Credit where due: Samuelson gets it right!

THURSDAY, DECEMBER 1, 2011

Some updated facts about health care: It’s very rare to see Dean Baker praising Robert Samuelson.

On Monday, Baker praised the Post columnist for this column about health care. To read Baker’s paean, click this.

For ourselves, we have one complaint about Samuelson’s piece. For reasons of national security, we’ll postpone that complaint till next week. Today, we thought you might like to see some updated data about national health care spending.

How much do OECD nations spend on health care? Per person, in 2009, the figures looked like this:
Per person spending on health care, 2009 (or nearest year):
United States: $7960
Canada: $4363
Germany: $4218
France: $3978
United Kingdom: $3487
Australia: $3445
OECD average: $3233
Italy: $3137
Spain: $3067
Japan: $2878
We’re including the big major nations with which the U.S. can best be compared. Simple story: We spent twice as much per person as France; more than twice as much as the U.K.; almost three times as much as Japan. Meanwhile, let’s revisit our favorite old hook:

Finland spent $3226 per person. Why aren't journalists being flown to Finland to tell us about that miracle?

For the full OECD report, just click here. Meanwhile, why do we spend so much more than everyone else? Are “journalists” allowed to ask? Does any “journalist” care?

26 comments:

  1. I used to think that these mainstream, establishment journalists were sworn to an omerta about the reality of US vs. non-US peer nation health care spending, but I've come to realize many are just plumb stupid and do not know this basic information you have repeatedly laid out here. Or if they do, they're juggling so many pre-existing narratives (US public schools are bad! We can't raise taxes on the "job creators"! Iran is the new imminent threat! We must cut entitlements to resolve the debt crisis! The Democrats won't concede anything to the GOP! Ronald Reagan was a saint! etc.) that they still revert to the same scripts (percentage of GDP! bending the cost curve, etc.) that they have internalized. They're hopeless. And dumb.

    (James Fallows, Paul Krugman and a few others who can read basic economic reports and charts or who have looked into this issue carefully and not reverted to the elite class script are the exceptions.)

    But don't you also wonder whether deep inside, many establishment journalists take as a given that we should have the neoliberal health care system we do, with these private for-profit industries running things as opposed to a single payer or even mostly-public option with some private health insurance option model? I think many of our journalists, now products of the elite classes or at least elite institutions, have bought into the anti-government hysteria, and no matter how awful the US health care and health insurance systems are, they would rather just believe that they're better than anything the government could provide. As other nations show, that's just not true. It helps them too that they're mostly rich, so they don't know what it's like to be without health care and to have to deal with the system as it currently exists.

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  2. We pay so much more because the "users" of health care have too little investment. That is to say, deductibles and copays are too low. If the persons using health care services had to pay more out of pocket they would not demand to have all of that poking and prodding, having scopes shoved up their backsides, and getting cut up with sharp knives... You know all of the fun things that are involved in health care that patients clamor for because they only pay about 20% of the cost.

    Oh wait. How much do French people pay? Oh crap, they don't pay anything, and France spends half what we do. Maybe the French don't like getting things shoved up their backsides or getting cut on with sharp knives. See? We knoew the French were messed up.

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  3. Americans have a lot more 'skin in the game' on health care spending than is typically recognized. There's a lot more than deductibles and copays for the under-65 crowd; employees are paying increasingly larger shares of their health insurance costs for less and less generous coverage, part of the reason middle-class wages and salaries have not kept pace with the spectacular income growth experienced by the top 1% or the less spectacular growth for the top 20%.

    Costs are higher in the US because we pay lots more for specialist MD care, for hospital stays, and for Rx drugs than people do in Canada or France or the UK -- as well as lots more for multi-payer system inefficiency. Millionaire pundits don't "know" this because their privileged status protects them and because knowledge would only get in the way of bloviating about how coddled the US middle class and working class is by all those safety net programs.

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  4. This is yet another example of why I first look to blogs for accurate information instead of the propagandists in the mainstream media.

    Corrente has stickied a nice graph of the previous version of this information for a while now: http://www.correntewire.com/murder_spreadsheet

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  5. Striking as the disparity is between the U.S. and every other industrial democracy, it's actual more extreme than these figures suggest.

    In Japan, for example, citizens make substantially more use of the health care system than do Americans. This is true in a number of other countries as well.

    And, unlike the U.S., these other countries COVER THE ENTIRE POPULATION with comprehensive insurance. If every American received the same ration of care that the well-insured do here, or that the average Japanese or Frenchman does, our per capita cost would soar far beyond $7900+. So just thanks your stars you're free to get sick and go untreated in the greatest country on earth.

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  6. The main difference in the U.S. from the rest of the world is that here we have huge murderous leaches sucking at the body politic--health insurance companies and their whore politician manservants like Barack Obama.

    Many people put the cost of these middle men (not to mention their cartel drug pusher pals in the pharma industry) at almost 1/3 of health care costs. Just look at the above chart at corrente and one can see this looks probable.

    Our system is designed to be inefficient so that some fat corrupt gamblers can get even richer. Just look at the health savings accounts and the amount of money lost or wasted or spent administering these things, or on figuring out the taxes on them.

    Also, how corrupt is it that the health insurance industry is EXEMPT from anti-trust laws and is largely protected from bad faith tort claims and other lawsuits. A health insurer can wrongly withhold payment and he would not be punished in the same way that an auto insurance company would, for instance.

    It's a crime that the crooks in Congress have handed so much of our health care dollars to the leeches in the insurance industry. There is no rational explanation other than robbery. These are criminals we're dealing with.

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  7. Good point Anonymous,

    If you look at the chart at Corrente the number of patient visits is represented by the thickness of the line.

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  8. It seems Robert Samuelson is undergoing a learning curve. He gets more liberal as time passes. Perhaps looking at numbers instead of neocon ideology is one path to the truth.

    The price of healthcare keeps going up. I don't know if these figures are adjusted for inflation. If they are, the price increase is worse than it looks.
    On 26 JUNE 2009 TDH published these figures: United States: $5711
Denmark: $2743
France: $3048
Germany: $2983
Italy: $2314
Japan: $2249
United Kingdom: $2317.
    Presumably, they were collated several years before.

    If you want some numbers from 2009, go here:
    http://gravymeister.blogspot.com/2009/09/show-me-money.html
    For an anecdotal (but revealing) report, go here:
    http://gravymeister.blogspot.com/2009/08/eyewitness-report-french-healthcare.html

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  9. Baker writes, the long-term deficit problem is primarily health care... However, health care paid for privately doesn't affect the federal deficit, so a more precise comment would be:

    The long-term deficit problem is primarily that portion of health care paid for by the government.

    Bush, Obama, Read and Pelosi made this problem worse by having even more health care paid for by the federal government. Now, they discover that the federal government can't afford to pay for all the health care it committed to cover. What irresponsibility!

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  10. There's our boy Dave, spreading disinformation yet again.

    Health care spending as a share of US GDP is traveling an unsustainable path -- not just the share paid for by government. If Obama and the congressional Dems are right and the ACA successfully applies some restraints to the spending curve, the federal burden will lessen over time.

    Yes, Dave, ACA did expand health insurance coverage, with the federal govt offering support, because it's shameful that the US is the only major developed nation that fails to provide universal coverage. Obviously, you and your ilk are happy to see millions of people go without health insurance and, presumably, without health care when sickness strikes. Apparently, you've discarded even the pretext of compassion for your conservatism.

    Oh, by the way, the completely unfunded Bush tax cuts are another major component of the short-term and long-term deficit problems. What irresponsibility!

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  11. BillNRoc, what you say is true, in theory. However, IMHO the private health market is lot more likely to figure out how to restain health costs than the government is. Government is vital for many reasons, but government isn't noted for running low-cost, efficient operations. Mostly, it's the reverse, e.g., the Post Office or military procurement or airport security.

    Unfortunately, the growing number of government health programs and health regs have sapped the ability of the private health system to created economies.

    It's interesting to note that Lasik surgery, which is not supported by government insurance, has had rapid improvements in quality along with huge reductions in cost. It illustrates what the free market can accomplish, when it's left free.

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  12. BillNRoc,

    Stop your sanctimonious prattling about saving life and helping the American people! Please! Don't you lecture Dave about how the Republicans are heartless and want Americans to die. This is a bipartisan decision and YOU ARE ON THE SAME SIDE AS THE MURDERERS when you side with Obama and the ACA! You are acually on Dave's side so stop your preaching son.


    If losing 50,000 people a year to our murderous health care system was such a national emergency why did your party of "progressives" wait until 2014 to implement your "reforms" (ha! this doesn't even deserve scare quotes you Democrat propagandists so tarnished the word).

    Let's go to some of the standard Democrat vomit that Dave spews:

    "If Obama and the congressional Dems are right and the ACA successfully applies some restraints to the spending curve, the federal burden will lessen over time."

    1. How naive can onebe to write that sentence? If Obama and the Dems are right. . . . ha ha ha. Give me a break sucker.

    2. They do no such thing to lesson the spending curve (in fact, it is unrestrained. There is no gov. control over premiums as we saw this year as insurers upped premiums by as much as 50%. Courts can't even deal with this as the feds have EXEMPTED these leeches from antitrust laws and other reasonable regulations. Plus, citizens are required to purchase this usurious product!

    The curve that is flattened is spending on Medicare because BENEFICIARIES WILL NOW BE REQUIRED TO PAY FOR MORE OF THEIR CARE DIRECTLY. It may be "saving" the goverment a bit of money, but it is simply passing on the spending by a more efficient single payer (the gov.) and instead sending individual elderly out into shark infested waters.

    The cost curve talking point is bullshit and only a Democrat partisan can believe that lying stinking pile of garbage.

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  13. Another Democrat talking point (lie):

    "Obviously, you and your ilk are happy to see millions of people go without health insurance and, presumably, without health care when sickness strikes. Apparently, you've discarded even the pretext of compassion for your conservatism."

    You do realize Bill, that under Obamacare there will still be millions of people without health insurance, right? So much for your vaunted compassion (but we all know Obamacare primarily benefits the insurance companies and pharmaceutical companies and that's why the Democrats are pushing it--they don't give two shits about the health of the American people). Not to mention you Democrats are going to force middle class people to buy a usurious and defective product or face a government fine.

    Dave is totally wrong on the subject. Government run health care is more efficient and better for 99% of the populace.

    But Obamacare makes things even worse, solidifying fascist control over our health care system, while Democrats get to prance around and pretend like they are helping real people. They're not. They're sending them to the slaughterhouse.

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  14. @David in Cal

    Yet again, bro? Even with enormous private-sector fraud and unnecessary procedures, Medicare is substantially cheaper to run (both costs and administration) than equivalent private sector health insurance, which no "senior" would ever be able to obtain anyway without government supports and government mandates. Haven't you heard? Insurance companies only want to ensure the young and healthy. That's the best way to make money.

    You also fail to note that the private sector has had decades to reduce costs, and has yet to work the magic of the market place. You claim to be retired, so what I suggest is, you start pricing private health insurance and so how you do. For a guy who hates government so much, you ought to welcome the opportunity to get off what you see as the dole.

    Finally, medical inflation at the current rate will effectively bankrupt the nation EVEN IF WE ELIMINATED MEDICARE AND MEDICAID. Got that? The private sector will kill the private sector, if left to its own devices.

    But jeez, that's still better than socialized medicine, ain't it?

    You really need to get your talking-points in better order.

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  15. We no longer have a free press an envisioned by the Founding Fathers, they are very well paid to type the truth as seen by Big Business and Wall Street.

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  16. Dave in Cal wrote:

    "BillNRoc, what you say is true, in theory. However, IMHO the private health market is lot more likely to figure out how to restain health costs than the government is. Government is vital for many reasons, but government isn't noted for running low-cost, efficient operations."

    Dave. We've been over this before. I wish you would look at the evidence. It's funny how conservatives try to spin the most obvious example of the government being more efficient than the private market but the facts never seem to stop them much. Seriously, one would think they would at least give a cursory look tot he facts before proclaiming the "free market" always superior--because in this case Dave, the state is MUCH more efficient than the free market. Check it out Dave. It's true. Single payer or socialized health care IS MUCH MORE EFFICIENT.

    Think about it. We pay almost 1/3 of our health care dollars to a few people so they can make a "profit" on insurance. And these aren't the doctors and the nurses, these are mainly the insurers! This is a totally useless service. It's a middle man that is totally unnecessary. What value added does an insurer provide?!!!!!!! This industry does not even exist in most compassionate countries (Democrats evidently think sending citizens into the clutches of bloodthirsty parasites is 'compassionate').

    If you think about it I'm sure you are smart enough to figure out that our model isn't a private model that efficiently delivers health care--it's a racket! The insurers buy polticians like Obama and Obama suckers his base into supporting something totally against their interests. Obama and the Democrats work for the insurers--and so do the Republicans.

    They are two peas in a pod and it's no wonder that between the BillNRoc and Dave in Cal we get more and more fascism.

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  17. Walter,
    Germany has private healthcare insurance, but rates and profits are strictly controlled. They are a little higher than most of the other OECD costs, but still much lower than US costs.
    The way we deliver healthcare is a major flaw.
    We cannot continue with a system where every factor of healthcare is based on free enterprise.
    We cannot sustain a system where every physician in America earns enough to buy a Napa Valley winery and a Ferrari for his golden parachute. Some will have to settle for less.
    The entire system is broken and need to be re-engineered.

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  18. Walter Wit Man said...
    This is yet another example of why I first look to blogs for accurate information instead of the propagandists in the mainstream media.

    Hear, hear. Commente threads often expand on the posts with further information, insights, and criticisms.

    LOL at how DoC quotes from the Gospel of the Free Market on cue with the usual claim that the private sector always delivers goods and services more cheaply than the public sector and cites elective lasik surgery costs, which apparently must be the sole example since it's the only one that regularly appears in posts by Libertarians and other free market evangelists. Talking points are devalued into platitudes quickly in the blogosphere.

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  19. gravy,

    You're right to point out that the private model in Germany or Switzerland for instance is nothing like the private U.S. model. In those countries insurance is strictly regulated for the public good and there is less profit (from what I read on the internet somewhere, anyway . . . ). Those countries may have also been irredeemably overtaken by fascists as well, so I wouldn't look to them as a model, although their legacy health care systems are decidedly more socialist than ours. I have no hope that our fascist system will seriously enact a REAL private insurance regime that would adequately protect the public. I mean just look at what we got with Obamacare. A Trojan Horse death trap.

    And you're right to imply it's more than just insurers that are sucking at the free market teat. They are the big boys though.

    This is what happens when we go full metal jacket neoliberal. It's all about the profit motive and 'free markets' and magic pixie dust. It's really about theft. About a very few rich jerks lining their pockets at the expense of the health of our community (those 50,000 people dying a year).

    We really need full socialized health care. It's the only solution. At least single payer health care. Now. It's the most efficient and most just for all citizens. The thieves in political and corporate office have stolen a public good from us and we need to get it back.

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  20. only a fraction of the population receives medical care on an annual basis is what really makes the data even more compelling.

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  21. David Brooks makes the anti-socialism case in the New York Times:

    Why are nations like Germany and the U.S. rich? It’s not primarily because they possess natural resources — many nations have those. It’s primarily because of habits, values and social capital.

    It’s because many people in these countries... believe in a simple moral formula: effort should lead to reward as often as possible.

    People who work hard and play by the rules should have a fair shot at prosperity. Money should go to people on the basis of merit and enterprise. Self-control should be rewarded while laziness and self-indulgence should not. Community institutions should nurture responsibility and fairness.

    This ethos is not an immutable genetic property, which can blithely be taken for granted. It’s a precious social construct, which can be undermined and degraded.


    One can argue that socialized medicine is more efficient than private, free-market care. Maybe it is, although we haven't had real free market medical care in this country for many years. However, IMHO the the more important difference is that with socialism, people are given medical care. In a free market, people have to earn medical care.

    Obviously, it's generous to give people medical care, and to give people housing, and and give people food, and to give people higher education, and all sorts of other things. But, if people don't have to work for these things, they may become as unproductive as I am (I'm retired.) Then, we find ourselves with less food, housing, medical care, etc. to share.

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  22. Obviously, it's generous to give people medical care, and to give people housing, and and give people food, and to give people higher education, and all sorts of other things. But, if people don't have to work for these things, they may become as unproductive as I am (I'm retired.) Then, we find ourselves with less food, housing, medical care, etc. to share.

    Japan, Germany and Scandinavia offer most of the stuff you are talking about to all of their citizens, but they have all have very high rates of productivity. There are lots of things that can be critiqued about their economies, but it doesn't make their citizens lazy.

    I have a hard time understanding how Brooks can mention the US and Germany in the same sentence. He simply doesn't know what he is talking about. Bob Somerby has gone over Arthur Brooks' slippery work on charity before at the Daily Howler. Economic journalist Doug Henwood refutes Brooks here effectively. Brooks needs to acquaint himself with the basic facts before he decides to write his next column.

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  23. Please see here for the Arthur Brooks critique.

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  24. hardindr, you may have a valid point regarding Japan, Germany and Scandinavia. OTOH their high productivity may be due to a long-standing culture.

    It's a different story when one compares the same country split between a more socialistic part and a more free market part, such as mainland China vs. Taiwan, East Germany vs. West Germans, N Korea vs S Korea. Or, compare US big government states like Texas vs. US small governent states like California. In each of these cases the free market part of the country was more productive.

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