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Value for Money

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The article from this week's New England Journal of Medicine that got the widest pickup in the MSM was Harvard University professor David Cutler's study suggesting the U.S. health care system, despite its skyrocketing costs, provided a reasonable return on investment over the past 40 years.

For those who may not have seen the news reports, the study pointed out that life expectancy has risen from about 70 to about 78 over that period. He attributed half the increase to improved medical technologies, and half to other factors (improved diet, less smoking, etc). Then he compared that to the amount we spend on health care and suggested that the cost of health care for each additional year of life fell well below $100,000. That, he concluded, makes our off-the-charts health care spending a decent buy.

I have no quarrels with the data. But the interpretation leaves something to be desired. How about all those other industrialized countries around the world that have increased their life expectancies by an equal or greater amount (most, by the way, are greater)? What would he say about their state-run health care systems, which generally cost about half to 60 percent of what the U.S. spends?

As Jack Benny used to say: What a bargain!

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