Philosophical Musings

Philosophical Musings

Tuesday, August 9, 2011

Health care spending.. National comparisons

Here is an interesting table.

It seems from this chart that the US spends way more per capita on health care than any other nation. ..more than twice as much as Sweden, for example. And considering our GDP is also the highest in the world, we spend a greater percentage of that than any other nation. So obviously money is not the key to good health care. But why does the US spend more than anyone, yet get the least return? Is it because of the evil capitalists who are in complete control of our health care system?

I don't think so. I also see some major factors in this chart that are not pointed out, as well as some major omissions. There are only 2 countries here in the top 10 populated countries of the world. The US is #3 with ~ 312m people. Japan is #10 with 128m. Most of the rest of the countries listed are the size of some of our states. The point being that it is easier to manage things like health care in smaller states, with smaller populations.

It seems whenever the US Fed. govt. gets involved in controlling an industry, that the costs go up & fraud & corruption increase. I would point to this as a source of our increased cost of health care. If the fed would get out of micro managing everything, & let some free market solutions come in, i believe we would see decreased costs in health care, as competition to provide a better, more cost effective product would drive the market. Certainly we need some regulation, but not the massive control the fed is trying to do.

I still have no problem with a state having universal health care if it wants it. Massachusetts decided to try it a few years back. Obama used them as a model. In a state the size of Sweden or New Jersey, it is easier to manage things without the accompanying fraud, corruption, & inefficiency that you get when you expand it 10 fold. To be fair, there should be larger countries in the chart... some that are more the size of the US. I'll list a few. This is from wikipedia list of world population.

1 China 1,339,724,852
2 India 1,210,193,422
3 United States 311,946,000
4 Indonesia 237,556,363
5 Brazil 190,732,694
6 Pakistan 176,873,000
7 Nigeria 158,423,000
8 Bangladesh 151,053,000
9 Russia 142,905,200
10 Japan 127,950,000

There are other factors as well. How multicultural is Japan? Not very. It is more like Sweden than the US. How much does Japan spend on defense? How much do they contribute to world security? How many Norwegians have gone to police actions in Iraq, Afghanistan, Korea, Africa, etc? How much immigration does Norway have compared to the US? How many Swedes pay taxes? How many are on the dole?

I would say that considering the US is the 3rd largest country in the world, & spends the most per capita on heath care, & spends the most as percentage of GDP, we are doing surprisingly well, considering the other larger countries & the problems they have. Not too many Europeans go to China, India, Indonesia, or Brazil for health care. A lot come to the US.

Most of the larger countries of the world do not provide very good health care for their citizens, public or private. It is financially impossible. If the US tries to offer Swedish style services with the associated costs, we will end up looking more like India or Bangladesh than a western country. It will bankrupt us, as our higher costs drain our resources. Health care is a cost. It does not produce anything. It is more like money spent on defense. It is an industry that is supported by the rest of the citizens of the country. It is a luxury, not a divine right. Many of the countries with high marks on World Health Organization lists are in trouble financially. Italy, Greece, & Portugal have pretty high marks.. according to the WHO. I'm not sure of their data or agenda, but I'll take their rankings at face value.

Like most statistics, anything can be spun to prove almost anything. Either side of a debate can use the same data to prove their points. Charts & graphs are fun.. they look good & imply authority on a topic.  They provide interesting data.. but there are so many variables that it is hard to draw any hard conclusions about the data, except that there are a lot of variables! .. and that statistics are fun for bean counting nerds.

But i will draw one conclusion from this.. it is a conclusion i had already made so it was easy to spin the data to fit my pre-conceived notion:

Larger countries have more trouble providing good health care for their citizens. It is more practical to do it on a smaller, local level, where the actual services are offered.

If we can grasp this, we will return this sort of responsibility to the state & local level, rather than have the Fed. try to manage it. You get the least bang for your buck when the federal govt. does anything. Why would we even want them to do this? Keep it simple. Keep it local. Bigger is not better, when it comes to efficiency in govt.

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