Trying to distract myself during a medical appointment this morning, I asked my doctor what she thought of the health care reform proposals before the House and Senate. In a resigned tone, she flatly stated that the proposals did little for doctors or patients and mostly benefited insurance companies. I agreed with her and we commiserated together that little would probably end up being done to fundamentally reform health care. Then I asked what she thought about a government funded health care system. She was favorable to it and had familiarity with the British system but wondered how such an overhaul could be carried out in the United States. I was encouraged that she didn’t run a mile from the suggestion. So often we are told that our doctors would stop being doctors under a government funded national health care plan. In fact, my doctor seemed to indicate just the opposite. She told me stories of her doctor friends who are struggling just to stay in business under the current system. When I got home I checked the number of doctors per patients in major industrialized countries to see if there was any truth to this argument. According to the OECD, Australia, France, Germany, and the UK, all nations with so called ‘socialized medicine’ have more doctors per patients than the US. Only Canada and New Zealand have fewer doctors per person than the US. The claim that there would be a doctor shortage under “socialized medicine” turns out to be just another myth.
Practicing physicians, Density per 1 000 population (head counts)
(Source: OECD 2006 data)
Australia 2.81 Canada 2.15 France 3.37 Germany 3.5 Netherlands 3.82 NZ 2.28 UK 2.44 US 2.42
Monday, January 25, 2010
Tuesday, January 19, 2010
This morning I listened to NPR and was interested in the latest findings about the economics of marriage. New research by the Pew Research Center has found more men are marrying women with higher incomes than anytime in the past. Both the radio and newspapers portrayed this in a positive way for women—that women are becoming more educated than men and in fact are making gains in the workforce. I wish that were the entire story. Unfortunately there is a disturbing and darker side to this. Is it really women making gains in wages or could it also be that high paying jobs, traditionally held by men, are disappearing? Haven’t we all heard that during this recession most jobs being lost are by men? According to the US department of labor, women’s median wages were still 79.9% of men’s in 2008. While women’s wages have been increasing as a percent of men’s over the past few decades those gains are masked by what is happening to average male earnings. They have been stagnating at best. According to the National Association of Colleges and Employers, real starting pay for men with bachelor’s degrees fell 3.2 percent between 2000 to 2007 and 1.7 percent among women during that time. This isn’t only about gender it’s about what’s happening to the middle class. And it’s not a pretty picture.
Friday, January 15, 2010
This week Jonathan Gruber, an MIT health economist who provided the key analysis which supported the Obama Administration’s health care reform plans, was being criticized for not disclosing a lucrative government contract. What’s fascinating about this incident is what it reveals about public policy. (See my HuffPo post for more) There’s only one expert in the entire nation who has the know how to quickly estimate the effect of health care reform in various scenarios. And none of us have a clue so we have to take his word for it. Isn’t that a little crazy? What’s the value of having such complicated legislation so that only one person in the entire nation actually takes the time to dig through it?
Friday, January 8, 2010
At first when I thought about health care reform I thought of universal health care as a moral issue. But when I took the time to look behind the rhetoric and dig into the numbers I discovered that universal health care, or more explicitly government funded universal health care, is really an economic obligation. When you compare the US to other industrialized nations on the basis of costs, health outcomes, quality and satisfaction there’s only one conclusion you can reach—it’s foolish and wasteful not to move to a government funded health care system. I just wrote a Huff Po post looking at one of the more startling facts about cost. There are lots of angles to look at, and they all seem to point in the same direction. If the current health care legislation does pass, it absolutely can’t be the last word. Without a common sense system similar to other developed countries, the US will be competing with a serious economic handicap.