Some reasons why we spend so much on health care

One of the key arguments underpinning Democrats’ push for health-care reform is that not only do we spend more money on health care than other rich countries, but we get less for it. In particular, critics cite international statistics showing that our life expectancy is lower than that of people in France, Japan and other countries.

Well, the New York Times’ John Tierney reports on a study that may have just put paid to the notion that our health-care system is responsible for our lower life expectancy. Samuel Preston, a demographer and expert on mortality rates from diseases at the University of Pennsylvania, says we are not “in dire straits” according to his review of the international data. Writes Tierney:

No one denies that the American system has problems, including its extraordinarily high costs and unnecessary treatments. But Dr. Preston and other researchers say that the costs aren’t solely due to inefficiency. Americans pay more for health care partly because they get more thorough treatment for some diseases, and partly because they get sick more often than people in Europe and other industrialized countries.

(snip)

…there are many more differences between Europe and the United States than just the health care system. Americans are more ethnically diverse. They eat different food. They are fatter. Perhaps most important, they used to be exceptionally heavy smokers. For four decades, until the mid-1980s, per-capita cigarette consumption was higher in the United States (particularly among women) than anywhere else in the developed world.

In fact, according to Preston, smoking alone is responsible for our being at the bottom of longevity rankings rather than in the top half — and we might be able to close the longevity gap further if more of us would just quit smoking.

Read the whole thing.

21 comments Add your comment

Road Scholar

September 23rd, 2009
7:30 am

I find it interesting that the report states that people in the US smoke more than those in Europe and Asia, esp the French and Germans. What are the differences in salaries and profit margins for those who work in the industry? Americans are more overweight.

I wish the Repubs would document the 80% of the health plan that they are alledgedly in agreement with. And then document the 20 % and reasons for their rejection. Only then can we get passed the stall tactics they are using. Isn’t that what constuctive dialogue is about? Or are they just too lazy, non-committal, or, even worse, just lying?

Jimmy62

September 23rd, 2009
8:11 am

Actually, Road Scholar, it very specifically says that Americans smoked more till the mid 1980’s.

The GOP has suggested many a free market based reform, and gets ignored. Maybe the Dems should learn some bipartisanship themselves and look at some ideas that don’t mean a massive government expansion.

TRUTH

September 23rd, 2009
8:41 am

Please post the link to the Republican Health Care plan that was not written by the insurance industry.

David Axelfraud

September 23rd, 2009
8:56 am

Obamalamadingdong said he had a health care plan two weeks ago. Where is this plan he speaks of?
Oh yeah, HE DOESN’T HAVE ONE. JUST LIKE HE DOESN’T HAVE A PLAN FOR THIS RECESSION, THE TWO WARS WE ARE IN AND EVERY OTHER PROBLEM.

OBAMA/BIDEN CHAINS WE CAN BELIEVE IN! YES WE CAN! POOOOOOOOOOOOOOT

jconservative

September 23rd, 2009
9:08 am

If smoking is a problem why do we not just simply outlaw cigarettes?
Oh yeah, we tried, Republicans blocked it.
If being fatter is a problem why don’t we just block certain foods from the school lunch programs?
Oh yeah, we tried, Democrats blocked it.

Kyle this column has nothing to do with the debate on health care.
We smoke, we are fat & we drink to much & get to little exercise.

But what are we going to do to control the exploding cost of health care?

Joan

September 23rd, 2009
9:39 am

Americans tend to excess, and excess is bad. There are way to many gluttons in this country. So, we are killing ourselves with obesity. I have read that it would lower healthcare costs about 1/3 in this country if we would just resume “human” weights. But the costs in this country aren’t just due to this. They are to due to the lack of tort reform. When an ambulance chaser sues your doctor in a BS case, the doctor (insurance) settles. In other countries, the doctor would fight, and if the ambulance chaser lost he would pay the costs and fees. Tort reform is essential to cutting costs (of course Democrats won’t hear of it as they are in the trial lawyers’ pockets).

Chris Salzmann

September 23rd, 2009
11:00 am

Joan September 23rd, 2009 9:39 am SAID: Americans tend to excess, and excess is bad. There are way to many gluttons in this country. So, we are killing ourselves with obesity. I have read that it would lower healthcare costs about 1/3 in this country if we would just resume “human” weights.
CHRIS SAYS: And the tax of sugar drinks would help reduce that consumption. But that would encroach on personal freedoms, right? I don’t see the difference between taxes on alcohol/tobacco and taxing sugared drinks.

Joan September 23rd, 2009 9:39 am SAID: But the costs in this country aren’t just due to this. They are to due to the lack of tort reform. When an ambulance chaser sues your doctor in a BS case, the doctor (insurance) settles. In other countries, the doctor would fight, and if the ambulance chaser lost he would pay the costs and fees. Tort reform is essential to cutting costs (of course Democrats won’t hear of it as they are in the trial lawyers’ pockets).
CHRIS SAYS: Joan, Tort reform is a pipe dream that is being pedaled by the insurance industry and their Republican allies. BTW, we have Tort Reform in some states, Georgia and Texas come to mind, among others. There has been no impact on costs in these two states whatsoever. So where are all the savings? Tell your Republican friends to ask their buddies in the insurance industry.

David Axelfraud

September 23rd, 2009
11:59 am

Chris Salzmann, no one is saying that insurance companies are innocent. Insurance companies have a lot of the blame to bare. But, if insurance companies were allowed to compete between states the cost would go down. SIGNIFICANTLY. Democrats are just as much to blame as Republicans.

David Axelfraud

September 23rd, 2009
12:12 pm

In other news, Obama just gave America to our enemies. He says we are no longer a super power. His words.

Bottom line: the democrat party is communist.

Joan

September 23rd, 2009
1:02 pm

Chris: Where is it written that the government has the duty to keep people slim? Doesn’t personal responsibility play any part in your world? People have a duty to themselves and their fellow citizens to live healthfully, and to be productive. That duty has been forgotten.
About the tort reform, it is important. I served on a jury in Georgia, in a medmal against two young gynecologists. It was slam/dunk for the defense to a thinking person, yet 5 people voted to give the plaintiff some money. Happily we were able to disuade them, but the people who wanted to give the money had no concern for the continuing reputation and practice of the doctors. A doctors reputation is of super importance. There are lots of people in this country for whom the word “reputation” is a foreign concept, ergo, you see people making idiots of themselves all the time on reality shows and the like.

Chris Broe

September 23rd, 2009
1:36 pm

We could lower health care cost by using Khadafi’s tent for triage!

Odd Couples: Kahdafi and Trump. Whose the apprentice?

They both should be fired, if you ask me.

Along with Lyle Kingfield. Anyone notice how Lyle K, B. Barr and other partisan foam never actually have a point of view? It’s just, “Some people like it and some people dont, I dont know, wow, who knew? What a crazy world it is, eh? Oh well. la dee dah. I can’t believe I just said La Dee Dah, I mean it’s so stupid, you know?”

But Lyle Kingfield’s distracting, non sequitur piece above is especially aggregious. Smoke less? Eat less? It doesn’t matter why our nation’s healthcare needs a splint. Lyle Kingfield should get a Medical degree, and then argue with the Mayo Clinic and discover how much diagnostic talent he has.

State-of-the-Union Healthcare reform must evolve with the reality of the state of our bunion’s health. We must face the existing crisis as it appears, not as we wish it were. Lyle Kingfield can wish we were all German or French if he wants, but then he better remember the horrors of Leiderhosen and the shame of the Croissandwich before he changes our flag just so we might smoke less.

Sunshine patriots, cornpone opinions, and hacks are a dime a dozen. Good presidents like Obama are rare.

Kyle Wingfield

September 23rd, 2009
2:17 pm

For those who don’t think this has anything to do with the health-care debate: Of course it does. As I said, a large part of the premise that we have a health-care “crisis” is that we are spending so much money AND allegedly not getting as much in return as countries that spend less. But if we are spending more money because we need more care — whether due to smoking, eating fatty foods, having bad genes, whatever — then perhaps we are getting value for our spending. In which case it doesn’t stand to reason that we need to cut down on health spending until we’ve addressed those other problems.

David Axelfraud

September 23rd, 2009
2:23 pm

Chris Broe, are you Chad Harris by chance?

NetBanker

September 23rd, 2009
2:59 pm

Very interesting that Americans get sick more than people in other industrialized nations. I wonder if it’s that we really do get sick more frequently or is this really a reflection of our ‘instant gratification’ society that sends people to the doctor demanding anti-biotics at the first sniffle and cough? I was taught to wait 5-7 days when you got sick and if you weren’t feeling better at that point you see the doctor. Of course that was before the days of the HMO when you could actually get in to see a doctor same day or tomorrow when you’re sick. Now you call and the first available appointment is in 2 weeks.

Cutty

September 23rd, 2009
3:03 pm

The cigarette lobby had to be strong-armed from advertising their habit to kids, the FDA finally received a financial boost in February but has had depleted resources for years, and big corporations seem to get what they want from Congress no matter how bad it may screw the people.

Do tell your plan to lower health care costs via the method you proposed. Eric Cantor recently told one of his constituents who had a friend dying from a stomach ailment to enroll in one of the many government programs or find a charity willing to assist her. Although he’s against government intervention.

jconservative

September 23rd, 2009
3:45 pm

Joan September 23rd, 2009 9:39 am
“So, we are killing ourselves with obesity…”

True. And the kicker is that we subsidize the US sugar industry.

So we spend money to make more sugar to make more people fat so we can spend more money on health care.

Is this a great country or what?

Kyle Wingfield

September 23rd, 2009
4:58 pm

Now, now, jconservative. We do put tariffs on that evil sugarcane from Brazil…

reality

September 23rd, 2009
5:29 pm

All I know is that metro Atlanta is devastated, we have loss of life, power is out, and water is cut off in many counties. Barack Obama, FEMA, and the Federal government are no where to be found and have been silent on help with the damage. Hope and change my azz.

Chris Salzmann

September 23rd, 2009
6:24 pm

Joan September 23rd, 2009 1:02 pm SAID: Chris: Where is it written that the government has the duty to keep people slim? Doesn’t personal responsibility play any part in your world? People have a duty to themselves and their fellow citizens to live healthfully, and to be productive.

CHRIS SAYS: Joan, you could say the same for taxing alcohol and especially tobacco. As far as your argument that “People have a duty to themselves and their fellow citizens to live healthfully”, that doesn’t fly in the real world. Why? Because there are a lot of people out there who have illnesses that have nothing to do with “living healthfully”. Cancer (most types) or mental disorders is just a few examples of that. You can’t in reality “blame” folks for falling victim to either. Also the fact that since most folks get their health insurance through their jobs, then losing a job is doubly traumatic for these folks who themselves, or have family members who are sick and disabled. A civilized society is judged on how it cares for its weakest members, than the other way around.

Here a little experiment for you: As a country, we spend about $7200 per person on health care. Yet, we are ranked 37 in the world. France spends about $3600 per person on health care and are rated 1 in health care. They also on average live longer than we do. What’s wrong with that picture? Suppose I went to a store to buy a suit and was quoted a price of $720 for a suit. I go to the store next door and find a BETTER suit for $360. Would you recommend I buy the $720 suit? That would be stupid now, right? That’s where we are right now in this country with the politicians and the health insurance industry telling us to buy the $720 suit, flaws and all. And you agree to that?

Chris Salzmann

September 23rd, 2009
6:34 pm

Kyle Wingfield September 23rd, 2009 2:17 pm SAID: For those who don’t think this has anything to do with the health-care debate: Of course it does. As I said, a large part of the premise that we have a health-care “crisis” is that we are spending so much money AND allegedly not getting as much in return as countries that spend less. But if we are spending more money because we need more care — whether due to smoking, eating fatty foods, having bad genes, whatever — then perhaps we are getting value for our spending. In which case it doesn’t stand to reason that we need to cut down on health spending until we’ve addressed those other problems.

CHRIS SAYS: Kyle, wouldn’t taxes and/or surcharges on harmful ingredients then discourage consumption? For example, taxing a can of regular coke, which has the equivalent of 10 teaspoons of sugar, should significantly cut down consumption and in the long run, health risks. We do the same for tobacco. Here’s another point for those talking about “personal responsibility”: We ban the distribution and sale of heroine, cocaine, crack, LSD, etc. Why shouldn’t we use the “personal responsibility” argument and allow these drugs?

marcosalberto

October 9th, 2009
7:25 am

some basic considerations about stats (averages) will help here:

there are more smokers in europe.

but their health stats seem to be similar to those of european non-smokers, since

crass differences between europe and the usa –in europe’s favor– disappear when you remove smokers from the comparison.

this means that usa smokers fare horribly compared to european smokers (or, much less likely, that european smokers have much better health stats than european non-smokers).

it’s almost sure that usa smokers fare much much worse than european ones, simply because smoking is a lower-class thing in the usa.

so among usa smokers there must also be many more diabetics, drug addicts, alcoholics, reckless drivers, wife beaters, hypertension acrobats, overweighters, etc, i.e., people who do all those things that make “life worth living”TM.

in other words, the usa’s “melting pot”TM not only segregates by race and class, but also by morbidity, three things that because of “manifest destiny”TM tend to coincide!

the country indeed gives the poor and the lower middle class the “freedoom to choose”TM to be diabetics, drug addicts, alcoholics, reckless drivers, wife beaters, hypertension acrobats, or overweighters, etc, a very diverse “plethora of opportunities”TM to choose from, opportunities that these less deserving classes like to take as a combo more often than not.

obviously europeans are not enjoying these basic freedoms as freely –oh freedom! as aretha would put it– (although europeans have been catching up thanks to the recent efforts for “labor flexibility”, “private pensions”, by some of their most illuminated –if venal– leaders and intellectuals).

so the innocuous exclusion of smokers “for fairness” by the authors removed many of the most self-destructive poor and under-insured people from the usa data and left more affluent, better educated, more health-conscious upper-class usa people to be compared with a more random segment of the european population. not exactly fair, one would say.

one has to wonder though if the authors did not know about this in advance and, if they did not, why on earth they chose not to dissect the above superior health of european smokers that the effect of the smokers’ exclusion made evident.