In his weekly column, David Leonhardt tells readers that the problem with the U.S. health care system is not waste, rather we are getting what we pay for. I'll leave it to others to assess the value of good health and longer life expectancies, I'll simply point out that everyone else seems to get much more for what they pay. As I've noted before, every other wealthy country enjoys longer life expectancies than the United States and they pay on average less than half as much per person. We can also say the same thing about the change in spending over the last 35 years, with the increase in spending in the United States vastly exceeding the increase in spending in other countries, with no corresponding gains in outcomes. For example, while life expectancy incrased by 5.9 years between 1970 and 2000 in the United States, it increased by 6.4 years in Canada. Over roughly the same period, Canada's per person health care spending went from 85 percent of the U.S. level in 1970 to 52 percent in 2003. Life expectancy in Germany increased by 8.0 years, while its per capita health spending went from 76 percent of U.S. levels in 1970 to 53 percent in 2003. France had a gain of 6.8 years, although its spending levels only dropped from 58 percent in 1970 to 53 percent in 2004. Norway and Sweden did have smaller gains than the U.S., but their life expectancies are still 1.9 years and 2.9 years longer than ours, respectively. (They pay 65 percent and 48 percent as much per capita as the United States, respectively.) Maybe the benefits from our health care spending are worth the cost, but then everyone else in the world seems to be getting a really good deal. Where oh where are the proponents of free trade?
--Dean Baker
