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Politics : Politics for Pros- moderated -- Ignore unavailable to you. Want to Upgrade?

To: JohnM who wrote (109426)	4/15/2005 3:35:02 PM
From: aladin	Read Replies (1) \| Respond to of 793624

John, Krugman's argument is at the macro level, that we spend more and, in the aggregate, get less. Its more complicated than that John. I think we spend more AND get more, but we may not be cost effective. We are spending maybe double some other societies, but maybe only getting 25% more. On the equivalency issue - you (and all of us) need to calibrate our discussions and stats. For example - Cuba advertises outrageously good health numbers. What gets reported is the lower infant mortality rate, but under the covers they have a much higher stillborn rate than we do. Combine the two and you see that despite a much less homogeneous population and higher drug use rate we actually have a lower rate of infant death. This kind of stats usage also occurs with Western European and Canadian data. The reality is that if you are middle class or above with health benefits you are better off here. If you are without health benefits you are better off in a state system. Our problem is the uncovered, not the quality of care. John

To: JohnM who wrote (109426)	4/15/2005 4:22:19 PM
From: TimF	Respond to of 793624

Krugman's argument is at the macro level, that we spend more and, in the aggregate, get less. We spend more that is for sure, but the contention we get less is very debatable. Also part of the reason we spend more is that we do in effect give a subsidy to much of the rest of the world. New drugs (including drugs developed outside of America) get a high rate of return in the US. That high rate of return encourages a lot of investment despite the fact that in many other countries drug prices are controlled in one way or another. (This effective subsidy is someone mitigated by the fact that we tend to have lower prices for generics then most other developed countries). Both sides of the debate often make the mistake of calling the US health care system a "private" or "market" system. There is a lot of government involvement in the US system. If we are going to have that level of involvement we could work to make the government involvement more efficient without increasing it. Tim