Wednesday, November 18, 2009

German health care costs: Uber oder unter alles?

I was struck by the chart that accompanied this Wall Street Journal article today (scroll down).

The chart lists 5 countries (Netherlands, France, Switzerland, Germany, and Canada) whose overall health care spending - according to OECD data - is between 9.8% and 11.0% of GDP.

Not that long ago, spending in the US was at 11% of GDP and pundits were predicting disaster. Well, now these 5 countries are at that level.

I think this information suggests that these nations have not really "solved" the problem of health care spending because they have failed to stabilize their health care spending. They have maintained a lower overall spending level than the US (which may be related to other factors, e.g. behaviors, diet, income levels, etc) but they have not stabilized the growth of their costs and as a result have caught up to where the US was, not so long ago. It's tempting to believe their costs will continue to grow and will reach the level where we are now, in not so many more years. Shouldn’t we know for sure whether that’s true?

So wouldn't it be useful to compare per capita US health care spending for our Medicare population with the corresponding per capita numbers in other countries for their over-65 populations? Such a comparative analysis could be designed so as to reflect like populations, insured in like manners by federal programs of health insurance (Medicare in the US, the national health systems in the other countries). If per capita US expenditures for this population are consistent with the other countries', well then that could be evidence that extending a Medicare-like, federal, single-payer system to the rest of our population would result in lower spending - like the rest of THEIR populations. If the US per capita expenditures are higher, that could mean that universal single payer systems may not be so effective as is widely believed.

I'd be surprised if this comparative analysis has not already been done - but I've been unable to locate anything. Yet.

[Graphic courtesy WSJ]

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