Just a small note as I start dipping into Paul Starr’s well-received book on national health care reform. In the introduction he mentions all the usual stats on U.S. vs international comparisons – spending more per capita than other developed countries, far greater incidence of avoiding medical care because of the cost, lower life expectancy, mediocre health outcomes for specific sub-sets of diseases – etc, etc, etc.
The one factor I wasn’t expecting was this tidbit (my emphasis in bold):
Since health expenditures vary directly with national income, the United States would be expected to spend more on health care than other countries did. But by the early 2000s, health spending was 42 percent greater in the United States than its income would predict. (p.5)
The footnote points to an issue of Health Affairs – found here– authored by Uwe E. Reinhardt, Peter S. Hussey and Gerard F. Anderson. The relevant paragraph (and point in bold from myself) from “U.S. Health Care Spending In An International Context:”
GDP per capita. No single factor explains the levels or rates of increase in health spending among industrialized countries.7 However, ability to pay, as measured by GDP per capita, has repeatedly been shown to be one of the most important factors.8 About 90 percent of the observed cross-national variation in health spending across the OECD countries in 2001 can be explained simply by GDP per capita. An estimated bivariate relationship between GDP per capita and per capita health spending predicts a U.S. per capita health spending level of $3,435 for 2001. The actual level, $4,887, is $1,452 or 42 percent higher than the predicted level.9 Both policymakers and clinicians need to examine what other factors can account for that remaining differential.
I’ve never heard or read this particular statistic, but it makes sense that a straight comparison on per capita spending would have some caveats. So yes, while we do spend more on health care in the country and that’s to be expected given our greater national income vis a vie these comparisons, it is still higher – 42 percent higher – than such a factor would predict.