Evaluating Health Care Systems
By Arnold Kling
How can you tell whether one country’s health care system works better than another? In this essay (read the whole thing), I talk about how not to make the comparison.
Overall, I think that it is a mistake to define the health care problem as the need to reduce the ratio of expenditures to life-expectancy gains. I think that the policy implications of such a definition are mostly unacceptable.
UPDATE: Patri Friedman writes,
(note: for this analysis I am assuming the viewpoint of an economist designing a nationwide health care system and ignoring the problems with public, centralized solutions.)
…The money we spend on a hopeless cancer patient is money we don’t spend on people with full lives ahead of them. Improving our spending to health ratio is improving the efficiency with which we produce health care – how can that be a bad goal?
I think that Patri is attacking a straw man here (something which my original piece also might be charged with). I did not argue against trying to minimize the cost of achieving a given degree of longevity. I simply meant that we should not look at longevity and total spending side-by-side as indicators of efficiency. Implicitly, that approach treats all health care spending that is not longevity-related as waste, and that is wrong. Sorry if that was not clear.
For Discussion. Is there a straightforward way to compare the efficiency of different countries’ health care systems?