US Health Care: How Does it Stack Up?
This is not my normal sort of post, but because I collected all this data and my blog is my normal publishing outlet I am presenting it in a fairly rough form. It may be useful for you or someone else.
US Provides Most of Healthcare Research Occurring in the World
The US does most of the medical research in the world. For instance, the US has produced more Nobel Laureates in medicine than any other county. See http://stats.areppim.com/stats/stats_nobelxmedxnation.htm. According to a 2006 New York Times article (http://www.nytimes.com/2006/10/05/business/05scene.html?_r=0) “In the last 10 years, for instance, 12 Nobel Prizes in medicine have gone to American-born scientists working in the United States, 3 have gone to foreign-born scientists working in the United States, and just 7 have gone to researchers outside the country.” The Article goes on to state “In real terms, spending on American biomedical research has doubled since 1994. By 2003, spending was up to $94.3 billion (there is no comparable number for Europe), with 57 percent of that coming from private industry. The National Institutes of Health’s current annual research budget is $28 billion, All European Union governments, in contrast, spent $3.7 billion in 2000, and since that time, Europe has not narrowed the research and development gap. America spends more on research and development over all and on drugs in particular, even though the United States has a smaller population than the core European Union countries.”
Most academic articles on medical research come for the US and the difference is not small. The US produced over 40% of the papers which dwarfs every other country. See http://www.forbes.com/sites/matthewherper/2011/03/23/the-most-innovative-countries-in-biology-and-medicine/2/.
Other Countries Freeload Off of US Medical Research
Europe, Canada, Mexico and most other countries refuse to pay for the research that goes into medication innovations. These countries use their socialized medical system to force pharmaceutical and other healthcare companies to either lower their price so that they cannot recoup the cost of medical research or they are denied access to that market. As a result, US consumers have to pay for the medical research for the whole world.
If the US moves to a socialized medicine model along the lines of Canada and Western Europe, it will be a disaster for medical innovation. One of the biggest ways to save money in the short term for the US will be to cut research, both public and private. As a result, everyone’s healthcare around the World will suffer.
Why the Cost of Healthcare is so High in the US
There are three major reasons the US healthcare is so expensive. First, the US pays for most of the medical research in the world, as explained above. Second, the regulatory costs are very high in the US. For example, it costs about $1 billion dollars to bring a new drug to market. Most of that money is spent on complying with the FDA’s rules. Third, is the US tort system. The regulatory and tort systems are not part of a free market and should be drastically curtailed or eliminated. A cost benefit analysis of these systems would show they are a huge waste of money. If the US fixed its regulatory and tort problems and the rest of the World paid for the medical research they use, then the cost of US healthcare would be similar to other western countries.
Life Expectancy and Infant Mortality Rates
The US life expectancy and infant mortality rates are often used to condemn the US system of healthcare. A closer examination shows that US life expectancy, when grouped by ethnic background is about the same as the home country. See http://www.nationalcenter.org/NPA547ComparativeHealth.html “Comparisons of distinct ethnic populations in the U.S. with their country of origin find similar rates of life expectancy. For example, Japanese-Americans have an average life expectancy similar to that of Japanese.” In addition, healthcare is not a good indicator of longevity. The strongest correlation with longevity is per capita income. The US healthcare system measures very well from the point of intervention of medical treatment. See http://www.forbes.com/sites/aroy/2011/11/23/the-myth-of-americans-poor-life-expectancy/
The US supposedly has a very high infant mortality rate compared to other countries. But a closer examination shows that people are comparing apples to oranges. Different countries have different ways of measuring infant mortality.
But infant mortality tells us a lot less about a health care system than one might think. The main problem is inconsistent measurement across nations. The United Nations Statistics Division, which collects data on infant mortality, stipulates that an infant, once it is removed from its mother and then “breathes or shows any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or definite movement of voluntary muscles… is considered live-born regardless of gestational age.” While the U.S. follows that definition, many other nations do not. Demographer Nicholas Eberstadt notes that in Switzerland “an infant must be at least 30 centimeters long at birth to be counted as living.” This excludes many of the most vulnerable infants from Switzerland’s infant mortality measure.
Switzerland is far from the only nation to have peculiarities in its measure. Italy has at least three different definitions for infant deaths in different regions of the nation. The United Nations Statistics Division notes many other differences. Japan counts only births to Japanese nationals living in Japan, not abroad. Finland, France and Norway, by contrast, do count births to nationals living outside of the country. Belgium includes births to its armed forces living outside Belgium but not births to foreign armed forces living in Belgium. Finally, Canada counts births to Canadians living in the U.S., but not Americans living in Canada. In short, many nations count births that are in no way an indication of the efficacy of their own health care systems. (see http://www.nationalcenter.org/NPA547ComparativeHealth.html)
On a common sense level, do you think a pre-mature baby has a better chance of living in the US or Canada? Canada’s healthcare system will not spend the money necessary to keep a severely premature baby alive.
Access to Healthcare in the US
Everyone in the US has access to healthcare. Emergency rooms at hospitals are not allowed to turn people away for lack of insurance or the inability to pay. If you are “poor” you are covered by Medicaid and if you are old you are covered by Medicare. The myth that Canadians have better access to healthcare is nonsense. There are thousands of stories of Canadian dying while they wait for their “free healthcare”, including one of my aunts.
Morality of Paying for Healthcare
A common argument for socialized medicine is that it is a necessity so people should not have to pay for it. First of all, socialized medicine is not free. It just changes the payment system. Instead of the individual paying the doctor, hospital, or pharmaceutical company, the individual pays the government and then the government pays the doctor, hospital, or drug company. Second, food is a necessity and yet no western country has a socialized food delivery system. We still pay the farmer, or grocery directly. Only the USSR attempted to have a socialized system of food delivery and production and the result was catastrophic. Millions of people starved to death and the USSR was not able to feed its population until they allowed small private plots. By the way this is also the story of the Pilgrims.
Socialized medical systems are immoral. This system involves taking money from people against their will and giving it to other people for their private benefit. That is theft. Theft does not become moral, because it is for a good cause. It does not become moral because we all voted for it. Theft is always wrong and evil. On top of it those countries where government steals more from its people or inhibits their people’s ability to produce have shorter life spans, less access to health care, less education, more pollution, etc. etc. etc. See http://www.youtube.com/watch?v=66PZv7Vtw3I and http://filipspagnoli.wordpress.com/stats-on-human-rights/statistics-on-gross-domestic-product-correlations/
Every measure of human progress increase with increasing levels of economic freedom.
Reforming US Healthcare
This is not to say the US healthcare is perfect. However, it is clear that socialized medicine is not the answer. (Actually more socialized medicine. Medicare is already socialized medicine for people over 65). First of all, the US needs to get rid of the FDA or severely cut it back. Second of all, the US needs to reform its tort laws so doctors can practice without paying a fortune in insurance. This will also allow the cost of vaccines and other medicines to fall. One result of the US’s run out of control legal system, vaccines have gone from being almost free in the 1960s to being a very expensive part of young parents’ life. Third we need to eliminate the regulation of insurance companies at the state level and allow insurance companies to sell insurance across state lines. Fourth, we need to get the government out of the business of providing health insurance. This means we need to eliminate Medicare, Medicaid, and the VA system. Obviously, we cannot cut off today’s seniors on Medicare, but we need to move it to a more free market system. Seniors should be receiving a lump sum to buy insurance, with a fund that pays for people who cannot find insurance. Fifth, the tax code needs to be reformed so that people do not lose their health insurance when they lose their job. These reforms would drastically decrease the cost of insurance, increase the efficacy of the US healthcare system, and provide more access.
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