Money’s worth

Here’s an interesting chart.

There’s a profound flaw in it, of course, which is that longevity is not a good measure of health care quality. There are too many other factors: genetics, violence, and accident rates to name a few. (Then there’s lifestyle, but that’s more controllable, and the health care system can and ought to have some influence on that.) Nor is longevity the only outcome of interest. Quality of life is at least as important.

So the fact that longevity in South Korea is a few percent higher than in the US isn’t particularly significant. The fact that per capita health care costs in South Korea are four times less than in the US is, though. It’s the left side of the chart I find alarming, not the right. Even Switzerland pays only a little over half what we do.

What do we get for our 300% higher costs that South Korea doesn’t? The difference in longevity isn’t significant; the insignificance of the difference is significant. All that money isn’t buying us longer lives. Nor is it paying for more doctor visits. What does it buy us?

The accompanying comment here (which actually is the source of the chart, though they present it stupidly, hence the link above to FDL) suggests “The U.S. has a fee-for-service system—paying medical providers piecemeal for appointments, surgery, and the like. That can lead to unneeded treatment that doesn’t reliably improve a patient’s health.” I’d tend to put it this way: the US for-profit health care system provides both a carrot and a stick to increase costs. Carrot: More tests and procedures mean more profit for the health care provider — and then the insurance industry takes its cut too. Stick: Our litigious society punishes doctors with financial ruin if they make a mistake. The result is huge incentive to prescribe tests and procedures that do not significantly improve prognoses.

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One thought on “Money’s worth

  1. I agree with your last paragraph; I’d like to think my last blog post suggests this as well. So: diagnosis agree. Treatment plan, not so much. Also, another statistical worry – life expectancy at birth tends to be dominated by infant mortality, so doesn’t say much about adult life expectancy. (Not that I’d expect the US to play out much better that way, but it could look quite different.) US infant mortality is tragic.

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