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Sunday, January 3, 2010

American Health Care: Spend More, See Doctor Less, Live Less Than Average

The best we can say about the wimpy health insurance reform bill Congress is the Tim Johnson line that it's a step in the right direction. But America's broken health care system will need a lot more steps to get to the real solution: real universal health care that gets people to the doctor before there's an emergency and without driving them to bankruptcy.

What's wrong with our system? Check this graphic from the National Geographic blog. It shows compares health care spending per person, annual doctor visits per person, and life expectancy in countries with universal health coverage (whether publicly or privately funded) and countries without.

The developed countries listed spend an average of just under $3000 per person on health care. Their citizens live to an average age of 79.2. There's no great American exceptionalism on life expectancy: we clock out at a respectable 78—although 45,000 of us die early each year because we lack insurance. But we distinguish ourselves in the other categories depicted in the graph. We are one of only two countries without universal health coverage—the other is Mexico. We go to the doctor less than everyone except the Mexicans, the Swiss, and the Swedes.

And what do we pay for less access to the doctor and shorter lives than the Portuguese? $7290 per person.

Who says Americans are smart shoppers?

More notes on why health care reform won't be anywhere near done after the current bill passes:
  • 63% of staph infections in the U.S. are nasty antibiotic-resistant strains. Such cases cost us $6 billion and 19,000 lives a year. The Norwegians have figured out how to knock antibiotic-resistant staph infection rates down to 1%: require doctors to prescribe fewer antibiotics and isolate infected patients and staffers. It also helps to give workers paid sick leave and ban drug advertising.
  • From the same story, who's leading the way in the U.S. in fighting such infections? Government-run health care: VA hospitals have adapted the Norwegian model and achieved a 50% decrease in MRSA bloodstream infections.
  • Read Adam Geller's AP report on Remote Area Medical's efforts to bring free medical care to some of our fellow Americans whom we would otherwise leave to suffer and die. Read it, then go look RAM founder Stan Brock or his patients in the eye and tell them America has the best health care in the world.
Update 2010.01.04 10:50 CST: See also this graphic of America's status as the outlier on wasteful health care spending (Andrew Gelman, via Decorum Forum).

Update 2010.01.05 10:10 CST: Make that $7700. That's how much Americans spent per person on health care in 2008.


  1. Alternate versions of the graph data on different web sites show a clustering of cost versus life expectancy in many of the other countries, but the US is completely out in right field. Some how all these other countries have managed to get a better deal than the US with most of them having Universal Health Care. Yet, so many American citizens think that it would break the country...

  2. Well it's a SIXTH of our economy.

    Opponents of real reform (including our at-large Rep) say that like it's an argument to keep things they way they are!

  3. Steve Sibson1/03/2010 4:47 PM

    "45,000 of us die early each year because we lack insurance"

    That is a lie. Why are you lying for Big Insurance Cory? Obamacare benefits Big Insurance corporations and Big Drug corporations, and us little guys are paying for it. The problem is the government's tax policy that creates employer based insurance. This puts the employer in between the customers and the insurance companies, and the insurance companies are winning. By removing the employer-based system, the insurance companies have to compete with us on an individualized basis, especially if we allow AMericans to buy from companies in other states. That means more competiton, which the insurance companies do not want. Again, Obamacare does not fix that, but instead gives insurance companies even more business, subsidized by debt being passed on to future generations. Note that the Big Insurance stocks rallied after the Senate passed their Christmas gift to Big Insurance.

    Cory, when are you going to side with the working man instead of supporting the Big Corporate/Big Government lovefest that has created the current rip-off in health care.

  4. To me, the most interesting part of that graphic is Japan. They go to the doctor 10+ times per year, spend 1/4 of what we do, and live equally long.

    They have adopted a preventative/early intervention approach to health care rather than rationing/reactionary approach. While they go to the doctor a lot, they aren't dealing with the chronic illnesses that bleed our system because they catch it early/prevent it.


    Can anyone see a scenario where our free market system would lead to a preventative/early intervention approach rather than the rationing that we have now?

    It seems to me that such a transition would take years to develop and accordingly any corporation beholden to stock holders would not be able to support. Perhaps the free market can only find local minimums rather than global minimums?

  5. Steve Sibson1/04/2010 12:21 PM


    Do you have the oil changed in your car, or do you wait until it blows up and by a new one?

  6. Steve:

    Change the oil as per the manufacturer specifications. Though, my younger sister did destroy a family vehicle by not changing the oil.

  7. Tony: "local minima"—calculus imagery always excites me. Excellent!

    Your argument says a lot about the overutilization fallacy.


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