Health vs. Politics in US Healthcare

Here are two very simple sets of information for you to consider.

1) OECD Health Data 2006: How Does the United States Compare?

Amongst the Organisation for Economics Cooperation and Development, the US spends a lot more money on healthcare, in total and per capita.

Between 1999 and 2004, health spending per capita in the United States increased in real terms by 5.9% per year on average, a growth rate exceeding the OECD average of 5.2% per year.

Over the past decade, the share of health expenditure spent on pharmaceuticals in the United States increased from 8.5% of total health spending in 1994 to 12.3% in 2004. This remained below the OECD average of 17.7%. In 2004, the United States was the top spender on pharmaceuticals (with 752 USD per capita), followed by France.

The public sector is the main source of health funding in all OECD countries, except for the United States and Mexico. In the United States, only 45% of health spending is funded by government revenues, well below the average of 73% in OECD countries. The public share of total health spending remains the lowest among OECD countries. On the other hand, private insurance accounts for 37% of total health spending in the United States, by far the largest share among OECD countries. Beside the United States, Canada, France and the Netherlands also have a relatively large share of health spending paid by private insurance (more than 12%).

OECD health expenditure

But in terms of health outcomes?

Resources in the health sector (human, physical)

Despite the relatively high level of health expenditure in the United States, there are fewer physicians per capita than in most other OECD countries. In 2004, the United States had 2.4 practising physicians per 1 000 population, below the OECD average of 3.0.

There were 7.9 nurses per 1 000 population in the United States in 2002, which is slightly lower than the average of 8.3 across OECD countries.

The number of acute care hospital beds in the United States in 2004 was 2.8 per 1 000 population, also lower than the OECD average of 4.1 beds per 1 000 population. As in most OECD countries, the number of hospital beds per capita has fallen over the past twenty-five years, from 4.4 beds per 1 000 population in 1980 to 2.8 in 2004. This decline has coincided with a reduction in average length of stays in hospitals and an increase in day-surgery patients.

Health status and risk factors

Most OECD countries have enjoyed large gains in life expectancy over the past 40 years. In the United States, life expectancy at birth increased by 7.6 years between 1960 and 2003, which is less than the increase of over 14 years in Japan, or 8.6 years in Canada. In 2003/4, life expectancy in the United States stood at 77.5 years, below the OECD average of 78.3 years. Japan, Iceland, Switzerland, Sweden and Australia were the 5 countries registering the highest life expectancy.

Infant mortality rates in the United States have fallen greatly over the past few decades, but not as much as in most other OECD countries. It stood at 6.9 deaths per 1 000 live births in 2003, above the OECD average of 5.7.1 Among OECD countries, infant mortality is the lowest in Japan and in the Nordic countries (Iceland, Sweden, Norway and Finland), with rates all below 3.5 deaths per 1 000 live births.

That’s the first set of information. The second,

2) Surgeon General Sees 4-Year Term as Compromised

WASHINGTON, July 10 — Former Surgeon General Richard H. Carmona told a Congressional panel Tuesday that top Bush administration officials repeatedly tried to weaken or suppress important public health reports because of political considerations.

The administration, Dr. Carmona said, would not allow him to speak or issue reports about stem cells, emergency contraception, sex education, or prison, mental and global health issues. Top officials delayed for years and tried to “water down” a landmark report on secondhand smoke, he said. Released last year, the report concluded that even brief exposure to cigarette smoke could cause immediate harm.

Dr. Carmona said he was ordered to mention President Bush three times on every page of his speeches. He also said he was asked to make speeches to support Republican political candidates and to attend political briefings.

Dr. Carmona testified under oath at a hearing before the House Oversight and Government Reform Committee headed by Representative Henry A. Waxman, Democrat of California. The topic was strengthening the office of the surgeon general. Dr. C. Everett Koop, surgeon general in the Reagan administration, and Dr. David Satcher, surgeon general during the Clinton administration and the first year of the administration of George W. Bush, also testified.

Each complained about political interference and the declining status of the office. Dr. Satcher said that the Clinton administration discouraged him from issuing a report showing that needle-exchange programs were effective in reducing disease. He released the report anyway.

Dr. Koop, said he had been discouraged by top officials in the Reagan administration from discussing the AIDS crisis. He did so anyway.

All three men urged major changes in the way the surgeon general is chosen and the way the office is financed.

“Compromised” seems rather the understatement. The rest of the article is worth reading. I’m too lazy to go through this linking things, as I usually try to do. It’s hot, I have a headache and I’m also very lazy – did I mention that?

Related to this is the incredibly entertaining exchange between Michael Moore and the utterly non-respectable Wolf Blitzer, which can be found over at Crooks and Liars. Part One here, Part Two here.

Many people love to hate Moore (plenty of whom I know personally), the way he does things and the manner in which he employs statistics. Given the fact that he’s typically correct, and given the likes of the two sets of information above, I’m not one of those people. His willingness to go on people’s TV shows and tell them to their faces (this was not the first such time) that they’re willfully making Americans ignorant only adds to his charm.


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