Nov
06
2007

Health care by the numbers


Providing health care for all is no easy task.: Photo by Neimster at Flickr.com

There’s been a lot of talk about the American health care system of late. And there’s going to be a lot more talk in the months ahead, as it becomes a campaign issue in the 2008 Presidential election. Gregory Mankiw, a professor of economics at Harvard, has crunched the numbers on health care, and found that some of the issues aren’t quite what they seem.

Lower life expectancy

Demographically and economically, the United States and Canada are fairly similar. Yet Americans, on average, die about two-and-a-half years sooner than our neighbors to the north. So health care in the US must be worse, right?

Not necessarily. Mankiw found that Americans, especially younger ones, are far more likely to die in an accident or a homicide than a similar Canadian. Take that away, and the difference virtually disappears. As Mankiw states, “Maybe these differences have lessons for traffic laws and gun control, but they teach us nothing about our system of health care.”

Infant mortality

In America, a higher percentage of babies die during infancy than in other countries. Ironically, this is not a sign that American health care is worse, but rather, that it is better.

In many countries, low-weight babies who are born not breathing are considered stillborn—doctors do not try to save them. American doctors do. In fact, America has the best rate of success with low-weight babies, simply because we are willing to take on these high-risk cases. But high risk also means high failure rate: despite the doctors’ best efforts, many of these babies die anyway, raising our infant mortality rate. In other countries, the baby is not counted as ever having been alive at all, making their rate appear low.

Also, Mankiw notes that low birth weight is associated with teen pregnancy, and America has a higher teen pregnancy rate than many other countries. While there are steps we can take to reduce that phenomenon, overhauling the way we pay for health care is not going to have any effect on teenagers’ behavior.

Millions of uninsured

Many politicians have noted that some 47 million Americans – nearly one in six – has no health insurance. Some of these people want health insurance, but can’t afford it, or can’t get it through their jobs. This is a real problem.

However, Mankiw notes that this 47 million includes a lot of other groups. Millions of poor people are already eligible for Medicaid, but have simply never enrolled. Millions more have been offered health insurance through their jobs, but declined. We could reduce the 47 million substantially, without changing a thing, just by getting these folks to sign up.

Mankiw notes that a large number of uninsured are illegal immigrants. Getting these people covered is a matter of immigration reform, not health care reform.



So, when you hear politicians throwing numbers around in the health care debate, remember: the story behind the numbers is often a lot different than the sound bites make it appear.

Meanwhile, here’s a possible solution to providing health care to the uninsured.

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