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Fogel Compares Health Systems

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Timothy Taylor's column in the latest Journal of Economic Perspectives points to an interview with Robert Fogel.

What we currently call the poverty line is so high that only the top 6 percent or 7 percent of the people who were alive in 1900 would be above it. That, by the way, is also true when you compare us to other developed countries.

England is a rich country but we are 50 percent richer, and we do things that seem wasteful to the English. My wife came down with pneumonia in 2001 in London. She was treated at one of the city’s top hospitals, Guy’s and St. Thomas’ Hospital, which is directly across from Parliament. Everything there was in wards, whereas in the United States rooms are typically private or semi-private. Americans today are used to having a phone beside their bed and 40 channels of television to watch while they are recuperating from an illness. That is unusual, even in other rich countries. Also, the way the diagnosis of her ailment was conducted was different from the typical procedure used in the United States. The doctors and nurses were very good but they never X-rayed her. They just listened to her lungs and came to the conclusion that she had pneumonia. If she had been in the United States, the doctors typically would have X-rayed her as a precautionary measure. So we make all sorts of investments that the British are not willing to make.

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COMMENTS (7 to date)
Fundamentalist writes:
...the doctors typically would have X-rayed her as a precautionary measure

They would have X-rayed her multiple times and probably run at least one MRI, anything to milk the insurance company.

I've been awaiting the publication of the two books Fogel mentioned in that interview he was writing with his wife. Unfortunately, she just died recently.

Kimmitt writes:

Um, cable TV and x-rays are really cheap. I'm not sure what his point is.

Floccina writes:

Doesn't it makes you think that insurance companies, contrary to what people think, are a bunch of wimps compared to Governments.

Heather writes:

I think the point is that even though a single TV or x-ray is cheap, by multiplying it many times, costs go up. Think of the airlines who try saving a million dollars or so by reducing the number of tomatoes in an in-flight dinner or eliminating the meal all together. One time it isn't much, but the costs add up as the numbers increase.

mk writes:

I (basically) agree with the first commenter. The incentives in the US point towards spending more money on more care. Whereas in England you're directly charging the government, so they have more incentive to save money. That's my understanding, anyway.

SusieQ writes:

One of the money-saving tactits mentioned in the article was the use of wards instead of private rooms. How can one measure the cost of additional treatment due to catching diseases when treated in close confines with other patients? Also, is the cost of an x-ray worth possible misdiagnosis? Suppose she had something other than pneumonia? This would have led to a more lengthy stay and a higher cost. We may not have a perfect healthcare system in the US, but I think I would rather pay a few extra dollars for higher quality care.

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