The Fighting 29th

All about New York's 29th Congressional District

I've heard a lot of noise about numbers in the healthcare debate. People are uncomfortable with the claim that we spend far more than any other country, and with the claim that the quality of our healthcare trails other countries. So, this weekend I went looking for reliable sources for those two claims.

First, spending, which is the easy one. An organization called the Organization for Economic Cooperation and Development (OECD) has been compiling data on healthcare spending for years. Their latest report shows that the US spends significantly more than other developed countries, no matter how you slice it. The graph above uses 2006 OECD data, which is the latest full set available. As you can see, we spent about $7,000 per person on healthcare that year, far more than other developed countries.

One of the talking points I've heard is that per-capita numbers don't tell the whole story, because they don't count illegal immigrants. The graph above, based on the same OECD data, that shows spending as percentage of GDP. We still spend the most by a longshot using GDP as the benchmark. (Note that you can click on either graph to enlarge it.)

The second claim -- that the quality of our healthcare isn't as good as the rest of the world -- is harder to measure. The non-partisan Robert Wood Johnson foundation has sponsored a comprehensive analysis of the existing reports on healthcare quality. The full report is a dozen pages and cites a number of different studies. Here are some findings:

• The US is "one of several world leaders" in cancer care.
• US-Canada comparisons more often find that Canadian care is better overall.
• The US has more surgical and medical errors (known as "patient safety" issues) than other countries.

The report specifically debunks one talking point: that the higher US rate of homicide and violent death skews mortality statistics. The study authors looked at "amenable mortality", which adjusts for different accident rates, and found that the US still lags other countries.

Overall, the study found:

[W]hile evidence base is incomplete and suffers from other limitations, it does not provide support for the oft-repeated claim that the “U.S. health care is the best in the world.” In fact, there is no hard evidence that identifies particular areas in which U.S. health care quality is truly exceptional.