Thursday, December 01, 2005


People continue to decry the state of health care. They claim we spend too much, but do not realize commensurate improvements in life expectancy. I asked Robert Fogel this question when he was here last year, and his response was something along the lines of: We spend more on health care, not because costs are rising, but because consumption is rising, and rising in ways that do not improve longevity, but rather quality of care. Richard Lehman makes a similar point.

Have you been to a hospital lately? They no longer house patients in wards, in many cases you have your own room with TV and other amenities.

The sad truth is that if we are to reduce consumption we have to ration health care. That will likely happen, or be most effective if we ration the consumption of elderly near the end of their lives. Every dollar spent on a 90 year old provides the least bang for the buck in terms of spending and increasing life expectancy.

Keywords: Healthcare

1 comment:

PG said...

I agree that our spending is not commensurate with the improvements in life expectancy. First, life expectancy in aggregate numbers gets the biggest bang for the buck when you reduce infant mortality, death from childhood diseases, and the fatalities from unhealthy longterm behaviors such as smoking, poor diet and lack of exercise. These are mostly public health measures.

I don't think having your own TV and other amenities contributes to quality of care or even quality of life -- it's simply part of our expectations. My dad got sick overnight while we were in Hong Kong a few years ago, and my sister was horrified that the hospital there put him in a big hall with many other patients on beds. Yet this type of hospital frees up money to go to the measures that do improve health, instead of just pandering to one's non-bodily comfort. Dad himself, incidentally, didn't have a problem with his treatment, probably because he began working as a doctor in India and recently helped to start a hospital there -- where I doubt there are individual TVs.