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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: TimF who wrote (31553)	11/21/2013 3:06:50 PM
From: TimF	1 Recommendation Recommended By Lane3 Respond to of 42652

Judging the Health Care Olympics Posted on November 5, 2013 Avik Roy writes, What’s just as interesting is that Japan, the country that tops the overall life expectancy tables, finished in the middle of the pack on cancer survival. He finds, as have others (John Goodman comes to mind), that the five-year cancer survival rates tend to be higher in the U.S. than in other countries. The one issue I would raise with this is that survival is measured from the point of diagnosis, so that if we diagnose cancer sooner (or diagnose more non-lethal cancers), then we would come out ahead on that measure. Roy continues, A few years back, Robert Ohsfeldt of Texas A&M and John Schneider of the University of Iowa asked the obvious question: what happens if you remove deaths from fatal injuries from the life expectancy tables? Among the 29 members of the OECD, the U.S. vaults from 19th place to…you guessed it…first. Japan, on the same adjustment, drops from first to ninth. I think this study offers more reason to believe that the U.S. is really number 1 when it comes to health care outcomes. Still, it may not show that the U.S. is number 1 in terms of cost-effectiveness of health care. My guess is that comparing the additional amount that we spend on health care to the additional longevity we obtain would yield a very large cost per year of life saved. I have long argued against using longevity statistics to judge what I once called the international health care Olympics. As I pointed out in that essay, it would lead policymakers to make some really perverse choices. But even if we are number 1 in terms of medically-treatable life expectancy, that is no reason to be complacent that our system is cost effective. This entry was posted in Economics of Health Care, links to my essays by Arnold Kling. Stuart Buck on November 5, 2013 at 12:09 pm said: I’d be very dubious about international comparisons of cancer “survival” rates unless I was confident that there was some way of controlling for differential rates of early detection and monitoring. The USA has a high breast cancer 5-year survival rate, and it has improved over time, but many people have pointed out that this could be largely an artifact of doing more early detection that sweeps in both: 1) early stage cases of DCIS that may never have been life-threatening in the first place, and 2) invasive cancer that still does kill women eventually, but since we caught it earlier, we get to count them as having “survived” for the 5 year period. Megan McArdle on November 6, 2013 at 6:38 am said: It’s not all early diagnosis; even if you compare cancers at similar stages, you see significant variation in survival rates. For example, cancerresearchuk.org Which is not to say that early-diagnosis of slow-growing cancers doesn’t play a role. arnoldkling.com