Spending on Healthcare

Regarding healthcare, another argument that I find bizarre is “other developed nations spend a lot less on healthcare and get better results.” This statement doesn’t even attempt to take into account the differences in lifestyle that have an enormous impact on health.

How much physical activity do people in those countries get? How much time do they spend in their cars? What do they eat? What are the portion sizes? How high do they turn up the thermostat in winter? I just saw a photo of a thermostat in a Norwegian family’s home. It’s at 15°C. That’s 59°F. In Norway. In January. My thermostat is at 71°C, even though I know that I should go way down for health reasons.

If you want to have the unhealthiest lifestyle known to humanity and live as long or almost as long as people who have a much healthier diet and habits, then of course you will pay a lot more for healthcare.

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6 thoughts on “Spending on Healthcare”

  1. And then there are just the vast population and topological differences between the US and other developed countries. There are states as big or bigger than European countries. And even when they’ve normalized for that, there’s also the tax differences.

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    1. Exactly. It isn’t even working very well in Canada with its population of 30 million. We have 10 times more people here. And then some if we count illegal immigrants.

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    2. The size of the state is irrelevant when statistics are calculated on percentage or per capita basis. In fact, US per capita spending is double that of the next closest country, and we rank 50th if life expectancy. The huge variation between different parts of the US reflects lifestyle as well as access to doctors and quality of care — life expectancy ranges from 88 years in NYC and the LA area to 59 years in parts of South Dakota, and 67 years in most of the Midwest and South. (Yes, these data are available on a county basis for the US. The map is shown in one of my blog posts.) Now, smog and all, you’re going to tell me that New Yorkers live a healthier lifestyle than folks in Iowa? If not lifestyle, what explains why they go 20 years longer?

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      1. The kind of industrial farming they do in Iowa involves lots of chemical exposure and that’s probably as bad as smog for the people who are exposed to it. Iowa also has pretty bad water quality due to poorly controlled agricultural run off.

        Access to medical care is also not great in rural areas and people are much more likely to die in critical situations. Imagine you had a heart attack, or a stroke, or a serious car or tractor accident in a place like rural Ringgold County, Iowa with a population just over 5,000 people, a 16 bed hospital, and at least an hour and a half drive to any place substantially larger. How long does it take someone to find you? How long does it take an ambulance to get there and get you to the county’s tiny local hospital? Will the emergency doctor who happens to be on duty (there is probably only one) have the right expertise and the right equipment and the right drugs for your problem? Can they stabilize you well enough for you to survive the helicopter flight to a proper hospital?

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      2. It matters when it comes to implementation. Countries that have these successful universal healthcare systems are all a hell of a lot smaller than the US — both topologically and population-wise.

        And yes, different areas of the states have very different populations. Take your example of NYC vs Iowa, disregarding pollution effects. NYC has a hell of a lot more access to public transportation. There are a lot of cars on the road, but relatively few people own them, if you look at the population as a whole. Iowa has about a third the population of NYC, and is spread over more area. So right there, you have more transportation issues. A lot of people have cars. There’s more highway space spread over the state, and fewer areas where people can just walk places. Since towns and cities are smaller and more spread out, people in Iowa won’t have access to the same kinds or qualities of food as people in NYC to the same amounts. You also have to take into account the amount spent on public health awareness, which is very high in NYC and likely a fair bit lower in Iowa. The average winter temperatures in Iowa are also a bit lower than those in NYC, which means more spent on heating and electricity for your average person. They also get more snow.

        Also, your stats are a little off. Your NYC stats are not the average for NYC, which is actually closer to the NYS average (about 76). Rather, the 88 figure is in one particular area of NYC, where people tend to be wealthier. Which means they have more access to different food, different and more specialized healthcare (without paying through the nose), etc.

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