Maybe Health Care Reform Was Necessary

by Stuart Shapiro

One of the reasons often cited for needing to change the health care system in this country is the higher costs but lower life expectancies in the United States compared with other developed countries.  Critics of health care reform often counter that lower life expectancy is due to obesity, car accidents, homicides, and smoking in the United States.  In other words, lower life expectancies come from factors outside the health care system (funny, they rarely advocate gun control or stricter auto regulations).

Until recently, there was no good answer to this argument.  But last week a paper by two professors from the Mailman School of Public Health at Columbia (one of whom is on leave, working at HHS), was published that refutes this idea:

Others say that poorUS health outcomes are largely due not to health care but tohigh rates of smoking, obesity, traffic fatalities, and homicides.We used cross-national data on the fifteen-year survival ofmen and women over three decades to examine the validity ofthese arguments. We found that the risk profiles of Americansgenerally improved relative to those for citizens of many othernations, but Americans’ relative fifteen-year survivalhas nevertheless been declining. For example, by 2005, fifteen-yearsurvival rates for forty-five-year-old US white women were lowerthan in twelve comparison countries with populations of at leastseven million and per capita gross domestic product (GDP) ofat least 60 percent of US per capita GDP in 1975. The findingsundercut critics who might argue that the US health care systemis not in need of major changes.

The point is simple.  Americans are not killing each other or eating themselves to death at a rate high enough to explain the higher mortality rates in the United States than the rest of the world.  Something else must be responsible.  The health care system is the likely culprit.

By: Stuart Shapiro

Stuart is a professor and the Director of the Public Policy
program at the Bloustein School of Planning and Public Policy at Rutgers
University. He teaches economics and cost-benefit analysis and studies
regulation in the United States at both the federal and state levels.
Prior to coming to Rutgers, Stuart worked for five years at the Office
of Management and Budget in Washington under Presidents Clinton and
George W. Bush.