It’s a simple truism, often repeated, that other developed nations achieve better health outcomes than the US does despite spending less money on care.
A June 16 column in the New York Times was typical: “What Sweden Can Tell Us About ObamaCare.” Sweden spends less than half on health care per capita as the US, the author, Cornell University economist Robert Frank, points out, but achieves better outcomes by responding “efficiently” to treating illness, utilizing economies of scale for expensive procedures, and funding only treatments shown to be effective.
To accomplish these objectives, he says, the Swedish model relies heavily on government authority and nonprofit institutions — certainly far more than the Affordable Care Act does.
It’s all so obvious, simple, widely agreed upon among health-care experts — and completely irrelevant.
Yes, other nations do achieve better health outcomes, but this is almost entirely a matter of lifestyle (not “partly from lifestyle,” as Frank and so many others believe). Throughout the developed world, improvements in big things such as infant mortality, lifespan, even morbidity are almost completely attributable to diet; exercise; smoking, alcohol and drug usage; education; employment and income; family structure; environment; and community safety.
Next to these determinants, the additional contribution of more health care — along with its policy cousin, “access” to health care — is almost insignificant.
It may be more accurate to say that other developed countries achieve better health results not in spite of spending less on care, but because they spend less on care. In doing so, they free up resources — especially public resources — for the things that really matter: education, day care, recreation, even roads and bridges. In the US, our bloated health economy deprives other social needs of the resources required to genuinely improve and extend lives.
Bloomberg View