Arnold Kling  

Some Health Care Tidbits

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Education vs. Money Management... Jack Calfee, RIP...

1. The late John Calfee has an op-ed in today's WSJ that emphasizes the way that the Massachusetts health care reform raised costs.


Meanwhile, economists John Cogan, Glenn Hubbard and Daniel Kessler reported in the Forum for Health Economics & Policy (2010) that insurance premiums for individuals (alone or in employer-sponsored group plans) increased 6% to 7% beyond what they would have without the reform. For small employers, the increases are about 14% beyond those in the rest of the nation. Four years after reform, Massachusetts still has the highest insurance premiums in the nation, and the gap is getting wider.

2. Ezra Klein reports on Hansonian medicine.


Over the course of the study, the high-income patients were only 35 percent as likely to die as the low-income patients, and the highly educated patients only 26 percent as likely to die as the low-income patients. And the problem wasn't that the low-income and low-education patients were hanging back from the health-care system. Because they were getting sick while their richer and better educated counterparts weren't, they actually used considerable more in health-care services.

And that is from a study in Canada.

3. The Washington Post reports,


A 2006 study by the U.S. Department of Education found that 36 percent of adults have only basic or below-basic skills for dealing with health material. This means that 90 million Americans can understand discharge instructions written only at a fifth-grade level or lower.

My guess is that if you want to improve health outcomes in the United States, ignore health insurance and focus on literacy. Even if it has nothing to do with whether or not they can follow a doctor's written instructions, my guess is that better literacy has a positive impact on health outcomes. The question is whether educators know enough about how to improve literacy to be able to do so effectively. I hope that is the case.


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COMMENTS (11 to date)
mark writes:

How unfortunate Ezra Klein only learns these obvious facts after the health care reform act passed. One would think he owes the rest of us an apology, and a column saying we should repeal it.

Shangwen writes:

Here is a depressing example of some old, well-established empirical knowledge being repeated--and to deaf ears. Out of all the factors that contribute to the variation in health status between individuals, health care consumption accounts for about 5%. So why is real spending 17% of GDP in the US, and why is it even 10% in Canada? Even that it is too high.

Prior to PPACA, the US health care system was like an eighteen-wheeler speeding toward the edge of a cliff. Now it has been wisely redirected so the truck is speeding toward a brick wall, though the wall has a pretty Disney mural on it.

Yancey Ward writes:

You probably would get more bang for the buck, but there is almost certainly an upper limit to what could be accomplished by this method. It isn't easy to make people more intelligent.

phil writes:

Is there a high correlation between income and literacy?

Ray writes:

Some good comments on the Canadian health study, by Dr. Liberty:

http://bit.ly/hLzENr and http://bit.ly/ii3SDD

Seth writes:

"My guess is that if you want to improve health outcomes in the United States, ignore health insurance and focus on literacy."

To that I'd add critical thinking skills.

Chris T writes:

To that I'd add critical thinking skills.

Let's not get overly ambitious.

Some Random Economist writes:

[Comment removed for supplying false email address. Email the webmaster@econlib.org to request restoring this comment. A valid email address is required to post comments on EconLog.--Econlib Ed.]

Lars P writes:

Increases in life expectancy follows GDP increases closely and are independent of medical discoveries.

This is in part because rich people can afford more health care, but mostly because they live healthier lifes.

Thomas writes:

How unfortunate @mark was unable to follow the link Ezra Klein provided to the essay he wrote in 2009, titled "Fixing our health-care system will make us more economically secure. It won't make us much healthier." Perhaps @mark would benefit from a literacy intervention?

Joel writes:

You may want to look at these reports from the World Health Organization, European Union and the UK that describe determinants of health and some possible interventions:

http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf
http://www.who.int/social_determinants/thecommission/finalreport/en/index.html
http://www.marmotreview.org/

[shortened urls replaced with complete urls. Please do not use bit.ly urls on EconLog. We are not hardpressed to save space, and our readers prefer to know what will happen if they click a link. --Econlib Ed.]

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