Don't Fall Prey to Propaganda: Life Expectancy and Infant Mortality are Unreliable Measures for Comparing the U.S. Health Care System to Others
by David Hogberg, Ph.D.
How does the United States health care system fare when compared to the rest of the industrialized world? This is an important question. Accurately measuring our health care system relative to those of other nations can yield insight into the types of health care policies America should pursue.
New York Times columnist Paul Krugman has expressed the view that the U.S. health care system is inferior:
The United States spends far more on health care than other advanced countries. Yet we don't appear to receive more medical services. And we have lower life expectancy and higher infant mortality rates than countries that spend less than half as much per person. How do we do it?1
Life expectancy and infant mortality are two measures that are widely cited, yet seldom questioned. This is unfortunate, because life expectancy and infant mortality tell us little about the efficacy of a health care system.
This paper examines the deficiencies of using life expectancy and infant mortality to measure a health care system. It also examines the question: How should we measure a health care system?
Why Life Expectancy and Infant Mortality are Popular Measures
Type in the terms "life expectancy," "infant mortality" and "health care" into the popular search engine Google, and it will yield about 449,000 results. Clearly, linking these two measures to health care is very popular. It is easy to understand why.
Life expectancy and infant mortality are powerful tools for those who support some form of socialized medicine. On those measures the United States fares worse than all other industrialized nations. Most other industrialized nations have some form of government-run, universal health insurance. Thus, the reasoning goes, America's inferior performance on life expectancy and infant
mortality is due to its heavy reliance on a system of private sector care.
Paul Krugman is in good company. Liberal pundit Sebastian Mallaby recently lamented that the American health care system
...achieves shorter life expectancy than the British, French, German, Canadian or Japanese systems, but it eats up 16 percent of the resources in the economy, compared with between eight and 11 percent in those other countries. The difference - six percent or so of economic output - suggests that the waste in the American system comes to $700 billion a year.
He concludes that the "most plausible subsidizer of universal insurance is government, and the only entity with a stake in lifelong wellness is the government."2
A recent study that compared the U.S. to Canada and garnered some media attention used life expectancy as a measure of the efficacy of each nation's health care system. Noting that Canada spends about half as much on health care as does the U.S., the scholars stated, "Canadians live two to three years longer."3 The scholars concluded, "Universal health care attenuates inequities in health care and should be implemented in the United States."4
Physicians for a National Health Program, a vocal advocacy group, recently examined the health care systems in 16 industrialized countries. The only measures that the study used to compare the different nations were, not surprisingly, life expectancy and infant mortality.5 The Center for Economic and Policy Research, a Washington D.C. think tank that supports government-run health care, produced the following table. Using expenditure per capita on health care as a proxy for health care system, it shows that America spent more on health care but got less return than countries that had some form of universal health insurance. "The high costs and poor outcomes seem to stem from inefficiencies that are unique to the U.S. health care system," the Center for Economic and Policy Research claimed.6
nationalcenter.org |
