I found something to focus these posts.
The Opposing Viewpoints book (see below) is really sharp. They reprint an article by Steve Kangas, which is a virtual reprint of his FAQ page on healthcare (the book cites an old URL, but Google took care of that). His argument is very cogent, and one quote alone is worth the price of admission:
Part of the problem is that there is more profit in a pound of cure than an ounce of prevention.
However, his stats comparing America to other industrialized nations are from 1991. Is there a way to update these figures?
Looking around, I found
the Center for Disease Control (CDC) site with a .pdf download available for Health, America, 2003. This book must be the inspiration for the Health Nashville report that I've yet to acquire. It's Viagra for a healthcare policy wonk. Charts, statistics, trends...the sliderule factor is very high. But with Kangas' article as a guide, I can poke around and get the figures for today (or as close as possible). Please alert me in the comments if I'm going too deep into the numbers.
Kangas first compares health care spending in ten countries to their gross domestic product (GDP). His figures are first, and the latest figures from the CDC are second (page 305 in the report, 310 in the pdf).
Country | 1991 | 2000 |
United States | 13.4 | 13.3 |
Canada | 10.0 | 9.1 |
Finland | 9.1 | 6.6 |
Sweden | 8.6 | n/a* |
Germany | 8.4 | 10.6 |
Netherlands | 8.4 | 8.1 |
Norway | 7.6 | 7.8 |
Japan | 6.8 | 7.8 |
United Kingdom | 6.6 | 7.3 |
Denmark | 6.5 | 8.3 |
*Sweden's last available figure was from 1998, when healthcare spending was 7.8% of Sweden's GDP.
Some countries dropped in nine years, and others increased. But the United States still dwarfs them all.
But wait, there's more. On the next page of the CDC report, a similar report gives American information up to the year 2001. Our healthcare spending as a percentage of GDP went up to an incredible 14.1%.
There's two reasons for this. GDP did take a hit that year because of the 9/11 attacks. It only went up 2.6% from the year before, when a gain of at least 5.6% was the norm in the previous three years. But health costs were steadily accelerating in these years. In 1998, healthcare spending was up 5.1%, and in 1999, it was up 6.1%. The following year, costs went up 7.4%, and in 2001, the jump was 8.7% over the costs in 2000. Room-a-zoom-zoom.
In the year 2001, we spent over $5000 for every person in the United States on healthcare. I'll have to be honest with you - I didn't see a dime of it.
No, wait - full disclosure. That year I went fulltime and received health insurance from my employer. In December 2001, I had a physical. So I did spend some healthcare money that year. It couldn't have cost $5000, could it? Nah.
For the kind of money we spend, we should have a healthcare system that produces incredible results, right? Well, they're incredible, all right.
Life expectancy
The chart Kangas provides can be confusing. He ranks twelve different countries by life expectancy of women, but includes a column for men as well. The US doesn't fare very well in either one - we're ranked 10th in the female list, and 11th in the male. To update this table with CDC info (page 131, pdf 136), I'm breaking it into charts for men and women:
Men
Country | 1991 | Rank | 1998 | Rank |
Japan | 76.2 | 1 | 77.2 | 1 |
Sweden | 74.9 | 2 | 76.9 | 2 |
Switzerland | 74.1 | 3 | 76.3 | 3 |
Netherlands | 73.7 | 4 | 75.2 | 6 |
Canada | 73.4 | 5 | 76.0 | 4 |
Norway | 73.1 | 6 | 75.5 | 5 |
France | 72.9 | 7 | 74.8 | 7 |
United Kingdom | 72.7 | 8 | n/a* | ? |
Germany | 72.6 | 9 | 74.5 | 8 |
Denmark | 72.2 | 10 | 73.9 | 9 |
United States | 71.6 | 11 | 73.8 | 10 |
Finland | 70.7 | 12 | 73.5 | 11 |
*The CDC divided the UK into England/Wales, Ireland, and Scotland.
Women
Country | 1991 | Rank | 1998 | Rank |
Japan | 82.5 | 1 | 84.0 | 1 |
France | 81.3 | 2 | 80.8 | 7 |
Switzerland | 81.3 | 3 | 82.4 | 2 |
Netherlands | 80.5 | 4 | 80.7 | 8 |
Sweden | 80.4 | 5 | 81.9 | 3 |
Canada | 80.3 | 6 | 81.5 | 4 |
Norway | 79.7 | 7 | 81.3 | 5 |
Germany | 79.2 | 8 | 80.6 | 9 |
Finland | 78.8 | 9 | 80.8 | 6 |
United States | 78.6 | 10 | 79.5 | 10 |
United Kingdom | 78.2 | 11 | n/a* | ? |
Denmark | 77.9 | 12 | 78.8 | 11 |
*See note for male table above.
For men, the rankings remained about the same. There was a big shakeup for women, but in the end, the United States held onto the bottom of the list.
The CDC table here gives a worse picture. It lists 37 countries, from the dizzying heights of Hong Kong and Japan to the depths of the Russian Federation. Among these countries we rank 21st in life expectancy for women, and 24th for men. Guys, take heart - we managed to get on top of Hungary.
To be continued...