Home > Uncategorized > Life expectancy vs. health expenditure

Life expectancy vs. health expenditure

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  1. John deChadenedes
    May 25, 2022 at 2:24 am

    What is missing from this graph is data showing “Porsche purchases per medical professional”, “Second home ownership per medical degree”, and “Admiration quotient as a function of personal income by country”. I think this data would cast an entirely different light on the picture, which otherwise – inexplicably – appears to show that the US is not getting its money’s worth from so-called ‘health expenditures’.

    • May 25, 2022 at 2:30 pm

      You might want to some measure of arrogance or self esteem by country, too.

  2. yoshinorishiozawa
    May 27, 2022 at 2:22 am

    This figure reminds me of a joke often told in 1980’s in Japan: If the health expenditure increases at the present rate, the total health expenditure will exceed the GNP.

    In my impression, the conspicuous lesson that this figure tells us must be how the lack of universal public health care insurance (the case of the USA) is expensive and ineffective. John and Charles seem to be missing the point. Accusing medical doctors and their greediness does not help to change the situation.

    • Meta Capitalism
      May 28, 2022 at 12:27 pm

      A Moral Question
      .
      IF NIKKI WHITE HAD BEEN A RESIDENT OF ANY OTHER rich country, she would be alive today.
      .
      Around the time she graduated from college, Monique A. “Nikki” White contracted systemic lupus erythematosus; that’s a serious disease, but one that modern medicine knows how to manage. If this bright, feisty, dazzling young woman had lived in, say, Japan—the world’s second-richest nation—or Germany (third richest), or Britain, France, Italy, Spain, Canada, Sweden, etc., the health care systems there would have given her the standard treatment for lupus, and she could have lived a normal life span. But Nikki White was a citizen of the world’s richest country, the United States of America. Once she was sick, she couldn’t get health insurance. Like tens of millions of her fellow Americans, she had too much money to qualify for health care under welfare, but too little money to pay for the drugs and doctors she needed to stay alive. She spent the last months of her life frantically writing letters and filling out forms, pleading for help. When she died, Nikki White was thirty-two years old.
      .
      “Nikki didn’t die from lupus,” Dr.Amylyn Crawford told me.“ It was a lack of access to health care that killed Nikki White.” Dr. Crawford is a family physician at a no-frills community health center in an old strip mall in a downscale section of Kingsport, Tennessee. She sees lots of hard cases. Still, she couldn’t stop sobbing as she recalled her late patient Monique White: “I told Nikki that she had lupus. But I also told her that a diagnosis of lupus is not a death sentence. If Nikki had not lost her health insurance, she’d be alive today.” (The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care” by T. R. Reid – https://a.co/hXOW1Xc )
      .
      (….) But the larger tragedy is that Ms. White is not alone. Government and academic studies report that more than twenty thousand Americans die in the prime of life each year from medical problems that could be treated, because they can’t afford to see a doctor. On September 11, 2001, some three thousand Americans were killed by terrorists; our country has spent hundreds of billions of dollars to make sure it doesn’t happen again. But that same year, and every year since then, some twenty thousand Americans died because they couldn’t get health care. That doesn’t happen in any other developed country. Hundreds of thousands of Americans go bankrupt every year because of medical bills. That doesn’t happen in any other developed country either.
      .
      Those Americans who die or go broke because they happened to get sick represent a fundamental moral decision our country has made. Despite all the rights and privileges and entitlements that Americans enjoy today, we have never decided to provide medical care for everybody who needs it. The far-reaching health care reform that Congress passed in 2010 is designed to increase coverage substantially—but it will still leave about 23 million Americans uninsured. Even when “Obamacare” takes full effect, the American health care system will still lead to large numbers of avoidable deaths and bankruptcies among our fellow citizens. As we saw in the national debate over that bill, efforts to increase coverage tend to be derailed by arguments about “big government” or “free enterprise” or “socialism”—and the essential moral question gets lost in the shouting. (The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care” by T. R. Reid – https://a.co/6FJ4v2g )

      .
      Market fundamentalism is at its core an ideological and moral question and is why Americans are dying and going bankrupt when faced with medical emergencies. Even routine healthcare is too expensive for many. America could learn something from Japanese healthcare.

    • Meta Capitalism
      May 29, 2022 at 1:27 am

      Mr. Fenwood had a cow but no place to pasture her. So he went to see his neighbor, Mr. Potter, and offered to pay Potter twenty dollars a month to keep the cow in Potter’s pasture. Potter agreed. Several months went by. The cow was pastured at Mr. Potter’s, but Mr. Fenwood had never given Mr. Potter any money. Finally, Mr. Potter went to see Mr. Fenwood and said, “I know you’ve been struggling financially, so how about if we strike a deal? I’ve had your cow now for ten months, so you owe me $200. I figure that’s about what the cow is worth. How about if I just keep the cow and we’ll call it square?”
      .
      Fenwood thought for a minute and said, “Keep her one more month and you’ve got a deal!” (Cathcart & Klein, Plato and a Platypus Walk Into a Bar…: Understanding Philosophy Through Jokes, pp. 164-165)
      .
      John and Charles seem to be missing the point. Accusing medical doctors and their greediness does not help to change the situation. (Shiozawa, Possibly Missing the Sarcasm, RWER, 5/27/2022)

      .
      Possibly, Shiozawa, you are misreading sarcasm for a literal statement; kind of like the jokes poking fun about the if-pigs-could-fly assumptions used by economists–e.g., distinction without a difference. Of course, not all economists are such dolts. I interpreted John making a rather tongue-in-cheek sarcastic comment about the perverted upside-down values of American society with regards to healthcare being treated as just another market commodity and not a public good–i.e., a common good–better handled collectively rather than left to be dealt with by individuals alone without any collective help via social institutions based upon government regulation along with a mix of public-private services that are so common in countries with universal healthcare. It is easy to scapegoat doctors though, and Dean does it very frequently on this forum (which shows he really doesn’t understand the healthcare system very well). The major drivers of healthcare costs in the US are not doctor’s salaries but hospitals, insurance companies, big pharma drugs, medical equipment, education costs, etc. I know many doctors in the US who welcome a shift to a universal healthcare system in line with other advanced developed countries. Personally, I think the only solution is to address the problem in America by addressing the entire system, not piece-meal fixes that only pit one group against another without really addressing the systemic problems in the system as whole. But that requires a population wise enough to make the right moral, ethical, and political choices. Unfortunately, given the recent mass murder of children and the usual “guns don’t kill people,” and “the only way to deal with a crazy bad guy with a gun is good child, eh, baby with a gun” stupidity parroted by the GOP and NRA that doesn’t seem likely anytime soon. We cannot even address the epidemic of gun violence by mentally disturbed individuals–a healthcare issue if there every was one–let alone universal healthcare.
      .
      As I write this from Osaka Japan my wife and I are dealing with two end-of-life care experiences. One experience, here in Japan; her father has Alzheimer’s disease and is quickly losing his mind. Her mother simply cannot care for him alone anymore. While we do provide some financial support for her parents, we don’t need to worry about being force into bankruptcy or seeing her parents left destitute on the street because of lack of money. There are many state and private (public-private partnerships) resources that are making this experience so much more manageable. He has a close-by daycare facility just down the road where he can go and be cared for, with good meals, exercise, and social activities, that give his wife a break to recover emotionally from the constant care. In more ways than I can share here there are here in Japan a first-rate healthcare system (no place is perfect, of course) that supports these end-of-life transitions. The other experience is my own mother’s stroke that left here unable to care for herself recently back in the US. As we prepare to go to the states to help we are faced with a very different situation.
      .
      Economics cannot be disentangled from moral, ethical, and socio-political policy questions. That is the delusion of those who think economics is about finding hidden laws and the invention of socio-mathematics that uncover hidden mysteries of nature like how physics discovers the neutrino. This is scientism. Yes, we should be careful to make sure our ideals are tempered by pragmatism and the evidence and facts of how people actually behave in certain situations; this is where applied economics comes in. But first we must decide what values, what meanings, what mix of individual vs. collective responsibility will address our social provisioning in all its myriad forms. What we cannot do is let the Econocracy decide those values for us based upon hidden ideologies masquerading as science.

    • Meta Capitalism
      May 29, 2022 at 10:51 pm

      Mr. Fenwood had a cow but no place to pasture her. So he went to see his neighbor, Mr. Potter, and offered to pay Potter twenty dollars a month to keep the cow in Potter’s pasture. Potter agreed. Several months went by. The cow was pastured at Mr. Potter’s, but Mr. Fenwood had never given Mr. Potter any money. Finally, Mr. Potter went to see Mr. Fenwood and said, “I know you’ve been struggling financially, so how about if we strike a deal? I’ve had your cow now for ten months, so you owe me $200. I figure that’s about what the cow is worth. How about if I just keep the cow and we’ll call it square?”
      .
      Fenwood thought for a minute and said, “Keep her one more month and you’ve got a deal!” (Cathcart & Klein, Plato and a Platypus Walk Into a Bar…: Understanding Philosophy Through Jokes, pp. 164-165)
      .
      John and Charles seem to be missing the point. Accusing medical doctors and their greediness does not help to change the situation. (Shiozawa, Possibly Missing the Sarcasm, RWER, 5/27/2022)

      .
      Possibly, Shiozawa, you are misreading sarcasm for a literal statement; kind of like the jokes poking fun about the if-pigs-could-fly assumptions used by economists–e.g., distinction without a difference. Of course, not all economists are such dolts. I interpreted John making a rather tongue-in-cheek sarcastic comment about the perverted upside-down values of American society with regards to healthcare being treated as just another market commodity and not a public good–i.e., a common good–better handled collectively rather than left to be dealt with by individuals alone without any collective help via social institutions based upon government regulation along with a mix of public-private services that are so common in countries with universal healthcare. It is easy to scapegoat doctors though, and Dean does it very frequently on this forum (which shows he really doesn’t understand the healthcare system very well). The major drivers of healthcare costs in the US are not doctor’s salaries but hospitals, insurance companies, big pharma drugs, medical equipment, education costs, etc. I know many doctors in the US who welcome a shift to a universal healthcare system in line with other advanced developed countries. Personally, I think the only solution is to address the problem in America by addressing the entire system, not piece-meal fixes that only pit one group against another without really addressing the systemic problems in the system as whole. But that requires a population wise enough to make the right moral, ethical, and political choices. Unfortunately, given the recent mass murder of children and the usual “guns don’t kill people,” and “the only way to deal with a crazy bad guy with a gun is good child, eh, baby with a gun” stupidity parroted by the GOP and NRA that doesn’t seem likely anytime soon. We cannot even address the epidemic of gun violence by mentally disturbed individuals–a healthcare issue if there every was one–let alone universal healthcare.
      .
      As I write this from Osaka Japan my wife and I are dealing with two end-of-life care experiences. One experience, here in Japan; her father has Alzheimer’s disease and is quickly losing his mind. Her mother simply cannot care for him alone anymore. While we do provide some financial support for her parents, we don’t need to worry about being force into bankruptcy or seeing her parents left destitute on the street because of lack of money. There are many state and private (public-private partnerships) resources that are making this experience so much more manageable. He has a close-by daycare facility just down the road where he can go and be cared for, with good meals, exercise, and social activities, that give his wife a break to recover emotionally from the constant care. In more ways than I can share here there are here in Japan a first-rate healthcare system (no place is perfect, of course) that supports these end-of-life transitions. The other experience is my own mother’s stroke that left here unable to care for herself recently back in the US. As we prepare to go to the states to help we are faced with a very different situation.
      .

      The state and the market are complementary, not mutually exclusive. The market needs regulation; the state needs competition and incentives. (Tirole, Jean. Economics for the Common Good (p. 10). Princeton University Press. Kindle Edition.)

      Economics cannot be disentangled from moral, ethical, and socio-political policy questions. That is the delusion of those who think economics is about finding hidden laws and the invention of socio-mathematics that uncover hidden mysteries of nature like how physics discovers the neutrino. This is scientism. Yes, we should be careful to make sure our ideals are tempered by pragmatism and the evidence and facts of how people actually behave in certain situations; this is where applied economics comes in. But first we must decide what values, what meanings, what mix of individual vs. collective responsibility will address our social provisioning in all its myriad forms. What we cannot do is let the Econocracy decide those values for us based upon hidden ideologies masquerading as science.

  3. June 1, 2022 at 3:29 pm

    Sometimes a graph says more than a thousand words …

    • Meta Capitalism
      June 2, 2022 at 12:23 am

      So true; for example, NPR’s graph on the rate of gun violence in America compared to the world.

      • June 3, 2022 at 7:56 am

        Sad indeed to see!

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