About two years ago I created a long blog post arguing that the United States is not an outlier in healthcare expenditures per capita. Following renewed interest from a link from Marginal Revolution recently and some criticism from a few people on various comment threads, I thought I’d take the time to update the evidence, address some areas of criticism, and muster yet more lines of evidence to support my argument. This post should largely make the earlier post obsolete, but I will keep the earlier post up for posterity and to retain data/information that won’t necessarily be perfectly duplicated in this post.
There exist several popular plots like these that people use to make the argument that the United States spends vastly more than it should for its level of wealth.
These plots and the arguments that usually go with them give the strong impression that US spends about twice as much as it should. However, these are misleading for several reasons, namely:
- GDP is a substantially weaker proxy for “wealth” and a substantially weaker predictor of health care expenditures than other available measures.
- The US is much wealthier than other countries in these plots in reality.
- The arbitrary selection of a handful of countries tends to hide the problems with GDP in this context and, oddly enough, simultaneously downplay the strength of the relationship between wealth and health care spending
- Comparing these two quantities with a linear scale tends to substantially overstate the apparent magnitude of the residuals from trend amongst the richer economies when what we’re implicitly concerned with is the percentage spent on healthcare.
When properly analyzed with better data and closer attention to detail, it becomes quite clear that US healthcare spending is not astronomically high for a country of its wealth. Below I will layout these arguments in much greater detail and provide data, plots, and some statistical analysis to prove my point.