay for them.
Did you know that per person personal healthcare spending for the 65 and older population was 5.6 times higher than spending per child, and 3.3 times that for working-age people. In the United States the 65 and older population have universal coverage. So it looks like in the United States this is not keeping the lid on healthcare expenditures.
Thanks, fixed now.
My chart? National Geographic’s chart, you mean.
Their apples-to-apples chart covers sations that are comparable to the USA — the OECD nations.
One commenter over at NG comments that all 30 OECD nations are not shown, only 21 of the 30, and wonders why. Here is the blogger’s reply:
—————-
As the graphic indicates, all 30 OECD countries were not shown. Because many countries like Germany and Italy had similar numbers that overlapped on the chart, I left some off to make the graphic easier to read. Also, a few countries did not have data for annual doctor visits. Here’s how the nine omitted countries measure up:
HEALTH CARE SPENDING (per person in U.S. dollars)
Norway: $4,763
Netherlands: 3,837
Belgium: 3,595
Germany: 3,588
Ireland: 3,424
Iceland: 3,319
————-(OECD average: $2,986)
Greece: 2,727
Italy: 2,686
Turkey: 618
LIFE EXPECTANCY
Italy: 81.2
Iceland: 81.2
Norway: 80.6
Netherlands: 80.2
Germany: 79.8
Ireland: 79.7
Belgium: 79.5
Greece: 79.5
————-(OECD average: 79.2)
Turkey: 72.1
DOCTOR VISITS A YEAR
Belgium: 7.6
Germany: 7.5
Iceland: 6.5
Netherlands: 5.7
Turkey: 5.6
Italy: no data
Norway: no data
Ireland: no data
Greece: no data
Well Americans as a whole don’t seem very bright, do they? Not only re healthcare, but many other things, including wars, imperialism, and foreign policy. I hate to say that dumb people get what they deserve, but well…..just maybe.
Noni, I am going to second Cantab’s comment. A lot of the Dr visit data is actually an indictment of the national healthcare countries. It is part of the US mentality that healthy people do not go to the Dr. It is part of that rugged individualism strain that runs through our populace. That mentatlity is reversed for the 65+ population who if they are aging normally, will be seeing their internest and one or two specialists each quarter or semiannually. Those visits are mandated by their various Drs. to maintain the contact end refview efficacy of the medicines they have prescibed. That equates to 4 to 12 Dr visits annually for the elderly, which does not include any illnesses or injuries. All of which are paid by Medicare/Medicaid and any private insurance carried by the individual. In many extreme cases, (e.g. allergy shots) done weekly the visits are obviously higher andpriced quite nominally (often less than the price of a hamburger or a Coke.)
The bottomline? Always be skeptical of numbers in articles. Moreover, the American system is serving its populace very well. The healthy are getting the coverage they need, mostly for illness and injury, and the very young and elderly are seeing the Dr(s) as frequently as they are allowed by the system.
Moving away from medical care to dental care we see a similar pattern. Visits are more determined by the system than need. Prophylaxis covered semiannually; therefore, dental visits are semiannual. Unless there are extenuating circumstances, that is all most Americans will see a dentist. Is that bad dental service, too?
So with these facts how does the US system stack up? It still draws needy patients from all over the world due to its “exceptional” quality and speedy service.
Noni, I am going to second Cantab’s comment. A lot of the Dr visit data is actually an indictment of the national healthcare countries. It is part of the US mentality that healthy people do not go to the Dr. It is part of that rugged individualism strain that runs through our populace. That mentality is reversed for the 65+ population who if they are aging normally, will be seeing their internest and one or two specialists each quarter or semiannually. Those visits are mandated by their various Drs. to maintain the contact end review efficacy of the medicines they have prescibed. That equates to 4 to 12 Dr visits annually for the elderly for normal treatment, and which does not include any illnesses or injuries. All of which are paid by Medicare/Medicaid and any private insurance carried by the individual. In many extreme cases, (e.g. allergy shots) done weekly the visits are obviously higher and priced quite nominally (often less than the price of a hamburger or a Coke.)
The bottomline? Always be skeptical of numbers in articles. Moreover, the American system is serving its populace very well. The healthy are getting the coverage they need, mostly for illness and injury, and the very young and elderly are seeing the Dr(s) as frequently as they are allowed by the system.
Moving away from medical care to dental care we see a similar pattern. Visits are more determined by the system than need. Prophylaxis is covered semiannually by most insurance plans; therefore, dental visits are semiannual for insured individuals. Unless there are extenuating circumstances, that is all most Americans will see a dentist. Is that bad dental service, too?
So with these facts how does the US system stack up? It still draws needy patients from all over the world due to its “exceptional” quality and speedy service.
No wonder they love us so much.
http://www.telegraph.co.uk/news/worldnews/asia/afghanistan/6900673/Foreign-forces-kills-schoolchildren-and-adults-in-Afghanistan.html
It is a good system for the rich and well off. Of course you forget about the poor because you clearly despise them.
Lessee, for folks MM thinks have NO COVERAGE we have SCHIP, Medicaid, SSI, workers comp, and a myriad of other state programs. And, anyone can walk into an emergency room for treatment.
Sheesh! The noise level increases without a reality check.
From that left-wing rag (Not!), The Free Lance Star of Fredericksburg VA is a story very apropos to CoRev point (not!). I do note that he simply dismisses the facts and figures in the chart without offering any evidence of his own. If we are going to argue by anecdote, here is the following story about how for a 32 year old working poor (white) man, without insurance or dental insurance, an aching tooth turned into a $44,000 dollar bill and a visit to intensive care for the abcess that almost killed him. And since he can’t afford $25 for a visit to an (almost) free dental clinic, I think we, the taxpayers of VA, will be picking up the charge.
http://fredericksburg.com/News/FLS/2009/122009/12272009/516101
I do have a problem with such charts and comparisons as we have parts of our country that are much more 3rd world than Europe or Japan, we have a much more racially mixed population, we have higher rate of homicide, suicide, and accidental death, by being so much more car dependent and dispersed in our population we walk less and drive more, and more exposed to a variety of natural and artificial chemical toxins. However, I don’t know how much such factors really help the laissez-faire case and its assumption that we all start out with the same opportunity here in the good old U.S. of A and that we would have a libertarian Utopia if only the Government would restrict itself to the vigorous enforcement of copyright, patent, and all other property rights with the exception of nuisance to someone else’s property when making money with one’s property.
RS, Yup, bad things happen to those who may ignore a problem. For want of his $25 the good hearted residents of the Commonwealth of VA just paid $44,000 for his care.
My numbers are actually well know to the elderly which I was describing. They actually apply to me and my family, and I am not too unusually aged or unwell. So, are you asking for copies of my bills for confirmation? The fact you can not relate tells me you are probably in the younger healthier category. My advice? Stay as healthy as you can, as soon enough you will understand that old saying youth is wasted on the young.
I find the NG chart interesting in that it provides some useful data, is a good design for a chart, and is fodder for discussion.
Unfortunately that is about as far as one can take it.
While the chart is not really misleading, it is not a good basis for an argument against the US health care system. Some points follow:
a) Many factors go into average life expectency beyond quality and quantity of health care delivered, e.g., demographics, cultural differences, lifestyle. Comparing Japan (aging population, highly homogeneous, eat lots of fish, lower BMI) to the US (younger population, highly heterogenious genetically and culturally, culture consists of fast food + cars + TV) and assuming the difference in life expectency has anything to do with the health care system is crazy.
b) Even if we take ave. life expectency as the measure, it is important to consider what it really tells us about a health care system. The health care “system” in the US is really a “sick care system”. If you get a serious disease (like cancer) the US is the best place in the world to live. The US “system” does very little to keep people healthy however. Other countries do much more to keep you healthy, but are pretty lousy if you get sick. A key question for the US is this: who is responsible for keeping us healthy, and who should pay when we get sick?
c) Ave life expectency does not measure much about “quality health care outcomes”. Unfortunately, the other data one might use are even worse. In most countries with Govt Systems they measure the impact of spending on mortality, but it is much harder to measure the impact of spending on things like “reduced pain”. As a result most of the Universal Coverage countries deny many kinds of treatments available in the US.
d) Health care outcomes data and cost data are different, but horrible, in all countries. Therefore it is farsical to make much out of these cross country comparisons.
Clearly you do not “mean well”. Your should change your name to “Margery Angery-Frustrated Person”
Thank you for this great post. Clearly CoRev hates poor people. Clearly.
Thanks for this great post. Clearly CoRev despises poor people. Clearly.
Or maybe it should be “Margery the Hater.”
Or how about “Margery Meanswells just as long as the United States ends up as a third world country?”
Clearly you are well balanced and not in the least obsessed.
I would love to hear what this has to do with Health Care, and while you are at it maybe you could explain how Israel is really to blame.
P.S. In your google search for outrages in Af-Pak, maybe you could post some of the articles about the Taliban throwing acid on women who refuse to cover their faces, or stoning women to death for being raped.
How many African Norwegians live in Norway. You said you wanted to compare apples to apples. Different ethnicies tend to have slightly or greatly different health outcomes that others. This is also compounded by national habbits such as diet and exercise. Unfortunaly in the United States those of African decent tend not to live as long as people from other ethnic backgrounds. Since this population is around 12 percent of the population it tends to bring our numbers down. Add a poor diet and lack of exercise across ethnicies and you end up with the double and triple wide bodies you see at the mall – and I think you’ve explained the difference. So the reason our survival rates are a little lower than in Europe and Japan is because we have a higher percent of ethnicities with poor health genes along with bad diet habits in the greater population.
I’ll let you know if the whale people show up at my pool or jogging path.
Your point is well taken.
Best reason for death panels: “healthcare spending for the 65 and older population was 5.6 times higher than spending per child, and 3.3 times that for working-age people.”
I agree why spend more for a terminaly ill octogenarian than a perfrctly health child and worker!!
Euthanasia (is) forever. Keeps the heirs’ fortune intact, too.
CoRev,
See my respond to cantab.
Euthanasia is good!!
Guest,
If someone who lives in AF Pak cared about kicking out the Taliban it would be doable, actually already done.
Since there is no concern for the isolated religious punishments, the US is spinning its wheels.
The reason the Taliban exist is because there is no animus in AF Pak against them.
Okay maybe the drug lords want the Taliban out, as they tax them more than the US puppets would.
That is why Karzai is there.
Lessee, we have more spendig on the sick than the well per ILSM. Yup! Gotta agree. Who here realizes that wellness is a bell shaped curve?
I knwew you ole Libs would bring up the death panels again. 2slugs did two days ago and you did today. 😀 What’s next??? Firing squads? Nope it would have to be painless. Just the same as for those killed due to the death penalty. 😉
Lessee, we have more spendig on the sick than the well per ILSM. Yup! Gotta agree. Who here realizes that wellness is a bell shaped curve?
I knew you ole Libs would bring up the death panels again. 2slugs did two days ago and you did today. 😀 What’s next??? Firing squads? Nope euthanasia would have to be painless. Just the same as for those killed due to the death penalty. Or is there another plan for the elderly? 😉
Actually there is a severe kertosis in the age based distribution.
The republican way, get sick, die quick and cheap.
If there was money to be made from federal spending borrowed from rich people they would be all for it.
Without comparing the prevalence rates of illnesses and injuries, between nations, comparisons such as the one above are misleading and all too frequently used in this health care debate. The U.S. has a diet related disease epidemic and a penchant for auto accidents that is unrivaled the world over. We also also have an unwillingness to allow the chronically ill to die as inexpensively as what people in other nations do.
The chart in question shows that the Japanese go to their doctors often and live long lives. But Czechs also visit their doctors often, live short lives, but then they don’t spend much in doing so. Whether this means that Czechs need better doctors, or that Czechs are unhealthy for whatever reason, or just unlucky, is impossible to deduce from this chart.
As for the U.S., this chart suggests that Americans are so unhealthy, that no amount of spending will be enough to solve the problems. It might be argued that Americans would benefit from more frequent doctor visits although that leads back to the Czech conundrum. Perhaps I am missing something but this chart only tells me that the U.S. has a very serious health care problem that has to do with cost and health affects — but who doesn’t know that?
The US indeed is filled with people with bad habits, bad genetics and warmongers whose the propensity is to spend 5 times as much for corporate welfare and insane wars than other countries.
It is not just one thing.
The US has the slimmest social safety net of any nation with better average age at death.
And the by far the largest military and worst care for veterans.
I propose that some of the money spent preventing the US from losing to the Taliban and extremist Islam would better be spent on child nutrition, and numerous efforts at preventive medicine.
There are a lot of differences in the view of societies toward the ordinary people.
In the US the view of the ruling class, seen acting up in the US senate, is adverse to the health and welfare of the general population.
And the US has by far the largest armed sector in the world.
There is causation as well as correlation.
Send one up.
Jimi,
Thanks for the ad hominem, it contributes to our understanding of your state of mind.
o_O
ilsm,
Respectfully you miss my point. Since it seems to be happening frequently, I will assume it is my fault.
What does MM’s post have to do with health care?
Also, MM seems to have an interest in horror stories that explainn “why they hate us”. My point is that 99.9% of the real horror stories from the region have nothing to do with the US, they just don’t get played in our media.
Regarding the Taliban, I believe you are mistaken. Most Afghanis welcomed the Taliban at first because they brought order. But the Taliban soon devolved into a nightmare. Most Afghanis do not want to see the Taliban return to power. They would like the foreign forces to remain in country long enough to ensure a “good enough” Afghan govt is in place and then promtly leave. (Clarifying note: “Not wanting the Taliban return to power” is not the same as “killing all the Taliban”)
ilsm,
What do US wars in wouthwest Asia have to do with the health care debate or the average life expectency in the US?
Regarding your proposals that the US could (better) spend more money on public health, I would be interested in your suggestions.
Since you brought it up, I would be interested in your thoughts on improving child nutrition.
One thing to consider about the US as we discuss the options for public health: you can’t make people do things in this country, even if it is in their own interest.
I remember several years ago there was a minor uproar in Chicago because lots of parents in the city were refusing to get their children vaccinated, and the schools would not allow the kids to start school until they had received their shots. Expense was not the issue because the vaccinations were being provided for free. Instead, the parents had concluded that society placed a value on their children being vaccinated and educated, and the parents were demading TO BE PAID to get their children free vaccinations. No doubt they would also like to be paid to send them to school and be good parents. Truly depressing in my opinion.
i think it might be interesting to compare the cost of a dr visit to the monthly wage.
from people i know who have been there, seeing a dr in europe is easy and cheap.
seeing a dr in america is not easy and not cheap, and “emergency rooms” are very much not easy for the patient, nor are they cheap for the people who pay the bills.
and CoRev and everyone else keep ignoring the point of Atul Gowanda’s little research: the cost of health care in this country varies over a range of 3 to 1 for the same outcome, as a function of the local medical providers attitude about making medicine pay.
all of the rationalizations are just ways to avoid recognizing that basic fact. we live in a culture where at least some providers get away with “whatever the traffic will bear” pricing. unfortunately the present health care reform does not seem to be addressing that cost driver.
One word that never seems to come up in these discussions is iatrogenic which is defined as “treatment or physician induced.”
One of the basic tenets of capitalism is that it requires an ever expanding customer base and medical care in the United States is nothing if not a capitalist enterprise. There is probably no easier sale to make than the one that sells a person his life back.
The system is doing what it is designed to do–generate customers and increased profits.
Nothing will change until people’s lives are no longer for sale.