What a Group to be In
Per the Health at a Glance Chart Set, Powerpoint, available here:
All OECD countries have achieved universal or near-universal health care coverage, except Turkey, Mexico and the United States
And it’s even more impressive when you go to Slide 36 (whose header is quoted above) and realise that the Public Coverage in those three states is:
- Mexico: 82.5
Turkey: 67.2
United States: 27.4
Any room to bend the curve? Certainly looks as if there might be:
Well, at least Turkey and Mexico can feel good about themselves. Happy Xmas!
NOTA BENE: US per capita GDP is significantly higher than other OECD economies (because we work significantly more hours; not because we are significantly more productive) so “la differance” is even greater than the chart above shows.
The peons here are only capable of 1-dimensional analysis. ASSUME CETERIS PARIBUS is the law of the land.
To offset the difference you point out…. many of these countries count the health care costs of training their doctors as an education expense (think France). In the U.S. the training of our doctors gets counted as a health care expense (higher wages to pay for their education). But there is no such thing as an apples to oranges comparison when you pray to Jesus Christ and he tells you to ASSUME CETERIS PARIBUS.
I might add, Singapore is conveniently left off that list. We’ll chop that up as a RANDOM omission.
Mexico is more efficient with government spending than the U.S. ?
If the teabaggers don’t want government spending on healthcare, then they should move to Mexico !
Jay,
“many of these countries count the health care costs of training their doctors as an education expense (think France). In the U.S. the training of our doctors gets counted as a health care expense (higher wages to pay for their education).”
So a doctor’s pay is not really a health care expense in the U.S. because becoming a doctor is more expensive in the U.S. than in France? I gotta hand it to you… that ain’t 1-dimensional at all.
Let’s try the same logic in another setting, shall we? A meal isn’t really more expensive in at a 3 star Michelin restaurant than at McDonald’s once you have to factor in the educational expense of training the chef.
“I might add, Singapore is conveniently left off that list. We’ll chop that up as a RANDOM omission.”
Yeah, ’cause when the OECD is looking at the healthcare costs of OECD members, and it fails to include a particular non-OECD member that that you are convinced (for whatever reason) makes some random point you want to make, there must be some sort of scam.
If you’re convinced its a problem, why don’t you tell us what is going on in Singapore. And please provide links to reputable sources.
Cactus: “So a doctor’s pay is not really a health care expense in the U.S.”
I never said that. I am convinced your IQ is below 70, because your reading comprehension and/or logic is lacking.
If it costs you $0 for tuition to become a certified doctor you are going to demand salary $X. If another person has to pay $100,000 to become a certified doctor you are going to demand a salary $X + C, where C is the NPV of a cash flow annuity equal to the NPV of the cost of medical school (there is a risk premium attached to each cash flow as well).
In France doctors accept a smaller salary because they do not directly pay for their education. The French government’s department of education pays for their medical training by collecting taxes (from the rich).
In both France and the U.S. doctor’s pay is a health care expense. But the French hide some of their health care expenses in the department of eduction spending, by subsidizing medical school.
An apples to apples comparison would take the annual medical school tuition spent in the U.S. and subtract it from U.S. healthcare spending.
Jay,
If coming here with guns blazing, please make sure you are saying what you claim to be saying, with fewer asides and at least a link for each claim. Otherwise it merely looks like shooting blanks.
This article seems to suggest that public coverage inherently lowers the percentage of GDP in regards to health care. Mexico and Turkey might instead simply have lower prevalence rates of chronic diseases. Or maybe we spend a great deal more on extended care, or on tissues and unnecessary tests.
I don’t have the time to study the medical trends of second tier nations but I do know that the U.S. has 300% more diabetes than Switzerland. And it is fairly obvious that healthy nations should have lower per capita health care costs than what less healthy nations do. And of course there are many other factors, and one of those seems to have to do with political spin.
“And it is fairly obvious that healthy nations should have lower per capita health care costs than what less healthy nations do.”
Hmm. OK. So the USA, with the ‘greatest health care system in the world’ is a less healthy nation than the rest of the industrialized world?
I would have thought that all that health care excellence would have purchased, you know, better health.
It is fairly obvious that less healthy nations have less per capita health care than healthy nations. Health care costs have to do with the mechanism of health care delivery, not health per se. The US system of health care delivery guarantees higher health care costs, but does not deliver commensurately high health care.
Jay,
I followed your logic. As you wrote:
“To offset the difference you point out…. many of these countries count the health care costs of training their doctors as an education expense (think France). In the U.S. the training of our doctors gets counted as a health care expense (higher wages to pay for their education).”
I pointed out the same thing goes for the comparison between a Michelin 3 start and a McDonald’s. (Training to be a first rate chef is expensive.) But nobody who is older than 15 thinks that the quality of the food you get at McDonald’s is superior to the quality at a 3 start restaurant. And nobody makes bad excuses for the 3 star place, saying things like “OK, McDonald’s has better bread, but that’s because the people who eat at McDonald’s like dough more.”
And yet, in many ways, expensive American healthcare is not superior to French healthcare, and there are plenty of people offering up plenty of excuses.
As to your apples to apples comparison… what conclusion do you reach when you do an apples to apples between a greasy spoon and an expensive restaurant?
Joel
so true. the critical difference is the prime objective of the us health care system is not to deliver health care but to make as much profit as possible.
our health care system mirrors our soul as a nation. it isn’t broken. it’s doing exactly what it is designed to do. it’s our value system that’s broken.
Krugman, nonetheless, is encouraged by the recent legislation. Not what it should have been, but a decent start toward universal coverage, according to him. I would add that, given the degree that the US Congress is purchased by private interests, and particularly by drug companies and private health insurers, it is probably significant that anything got passed. All the money power of the insurance industry was unable to block everything. Now the goal will be to whittle down the power and influence of the insurers.
I did not say that the U.S. health care system is great, good, bad, or whatever; nor do I disagree that “it’s our value system that’s broken”. It is simply disingenuous to suggest that percentage of GDP is nothing more than a matter of public versus private coverage.
Jay,
You’ll have to do better than that. The cost of med school doesn’t come close to explaining the difference. The AMA says that we create about 25,000 doctors each year and the tuition is roughly $25-$50K per year, give or take. Sorry, but no way that even comes close to explaining the gap. That might explain a lot of the doctor’s salary, but the doctor’s salary is only a small component of healthcare costs. Insurance companies spend more money trying to exclude claims than we spend on med school tuition.
Health Care reform have become such a political, loyalist trench line that “real” reform won’t happen. Instead of focusing on identifying what is “real” and what is “political” the issue now boils down to if Mexico spends less on health care per GDP versus the good USA?
This is such as nonsense article. I expect better from the author and commentators to produce more constructive argument. May I suggest the following debate:
1) Reduce overlapping regulation between the Federal and State. Read: Reduce waste and redundency, saves tax payer dollars.
2) Make sure Congress and Senate agree on opening up competition for health insurance on a national level.
3) Push for Obama’s regulation on Brand name drug, instead of 12 years(congress) to what the president wants, 5-6 years.
4) It’s useless to tell American whom they can see, how much medical care they can get. Especially at end of life. It’s a different country folks. Try Mexican, Cuba healthcare if you like, I just hate armchair debators that never had the chance to live in another country and have to experience real difficult choice people have to make in those countries. i.e. Michael Moore; Try getting in to an automobile accident without cash in Mexico
5) Why are we allowing individual Senators and Congress members to put their own wasteful little projects into the bill? Did we not vote for change? Are we allowed to the President to ask some tough question?