Sunday, July 09, 2006

Health Care Costs

You often see comparison between how much the United States spends on health care vs. the anmount spent by European countries. The implication is usually that if only we adopted the French or British model of paying for health care, expenses would similarly go down.

This may be true as to one category of spending: administrative expenses. But it occurs to me that there are potentially many other areas where Americans are simply choosing to buy more health care than Europeans. Consider the following examples:

1. Elective plastic surgery. I don't know the overall statistics, but I have a strong hunch that Americans spend more per capita on facelifts, hair transplants, cosmetic dental procedures, breast surgery, etc., than do Europeans.

2. In-vitro fertilization. This procedure can cost tens of thousands of dollars. It is largely unregulated in America, but tightly regulated in Europe. Again, I have a hunch that Americans spend far more on this completely elective procedure, which is not only expensive in and of itself, but also leads to a higher rate of premature multiple births, which can cost hundreds of thousands of dollars.

3. Prescription drugs. As I alluded to earlier, a pharmacist friend of mine sees way too many situations in which people are relying on unnecessary, or needlessly expensive, drugs. Another doctor that I know believes the same thing -- that his fellow doctors rely way too much on the latest marketing from drug companies, which of course are hawking the latest and most expensive drugs that might not be the best remedy for any given patient. For a more systematic look at this subject, see Dr. John Abramson's book Overdosed America.

4. Alternative remedies. By some estimates, American spend $48 billion a year on alternative remedies. That said, I don't know to what extent this spending displaces spending on more traditional health care.

5. End-of-life care. America reportedly spends astronomical amounts of healthcare dollars on elderly people who are about to die anyway. This is why, according to one estimate, one percent of the nation "accounts for 30 percent of the nation's health care expenditures". According to another study, spending in the last year of life is over five times the spending during previous years. I can't put my hands on any data on European spending for end-of-life care, but I strongly suspect that it is lower than in America.

To repeat: I'm not 100% sure that Americans spend more per-capita on all of these types of medical care. But I'd like to see such data, if anyone collects it. Specifically, before I give any credence to suggestions that America could substantially lower its health care costs by adopting a more European model, I'd like to see a line-by-line comparison between American and European spending on every conceivable procedure. (I.e.: Line 457: Per-capita spending on liposuction. . . . Line 1285: Per-capita spending on New Age treatments. . . .).

2 Comments:

Blogger Michael Simpson said...

I take it, though, that the difference in costs comes not just from administrative costs but from a system that rations just the kinds of care you're describing. I've always thought that one of the reasons euthanasia is farther advanced in Europe is because the state pays the medical bills.

8:23 PM  
Blogger Stuart Buck said...

That may well be the case. But then proponents of the European model should make that clear -- i.e., "we plan to save money by restricting the availability of elective medical procedures" -- rather than pretending that America could cut its healthcare costs in half simply by reducing paperwork.

9:21 PM  

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