I attended a timely and constructive town-hall meeting on health insurance reform on Tuesday night, featuring several of my colleagues from the Department of Economics. I appreciate the time and effort that each of them put into their presentations. I found it interesting that many times, and across many of the various speakers, issues that I have blogged about here --- adverse selection, moral hazard, the historical accident of our employer-based health plans --- were discussed in the presentations.
As in any good debate, of course, and especially among economists, there were a lot of dueling statistics. I realized that I had long had on my “to do” list to go and look up some original source data on topics that I have read about through a lot of secondary discussion. So, I did that, and here are some facts and patterns I found interesting. These questions all address an obvious larger question : “What do we get in the
1 ) The
2 ) One thing the
3 ) Having some type of “universal access” health care system is not a sufficient condition for having bad cancer survival rates.
4 ) What does stand out in the world of universal access is the poor performance of
So what does this tell us about our current system? (By the way, the panelists uniformly agreed that our tying of health care to employment is a bizarre and inefficient historical artifact). One is that one cannot argue that any arbitrary universal access health care system will necessarily make our health outcomes worse than they are now, using mortality figures as a benchmark. Secondly, what we seem to do relatively well in terms of mortality is address health issues of middle and later age. This suggests that what we do less well is address health issues of young adults. Given that young adults are reported to be relatively less covered by health insurance in the U.S., it suggests that our system works best for the approximately 80 - 85 percent of our population (again, dueling statistics) that are insured, and this is consistent with the reports that the majority of Americans are satisfied with their current coverage, but are concerned for those who are uninsured.
Here are some unanswered questions that I still have.
1 ) The
2 ) Mortality is mortality, not quality of life. A lot of the discussion at the town hall meeting was over quality of life issues. One of my colleagues reports being able to obtain quasi-emergency glaucoma surgery in the
3 ) Can we explain the wide variety of differences (at least in mortality) of other countries that have some type of universal coverage? I was really surprised at the wide variation among countries like