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> Most advanced industrialized nations have a state-run health care system and pay on average half of what the US pays. The U.S. is not an outlier with regard

> Most advanced industrialized nations have a state-run health care system and pay on average half of what the US pays. The U.S. is not an outlier with regard to healthcare consumption when you factor in household income[1]. GDP is the wrong metric to measure against. [1]https://randomcriticalanalysis.com/2018/11/19/why-everything-you-know-about-healthcare-is-wrong-in-one-million-charts-a-response-to-noah-smith/ https://randomcriticalanalysis.com/2018/11/19/why-everything...

joe_the_user 7y ago
This argument uses average income as proxy for what health care spending in the US should be. That seems clearly wrong given that with US now having a GINI coefficient, high level of income inequality, median household income would be a better thing to measure health care spending, since every individual has to spend money on staying healthy. The argument generally seems wrong too. The need for health care isn't elastic - if someone need care, they need care and people going without needed health care is a humanitarian crisis (a situation that the US is arguable in - see the people giving free dental in a stadium a few years back).
- lliamander 7y ago
  > This argument uses average income as proxy for what health care spending in the US should be. > That seems clearly wrong given that with US now having a GINI coefficient, high level of income inequality, median household income would be a better thing to measure health care spending, since every individual has to spend money on staying healthy. The author responds to that criticism in the following comment[1]: >> Two, I don’t understand why you’re using mean rather than median AIC throughout. > Several reasons. > 1) We don’t have good internationally comparable statistics for income or consumption at various points in the distribution... > 2) When I’ve looked into this I have not found measured differences in the distribution or the median to be particularly informative... > 3) This makes sense because there is approximately no relationship between individual income and health spending in the developed world, including the United States... As for your second argument: > The argument generally seems wrong too. The need for health care isn't elastic - if someone need care, they need care and people going without needed health care is a humanitarian crisis (a situation that the US is arguable in - see the people giving free dental in a stadium a few years back). I'm not sure I follow your argument. RCA is saying that, as a country, the U.S. spends more on healthcare because we consume more health care than other countries. The U.K. kept their prices low for a long time only because the NHS engaged in intense rationing[2]. [1]https://randomcriticalanalysis.com/2018/11/19/why-everything-you-know-about-healthcare-is-wrong-in-one-million-charts-a-response-to-noah-smith/#comment-1231 https://randomcriticalanalysis.com/2018/11/19/why-everything... [2] https://i1.wp.com/randomcriticalanalysis.com/wp-content/uploads/2018/11/rcafdm_uk_nhs_trend_2015_comparisons_aic.png?ssl=1 https://i1.wp.com/randomcriticalanalysis.com/wp-content/uplo...
  - joe_the_user 7y ago
    1) Using average income, a clearly bad statistic, can't be justified by saying you could not find a good statistic. Unless you use a good statistic, your argument isn't justified. (cue story of drunk looking for glasses under lamp post etc). Also, if there's no measured difference in individual household income versus health care spending, well then maybe his pet theory comparing average household income and health care spending isn't very applicable either. 2) "RCA is saying that, as a country, the U.S. spends more on healthcare because we consume more health care than other countries." That argument is either wrong or tautological. The US spends more on health care for worse outcomes, as many studies have shown. If this person means we buy better outcomes, they are wrong. If they are saying we buy more stuff labeled health care, maybe true but that's because the system is bad, not good.
    - lliamander 7y ago
      > 1) Using average income, a clearly bad statistic, can't be justified by saying you could not find a good statistic. Unless you use a good statistic, your argument isn't justified. (cue story of drunk looking for glasses under lamp post etc). You're not responding to the complete argument. RCA has looked into finding median measure of income, and not found them relevant to the discussion because (as he says in the third point of the argument) the rich do subsidize health care for the poor. > Also, if there's no measured difference in individual household income versus health care spending, well then maybe his pet theory comparing average household income and health care spending isn't very applicable either. But again, mean income is relevant because the important thing is how much a society as a whole puts into the healthcare system. Average is meaningful when the rich subsidize the poor. > 2) "RCA is saying that, as a country, the U.S. spends more on healthcare because we consume more health care than other countries." > That argument is either wrong or tautological. The US spends more on health care for worse outcomes, as many studies have shown. If this person means we buy better outcomes, they are wrong. If they are saying we buy more stuff labeled health care, maybe true but that's because the system is bad, not good. According to RCA, AIC isn't just correlated with spending, but also "the vast majority of socially relevant outcomes and their covariates." [1] [1] https://randomcriticalanalysis.com/2018/11/19/why-everything-you-know-about-healthcare-is-wrong-in-one-million-charts-a-response-to-noah-smith/#rcatoc-these-measures-are-also-superior-predictors-of-just-about-every-socially-relevant-metric https://randomcriticalanalysis.com/2018/11/19/why-everything... EDIT: fixed wording in my first response ADDENDUM: There are charts that show life expectancy to be lower in the U.S. than other developed countries, but that has to do with factors other than the quality of healthcare[2]. [2]https://randomcriticalanalysis.com/2016/11/06/us-life-expectancy-is-below-naive-expectations-mostly-because-it-economically-outperforms/ https://randomcriticalanalysis.com/2016/11/06/us-life-expect...

joe_the_user 7y ago

This argument uses average income as proxy for what health care spending in the US should be. That seems clearly wrong given that with US now having a GINI coefficient, high level of income inequality, median household income would be a better thing to measure health care spending, since every individual has to spend money on staying healthy. The argument generally seems wrong too. The need for health care isn't elastic - if someone need care, they need care and people going without needed health care is a humanitarian crisis (a situation that the US is arguable in - see the people giving free dental in a stadium a few years back).

lliamander 7y ago
> This argument uses average income as proxy for what health care spending in the US should be. > That seems clearly wrong given that with US now having a GINI coefficient, high level of income inequality, median household income would be a better thing to measure health care spending, since every individual has to spend money on staying healthy. The author responds to that criticism in the following comment[1]: >> Two, I don’t understand why you’re using mean rather than median AIC throughout. > Several reasons. > 1) We don’t have good internationally comparable statistics for income or consumption at various points in the distribution... > 2) When I’ve looked into this I have not found measured differences in the distribution or the median to be particularly informative... > 3) This makes sense because there is approximately no relationship between individual income and health spending in the developed world, including the United States... As for your second argument: > The argument generally seems wrong too. The need for health care isn't elastic - if someone need care, they need care and people going without needed health care is a humanitarian crisis (a situation that the US is arguable in - see the people giving free dental in a stadium a few years back). I'm not sure I follow your argument. RCA is saying that, as a country, the U.S. spends more on healthcare because we consume more health care than other countries. The U.K. kept their prices low for a long time only because the NHS engaged in intense rationing[2]. [1]https://randomcriticalanalysis.com/2018/11/19/why-everything-you-know-about-healthcare-is-wrong-in-one-million-charts-a-response-to-noah-smith/#comment-1231 https://randomcriticalanalysis.com/2018/11/19/why-everything... [2] https://i1.wp.com/randomcriticalanalysis.com/wp-content/uploads/2018/11/rcafdm_uk_nhs_trend_2015_comparisons_aic.png?ssl=1 https://i1.wp.com/randomcriticalanalysis.com/wp-content/uplo...
- joe_the_user 7y ago
  1) Using average income, a clearly bad statistic, can't be justified by saying you could not find a good statistic. Unless you use a good statistic, your argument isn't justified. (cue story of drunk looking for glasses under lamp post etc). Also, if there's no measured difference in individual household income versus health care spending, well then maybe his pet theory comparing average household income and health care spending isn't very applicable either. 2) "RCA is saying that, as a country, the U.S. spends more on healthcare because we consume more health care than other countries." That argument is either wrong or tautological. The US spends more on health care for worse outcomes, as many studies have shown. If this person means we buy better outcomes, they are wrong. If they are saying we buy more stuff labeled health care, maybe true but that's because the system is bad, not good.
  - lliamander 7y ago
    > 1) Using average income, a clearly bad statistic, can't be justified by saying you could not find a good statistic. Unless you use a good statistic, your argument isn't justified. (cue story of drunk looking for glasses under lamp post etc). You're not responding to the complete argument. RCA has looked into finding median measure of income, and not found them relevant to the discussion because (as he says in the third point of the argument) the rich do subsidize health care for the poor. > Also, if there's no measured difference in individual household income versus health care spending, well then maybe his pet theory comparing average household income and health care spending isn't very applicable either. But again, mean income is relevant because the important thing is how much a society as a whole puts into the healthcare system. Average is meaningful when the rich subsidize the poor. > 2) "RCA is saying that, as a country, the U.S. spends more on healthcare because we consume more health care than other countries." > That argument is either wrong or tautological. The US spends more on health care for worse outcomes, as many studies have shown. If this person means we buy better outcomes, they are wrong. If they are saying we buy more stuff labeled health care, maybe true but that's because the system is bad, not good. According to RCA, AIC isn't just correlated with spending, but also "the vast majority of socially relevant outcomes and their covariates." [1] [1] https://randomcriticalanalysis.com/2018/11/19/why-everything-you-know-about-healthcare-is-wrong-in-one-million-charts-a-response-to-noah-smith/#rcatoc-these-measures-are-also-superior-predictors-of-just-about-every-socially-relevant-metric https://randomcriticalanalysis.com/2018/11/19/why-everything... EDIT: fixed wording in my first response ADDENDUM: There are charts that show life expectancy to be lower in the U.S. than other developed countries, but that has to do with factors other than the quality of healthcare[2]. [2]https://randomcriticalanalysis.com/2016/11/06/us-life-expectancy-is-below-naive-expectations-mostly-because-it-economically-outperforms/ https://randomcriticalanalysis.com/2016/11/06/us-life-expect...