A new study by the Institute of Medicine, which is getting plenty of media attention, claims the United States public health care system is critically underfunded and thus — surprise — in need of new “investments.” Serious new investments. Recommendations include taxing medical care and doubling public health spending — and, no doubt, more top-down government intervention.
The United States spent $2.5 trillion on health care in 2009 according to the report, but scored lower on life expectancy, infant survival and “other indicators of population health than other wealthy nations report.” The groups also says that the “U.S. health system has a ‘fixation’ on clinical care, or treating people when they get sick, rather than preventing them from getting ill in the first place.”
Right now the U.S. spends far more per capita than any other country. We’re about to spend a lot more. Maybe we do need to raise taxes to create a more effective health care system. I have no way of knowing for sure. What I do know, though, is that statistics are often used to scaremonger and politicize this issue.
Doctors, for instance, can argue over the benefits of preventive care as a health issue — and there is no stopping you from having a fixation on your health — but it is a myth to conclude that it would save Americans any money.
Or, take infant mortality: During the initial debate over ObamaCare, we talked incessantly about the horrible American health care system. Back in 2008, Obama was already pointing out that “29 other countries have a higher life expectancy and 38 other nations have lower infant mortality rates.”
Actually, a recent study ranked the United States 41 out of 45 industrialized nations (take that Pakistan) in infant mortality rates (statistically speaking, deaths of infants 1 year of age per 1,000 live births). Scary stuff.
But I wonder how many pregnant women would prefer prenatal care by doctors in Malaysia or Croatia rather than the United States? Not many, I guess. I would also guess that those mothers would be making an exceptional choice.
To begin with, there is the issue of underreported and unreliable data coming from nations that are far less scrupulous about these sorts of things. Dr. Scott Atlas, at the Hoover Institution, points to a 2008 study by Joy Lawn that estimated 3/4th of the world’s neonatal deaths are “counted only through highly unreliable five-yearly retrospective household surveys, instead of being reported at the time by hospitals and health care professionals, as in the United States.”
Dr. Linda Halderman writes that in some countries a premature baby weighing 500g is not considered a living child, but “such very low birth weight babies are considered live births. The mortality rate of such babies — considered “unsalvageable” outside of the U.S. and therefore never alive — is extraordinarily high; up to 869 per 1,000 in the first month of life alone.” This skews U.S. infant mortality statistics.
The U.S. National Center for Health Statistics found that “the primary reason for the United States’ higher infant mortality rate when compared with Europe is the United States’ much higher percentage of preterm births.”
Then there is the issue of population. Per Atlas: “Throughout the developed world, and regardless of the health-care system, infant-mortality rates are far worse among minority populations, and the U.S. has much more diversity of race and ethnicity than any other developed nation.” This doesn’t mean we should be less vigilant when it comes to medical care for immigrants, but the facts can’t be discounted.
As for life expectancy, there are numerous studies that find that wealth, not health, is the leading driver of longer lives. One such study, by Sam Preston and Jessica Ho at the University of Pennsylvania, finds that “the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.”
Avik Roy has a rundown of much useful evidence in the his piece, “The Myth of Americans’ Poor Life Expectancy.”