The study that compares the US to Europe (linked in another commend) does these comparisons:
- Compare GDP between US and Europe and show that US is higher per capita on average. No debate there.
- Compare private consumption between the US and Europe, specifically stating that it does not control for healthcare and education. From page 14:
Different countries’ choices of public commitment influence, through taxation policy, the scope available for private consumption, at the same time as high taxation countries, through their public sectors, offer some of the things recorded in low taxation countries as private consumption. There is no easy way of getting round this, but it is an important point to bear in mind when comparing private consumption.
- It does then compare retail consumption which shouldn't include any of these things and thus be more objective. That one still shows the US as higher than Sweden. Another table shows that US households have more home appliances. So on that count Americans do appear to be richer, assuming of course they are getting equal average amounts of education and healthcare on their private purchases as the Europeans are getting on their tax dollars. Otherwise you'd just be displacing money from healthcare and education into buying retail goods. An argument can surely be bade that this is in fact the case and that although the higher end healthcare and education in the US is top notch the average over the whole population is not as good as the average in Sweden. Anyone know of any good data on this?
I did notice however that the disposable income argument was made about countries within the EU based on another study. So it is possible that the public/private mix in the several EU nations actually doesn't favor Scandinavia in terms of efficiency. All these things are hard to argue because there is no comparable definition of the extent of public services in the economies and how those are replaced or not by private spending.
> So on that count Americans do appear to be richer, assuming of course they are getting equal average amounts of education and healthcare on their private purchases as the Europeans are getting on their tax dollars.
That assumption is rather dodgy on a couple of points.
One is that a lot of healthcare and education in the US is tax-supported. Another is that a rational person may choose to spend money on things other than healthcare and education. Forcing them to spend it on healthcare and education can make them poorer, aka "less bang for same bucks".
> the average over the whole population is not as good as the average in Sweden.
How about we compare average cancer survival rates?
Relevant fact: a huge fraction of the "uninsured" in the US are eligible for free govt healthcare but simply haven't signed up. (When they run into problems, they typically, but not always, sign up.)
>That assumption is rather dodgy on a couple of points.
I thought so too, that is why I pointed it out.
>One is that a lot of healthcare and education in the US is tax-supported.
It may very well be but less of it is compared to Scandinavia so the point is the same.
>Another is that a rational person may choose to spend money on things other than healthcare and education. Forcing them to spend it on healthcare and education can make them poorer, aka "less bang for same bucks".
Very true of course, but then you can't really argue that the Scandinavians are worse off because they can buy less retail goods because they put more money into their government to get healthcare and education. Choice need not be only about how to allocate private spending, you can also influence the tax/welfare situation.
>How about we compare average cancer survival rates?
I could only find cancer deaths not survival rates once you do have cancer. In a lot of ways that is what matters and can mean better preventive care. On the other hand it adds a bunch of environmental factors. Anyway, according to this:
The US is middle of the board. Sweden, Finland and Norway all beat the US. The only surprising one on that board for me was the Netherlands, with such high rates.
Very true of course, but then you can't really argue that the Scandinavians are worse off because they can buy less retail goods because they put more money into their government to get healthcare and education.
Actually you can. That's part of the deadweight loss of taxation: you are forced to spend money on stuff you don't want and are unable to spend on stuff you do want.
If person X would choose to spend $100 on an ipod, but is instead forced to spend $100 on education which they only value at $80, they have lost $20 of value.
Now, in a democracy, people in the situation of person X may only make up 50% - 1 of the population, but that doesn't change the fact that they lose.
Actually you can. That's part of the deadweight loss of taxation: you are forced to spend money on stuff you don't want and are unable to spend on stuff you do want.
(...)
Now, in a democracy, people in the situation of person X may only make up 50% - 1 of the population, but that doesn't change the fact that they lose.
That is all true of course. What I was pointing out is that the democratic group decision to spend more on healthcare is also a spending decision. The counterpoint is what you mentioned, that 50% - 1 could be against it. In Scandinavia however you will find that support for the welfare state is very high. Another important consideration is that the public healthcare in these countries tends to be much more efficient per person than the one you get for you private dollars otherwise. You could of course argue that that is just the market currently being inefficient.
Support for "the welfare state" in the abstract is irrelevant. The relevant question is "would person X purchase retail goods or health care if given the choice?"
People might support the welfare state for various other reasons, including signaling [1], compromise and ignorance [2]. Regarding more efficient public health care (assuming it to be true for the moment, I've seen no compelling evidence for this), all this does is reduces the deadweight loss by lowering the price of the unwanted goods.
[1] I voted for X because I'm {religious/moral/not racist/hard working/$OTHER_TRIBAL_IDENTITY}.
[2] This is due both to politicians lying ("I won't force people to buy health insurance they can't afford") as well as to people not having a clue ("death panels").
> >One is that a lot of healthcare and education in the US is tax-supported.
> It may very well be but less of it is compared to Scandinavia so the point is the same.
Not so fast. You wrote "It does then compare retail consumption which shouldn't include any of these things and thus be more objective." You otherwise assumed that health care is largely private in the US. It's not - it's about half public. Moreover, the public spending is concentrated on the poor. So, they're getting govt healthcare and buying big screen TVs.
> I could only find cancer deaths not survival rates once you do have cancer. In a lot of ways that is what matters and can mean better preventive care. On the other hand it adds a bunch of environmental factors.
As someone else has posted, the "not get cancer" stuff, which isn't due to health care, overmatches what happens when you get cancer, which is when health care matters.
Not so fast. You wrote "It does then compare retail consumption which shouldn't include any of these things and thus be more objective." You otherwise assumed that health care is largely private in the US. It's not - it's about half public. Moreover, the public spending is concentrated on the poor. So, they're getting govt healthcare and buying big screen TVs.
What I assumed and is true is that healthcare is more private in the US than in Scandinavia, which it is. So the argument still holds that if you are comparing private spending in the US that will include more healthcare than in Scandinavia. Retail spending however will not as you don't buy healthcare as a retail good.
>As someone else has posted, the "not get cancer" stuff, which isn't due to health care, overmatches what happens when you get cancer, which is when health care matters.
What makes you think "not get cancer" has nothing to do with healthcare? Two very large healthcare factors come to mind. If you die sooner from another illness you won't get cancer and if you get continuous preventive medicine you won't get as much cancer. Diet and other unrelated factors will be important as well but "not getting cancer" has a lot to do with health care.
The other flaw in the whole "cancer survival is higher so healthcare must be better" argument is that although cancer is a very important illness it is far from the only important one and not even the major cause of death. Having very good cancer survival rates could just mean that the US healthcare spends an irrational amount of resources on it, neglecting other diseases. But I don't really know.
> What I assumed and is true is that healthcare is more private in the US than in Scandinavia, which it is.
You're ignoring the fact that US poor get govt healthcare. Unless you want to argue that said govt healthcare is better than the private healthcare that the rest of us get, the US has "govt healthcare or better" and more stuff. By cohort, our poor people have govt healthcare and more stuff than yours and our richer people have better than govt healthcare and even more stuff.
Which gets us to the question of how our govt and private healthcare compares to yours, because the "more stuff" conclusion seems pretty solid.
> Retail spending however will not as you don't buy healthcare as a retail good.
What is the basis for your claim that healthcare can not be a retail good? You may not think of healthcare as being available as a retail good, but I see it in stores and the like. I happen to received an advertisement for a "get an MRI to see anything interesting is happening inside you" service in the mail today, and that sort of thing is reasonably common.
Surely you're not going to argue "necessity", as food, clothing, and shelter are both necessities and retail goods.
> if you get continuous preventive medicine you won't get as much cancer
Oh really? We just started to see vaccines for a common form of cervical cancer, and that was a first. How about some supporting evidence. Be precise - what types of cancer and what kind of healthcare. (Note - precancerous growths are not really pre-cancerous - they're early stage, as evidenced by the fact that the success in treating them is evaluated the same way that we evaluate other cancer treatments.)
> The other flaw in the whole "cancer survival is higher so healthcare must be better" argument is that although cancer is a very important illness it is far from the only important one and not even the major cause of death.
I didn't say that cancer survival rates were a decisive argument. I said that they were more relevant to the healthcare quality argument. I'd be happy to see more and better data, but see no reason to assume anything about that data before it shows up.
Here's the link with the original "cancer rates" article
"U.S. Cancer Care Is Number One
No. 596
Thursday, October 11, 2007
by Betsy McCaughey
During this presidential election season, candidates are urging Americans to radically overhaul our “broken” health care system. Before accepting the premise that the system is broken, consider the impressive evidence from the largest ever international study of cancer survival rates..."
OK, we heard you already - you don't need to spam the comments with the same thing quite so many times.
I'm in the UK and this is the first I heard about "death panels". I looked at the top listing in the NYT and on ABC, as returned by Google, in order to get a definition.
Surely any country with limited healthcare resources requires someone (maybe a panel) to decide where to restrict application of resources. In many cases this failure to provide infinite resources to any health problem will result in premature death. So you could call the panels deciding on restricting care "death panels".
There's nothing controversial about that, is there. We have such panels in the UK, the only controversial part is that location within the UK gets factored in ("postcode lottery") when we are supposed to have a "national health service".
Some drugs and treatments are too expensive for the public purse.
If you are so out of the loop of American politics that you were not aware about the whole "death panels" uproar, you really aren't aren't in the loop enough to be discussing the rest of this subject matter on this thread either
"Palin: Obama's "Death Panel" Could Kill My Down Syndrome Baby
In a new posting on her Facebook account, former Gov. Sarah Palin (R-AK) made a dire statement about health care reform -- that it could result in an Obama-created "death panel" killing her infant son with Down Syndrome:
The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil...."
If the study's honest, those should already be factored into "cost of living", not "disposable income".