U.S. Health Care: Pay More, Get Less

Tyler Cowen quotes one of his readers:

Adam reports:

At birth, someone living in the Netherlands can expect to live 2.35 years longer than someone born in the US, but at age 65, the difference is reversed, and someone living in the US can expect to live 0.4 years longer than someone living in the Netherlands. This difference can be explained by assuming that semi-socialized health care is better for young and worse for old people, or, at least as likely, different policies are not the main cause of the difference[.]

Sources: CDC national vital statistics 2004, www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_09.pdf and RIVM 2007 levensverwachting, www.rivm.nl/vtv/object_document/o2309n18838.html (in Dutch)

One interesting feature of this data is that it can be used to argue for a number of different points of view.

Yes, indeed. As Matthew Yglesias shows us (emphasis mine):

The hypothesis that the health policy is not driving the difference is something we should seriously entertain. But insofar as we want to examine the health care issue, both sides of this factoid support socialism. Dutch people of all ages enjoy a quasi-socialized system of health insurance provision (by European standards, there’s a lot of private sector involvement in Dutch health care). Americans under the age of 65 participate in an overwhelmingly private sector health insurance market. But Americans over the age of 65 participate in a Canadian-style national health insurance scheme known as Medicare. The data, if we want to take it seriously, indicates that the Dutch system is better than private sector medicine but worse than Medicare and tends to support a “Medicare for all” approach.

My guess is that in the real world the higher Dutch life expectancy is primarily driven by things like Americans’ much-greater tendency to get involved in car wrecks rather than anything related to health care. But the point about poor U.S. life expectancy is simply that if we’re going to be paying dramatically more than Europeans for health care services it seems that we ought to be getting demonstrably better results. We’re not. But uninsured Americans are getting demonstrably worse results.