Category: Healthcare

When properly analyzed with better data and closer attention to detail, it becomes quite clear that US healthcare spending is not astronomically high for a country of its wealth.  Below I will layout these arguments in much greater detail and provide data, plots, and some statistical analysis to prove my point.

Using Actual Individual Consumption (AIC) we can explain the vast majority of healthcare expenditure differences between countries in any given year and the evolution of healthcare expenditure increases across more than 40 years!

Total per capita health care spending increases as wealth increases because people actually demand more goods and services (volume) per capita and because it is relatively labor intensive sector that does not enjoy the productivity gains found in some other sectors of the economy, i.e., overall costs increase through both volume and price together (volume * price).
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Now, to be clear, my position is not that we ought to be spending as much as we spend. My position is that the issues we face are very similar to the issues faced in Europe and other prosperous countries (and are generally similar to patterns many decades earlier). They are largely differences in degree, not kind. Our large apparent cost differences mostly originate from our significantly higher material standard of living. The long term increases found in the United States and other developed countries are generally a product of ever increasing material living conditions and varying levels of productivity in different economic sectors (healthcare being labor intensive and relatively high skilled at that).

There is much less low hanging fruit than people imagine, even less so at a political level when people can actually express their preferences at the voting booth and various other interest groups (providers, hospitals, etc) can influence the process.

Source: High US health care spending is quite well explained by its high material standard of living – Random Critical Analysis

Research shows that physical activity leads to better moods. The Nordics could be proof of that on a national scale.

Source: People in Nordic countries exercise more than anyone in Europe — Quartz

Long after research contradicts common medical practices, patients continue to demand them and physicians continue to deliver.

A 2007 Journal of the American Medical Association paper coauthored by John Ioannidis—a Stanford University medical researcher and statistician who rose to prominence exposing poor-quality medical science—found that it took 10 years for large swaths of the medical community to stop referencing popular practices after their efficacy was unequivocally vanquished by science.

Ideally, findings that suggest a therapy works and those that suggest it does not would receive attention commensurate with their scientific rigor, even in the earliest stages of exploration. But academic journals, scientists, and the media all tend to prefer research that concludes that some exciting new treatment does indeed work.

At the same time, patients and even doctors themselves are sometimes unsure of just how effective common treatments are, or how to appropriately measure and express such things. … “NNT” is an abbreviation for “number needed to treat,” as in: How many patients need to be treated with a drug or procedure for one patient to get the hoped-for benefit? In almost all popular media, the effects of a drug are reported by relative risk reduction. To use a fictional illness, for example, say you hear on the radio that a drug reduces your risk of dying from Hogwart’s disease by 20 percent, which sounds pretty good. Except, that means if 10 in 1,000 people who get Hogwart’s disease normally die from it, and every single patient goes on the drug, eight in 1,000 will die from Hogwart’s disease. So, for every 500 patients who get the drug, one will be spared death by Hogwart’s disease. Hence, the NNT is 500. That might sound fine, but if the drug’s “NNH”—“number needed to harm”—is, say, 20 and the unwanted side effect is severe, then 25 patients suffer serious harm for each one who is saved. Suddenly, the trade-off looks grim.

Historians of public health know that most of the life-expectancy improvements in the last two centuries stem from innovations in sanitation, food storage, quarantines, and so on. The so-called “First Public Health Revolution”—from 1880 to 1920—saw the biggest lifespan increase, predating antibiotics or modern surgery.

Source: When Evidence Says No, but Doctors Say Yes – The Atlantic

• Helps chronic pain in adults
• Lessens chemotherapy-induced nausea and vomiting
• Relieves some symptoms of multiple sclerosis

• Worsens respiratory problems, such as chronic bronchitis episodes
• Motor-vehicle accidents
• Low birth weight in babies
• Schizophrenia or other psychoses

Source: An analysis of 10,000 scientific studies on marijuana concretely supports only three medical benefits — Quartz

The climax of a standoff with the pharmaceutical industry over high prices

The actual problem with vaccines is cost and access.

Of course, the doctors do see donations as valuable—simply not worth the costs in this context, which transcends seemingly straightforward philanthropy and medical science.

cost is the fundamental issue to Jason Cone, the executive director of Doctors Without Borders in the United States. He explained that donations from pharmaceutical companies are ineffective against a problem of this scale. While the donation would benefit people under the care of Doctors Without Borders immediately, accepting it could mean problems for others, and problems longer-term. Donations, he writes, are “often used as a way to make others ‘pay up.’ By giving the pneumonia vaccine away for free, pharmaceutical corporations can use this as justification for why prices remain high for others, including other humanitarian organizations and developing countries that also can’t afford the vaccine.”

Source: Doctors Without Borders Refuses Vaccines from Pfizer – The Atlantic