Inefficiency Hurts U.S. In Ranking of Health

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Inefficiency Hurts U.S. In Ranking of Health

• Nicholas Bakalar
• New York Times
• November 29, 2010

http//www.nytimes.com/2010/11/30/health/30life.ht
ml?refhealth
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Life Expectancy

• By any measure, the United States spends more on
  health care than any other nation. Yet according
  to the World Fact Book (published by the Central
  Intelligence Agency), it ranks 49th in life
  expectancy.
• Why?
• Researchers writing in the November issue of the
  journal Health Affairs say they know the answer.
  After citing statistical evidence showing that
  American patterns of obesity, smoking, traffic
  accidents and homicide are not the cause of lower
  life expectancy, they conclude that the problem
  is the health care system.

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Comparison

• Peter A. Muennig and Sherry A. Gleid compared
  the performance of the United States and 12 other
  industrialized nations Australia, Austria,
  Belgium, Britain, Canada, France, Germany, Italy,
  Japan, the Netherlands, Sweden and Switzerland.
• In addition to health care expenditures in each
  country, they focused on two other important
  statistics 15-year survival for people at 45
  years and for those at 65 years.

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Major Analysis

• In 1975 the US was close to the average in
  health care costs, and last in 15-year survival
  for 45-year-old men.
• By 2005 its costs had more than tripled, far
  surpassing increases elsewhere, but the survival
  number was still last a little over 90,
  compared with more than 94 for Swedes, Swiss and
  Australians.
• For women, it was 94 in the United States,
  versus 97 in Switzerland, Australia and Japan.

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Look at inverse of slope. Why?
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Basic Method

• The researchers first eliminated several other
  factors. Obesity and smoking are the most
  important behavior-related causes of death, but
  obesity increased more slowly in the United
  States than in the other countries and smoking
  declined more rapidly, so neither can explain the
  differences in survival rates.
• Homicide and traffic fatality rates have remained
  steady over time, and social, economic and
  educational factors do not vary greatly among
  these countries.

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Controlling for Race
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Not without criticism

• Samuel Preston They have no direct evidence
  about the health care system in this article, he
  continued. Their conclusion is extremely
  speculative.
• Muennig responds Smoking and obesity are still
  major risk factors for an individuals health,
  he said. But they are sapping life expectancy in
  all countries. Whereas in the U.S. we have a
  highly inefficient health system thats taking
  away financial resources from other lifesaving
  programs.