pushmedia1: Is American health care more expensive because its better...

3.06.2007

Is American health care more expensive because its better...

... or because its less efficient?

Here's one piece of evidence that American health care is better, but The Economist warns:

This is a good illustration of why it is so very, very difficult to do cross-country comparisons of the effectiveness of health care systems. They are plagued by definitional differences in statistics (is a baby born at five months gestation a neo-nate, who goes into your infant mortality statistics when he dies a few hours later, or a stillbirth, which does not?) They are heavily affected by differences in lifestyle, and ethnicity—almost no one thinks that the Japanese live so long because they have the world's finest health care system. And, as this example illustrates, many variables are but ambiguous signals of quality. A country may have longer hospital visits and more acute care because the comparison country is letting its citizens die in the street; or because the comparison country is much better at treating disease, forestalling crises and long hospital stays; or because you are paying doctors and hospitals to treat crises and provide hospital beds, and they are responding to the signal.

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Comments:

I don't disagree with any of the points listed there. This is an old problem that extends well beyond health care comparisons.

# posted by SWong : 3/07/2007 10:39:00 AM

I have a related question: is there a refutation to the "tragedy of the commons" scenario?

# posted by SWong : 3/07/2007 04:24:00 PM

The tragedy of a the commons is a fact. You can 'refute' it by saying it doesn't exist, I guess.

You could argue that humans aren't inherently self-orientated. But this seems like a steep hill to climb. At the basic level, physics determines our selfishness. Given that I'm here in this body, I can't see what you see. I can't care about what you care about in every instance.

To be honest, in my cold-induced stupor, I'm not sure of the relevance of this in this context...

# posted by Will : 3/07/2007 09:53:00 PM

Actually, I wasn't prepared to refute it, I wanted to confirm its validity from your point of view.

I was reading an article the other day about a new class of antibiotics that was being opened for use in livestock. As this is one of the classes currently used to treat drug resistant "superbugs" in humans, doctors are worried that its widespread use in livestock will eventually diminish its effectiveness in humans as more resistant bacteria evolve from the feed pens.

It's a "commons" scenario that coincidentally involves actual livestock. Ranchers have a strong profit incentive to use these drugs to boost their herd output, but this comes at the direct expense of the quality of healthcare available to the rest of us.

Actually, in my perfectly healthy state, I can't remember where I was going with that yesterday. I suppose you could easily turn that around and say that a free state clinic is definitely a "commons" and that every citizen has an incentive to bop down to the clinic every week and load up on vaccinations, dental work, and body scans.

# posted by SWong : 3/08/2007 10:53:00 AM

I'm still a little stuporish, but I'll take someone arguing my point for me anytime. :-)

I think the drug example is more an example of negative externality. I'm not sure, in my stupor, if these always map to the tragedy.

Typically, the commons problem is ivoked when the community pays for something, its free for individuals so they tend to over use it.

# posted by Will : 3/08/2007 02:28:00 PM

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