The Health Care Crisis and What to Do About It

By Paul Krugman, Robin Wells   NYRB - LIII #5 -March 23, 2006

...How do we know that the US health care system is highly inefficient? An important part of the evidence takes the form of international comparisons. The table above compares US health care with the systems of three other advanced countries. It's clear from the table that the United States has achieved something remarkable. We spend far more on health care than other advanced countries—almost twice as much per capita as France, almost two and a half times as much as Britain. Yet we do considerably worse even than the British on basic measures of health performance, such as life expectancy and infant mortality.

One might argue that the US health care system actually provides better care than foreign systems, but that the effects of this superior care are more than offset by unhealthy US lifestyles. ... But a variety of evidence refutes this argument. The data show that the United States does not stand out in the quantity of care, as measured by such indicators as the number of physicians, nurses, and hospital beds per capita. ...The frequent claim that the United States pays high medical prices to avoid long waiting lists for care also fails to hold up in the face of the evidence: there are long waiting lists for elective surgery in some non-US systems, but not all, and the procedures for which these waiting lists exist account for only 3 percent of US health care spending.

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