As a tenured Harvard professor with a PhD in economics it should come as no surprise that I am willing to concede that Greg Mankiw is a much smarter man than I. And it is under that pretense that I am left befuddled at the huge whole in his argument from last week's post where he attempts to debunk the international comparison "canard" for healthcare reform. Dr. Mankiw makes his point by quoting Dr. Gary Becker as follows:
the American system has sometimes been found wanting simply because life expectancies in the United States are at best no better than those in France, Sweden, Japan, Germany, and other countries that spend considerably less on health care, both absolutely and relative to their GDPs....
[However], national differences in life expectancies are a highly imperfect indicator of the effectiveness of health delivery systems.for example, life styles are important contributors to health, and the US fares poorly on many life style indicators, such as incidence of overweight and obese men, women, and teenagers. To get around such problems, some analysts compare not life expectancies but survival rates from different diseases. The US health system tends to look pretty good on these comparisons.
He then concludes with the following statement:
The next time you hear someone cavalierly point to international comparisons in life expectancy as evidence against the U.S. healthcare system, you should be ready to explain how schlocky that argument really is.
And he does make a compelling case against international comparisons, doesn't he? Good thing that is NOT the argument for healthcare reform. Case in point:
Let me start by saying that with a wife whose family has a history of breast cancer I am extremely grateful to live in a country with such a high breast cancer survival rate (amongst other reasons). But then again, no one is really arguing that the US Healthcare system is ineffective. The argument is that it is grossly inefficient, leaves millions uninsured, and delivers essentially the same quality of care at roughly twice the cost of our western counterparts.
Dr. Mankiw may be right to point out that life expectancy is not the best indicator of a country's health care system, but the chart above does a pretty decent job of illustrating that we may not be getting the best deal on an international basis either. The good professor should at least be willing to concede that point.