Tyler Cowen says that health care policy should be debated through micro-facts, like these:
- American health care outcomes look much better once we adjust for race and other demographic factors, including violence and car crashes. Some groups — such as Asian-American women — have remarkably good health care outcomes.
- Some of the health care savings of other systems occur through price effects (e.g., doctors are paid an average of $60,000 in France) and do not involve real resource savings.
- American’s high expenditures, however wasteful they may be, nonetheless drive much of the world’s medical innovation. Medical innovation is also a public good to some extent and no the pharmaceutical companies are not simply parasites on the NIH and universities.
- America has a different structure of interest groups. and therefore a single payer system in the United States would not operate as does a single payer system in other countries. It would more likely favor the interests of doctors and insurance companies, for a start.
- If we take the international health results/expenditures data at face value (and we shouldn’t), they imply that greater access to medical care does not itself improve health outcomes. So we should be careful in how we use and cite such results.
- Health care outcomes improve with income even under single-payer systems. Our best estimates suggest that this gradient is no steeper in the United States than it is in Canada.
- Having health insurance does improve your health care outcomes, but not to an amazing degree. The largest benefits are arguably the alleviation of financial risk, and no I am not meaning to slight that factor.
- Pharmaceuticals, unlike many forms of health care, have large and noticeably positive effects on individual health.
- The major Democratic health care plans on the table all, one way or another, admit they will spend more money on health care. The fact that other countries spend less therefore does not help predict the change in spending that would result from these plans.