Five Myths About American Health Care

1. Five Myths About American Health Care Christopher J. Conover, PhD Center for Health Policy and Inequalities Research Duke University February 28, 2012

2. Road Map • Myth #1: Relative to other countries, the U.S. spends “too much” on health care • Myth #2: Other countries do better at controlling health spending growth • Myth #3: The U.S. abysmal infant mortality rates compared to other nations • Myth #4: The U.S. has much lower life expectancy relative to its competitors • Myth #5. The U.S. has worse health outcomes than its peers

3. Myth #1: Relative to other countries, the U.S. spends “too much” on health care

4. 19.4a | The conventional wisdom is that U.S. health spending is 60 percent above its expected level given the nation’s per person GDP GDP per Person (U.S. Purchasing Power Parity, 2006 dollars)

5. 19.4b | Once sub-national areas are taken into account, U.S. health spending is almost exactly where it is expected to be given U.S. GDP Health spending per person (US purchasing power parity, 2006 dollars) Note: all areas with less than 4.1 million population have been excluded.

6. Myth #2: Other countries do better at controlling health spending growth

7. 1.6a | The difference between the U.S. and other G7 nations in the health spending share of GDP has grown wider since 1980

8. 1.6b | For 50 years, growth in real health spending per capita has not been noticeably higher in the U.S. relative to other G7 countries Countries ranked by size of GDP in 2007. Growth rates estimated from real NHE per capita (calculated in chained 2005 U.S. dollars using a GDP price deflator)

9. 1.6c | The U.S. advantage in inflation-adjusted non-health GDP per capita has increased since 1980 relative to nearly all G7 nations Countries ranked by size of GDP in 2007. Inflation-adjusted GDP per capita is measured in constant chain series, 2005 U.S. dollars, as reported in Penn World Tables.

10. Myth #3: The U.S. abysmal infant mortality rates compared to other nations

11. 19.10 | Except for Sweden and Norway, the U.S. generally leads to world in saving the lives of premature infants Infant mortality index (U.S. = 100) Note: countries ranked from best to worst for infants with the shortest gestation period.

12. Myth #4: The U.S. has much lower life expectancy relative to its competitors

13. 19.9a | Once higher-than-average U.S. rates of violent deaths have been taken into account, the U.S. leads the world in life expectancy Mean life expectancy at birth, 1980-1999 Note: Countries are ordered by standardized life expectancy derived by assigning each country the mean OECD fatal injury rate for the period shown; figures in parentheses denote ranking on unstandardized life expectancy at birth.

14. Myth #5: The U.S. has worse health outcomes than its peers

15. 19.11a | The U.S. leads the world in female cancer survival rates for the leading causes of cancer deaths Five-year female cancer survival rate indexes (U.S. = 100)

16. 19.11b | Despite a larger uninsured population, cancer screening rates for adults 50 and older are much higher in the U.S. than in Europe European cancer screening rates as a percentage of U.S. rates

17. Conclusions • The U.S. health system has many problems • But other countries do not offer a magic bullet • Misconceptions helped put health reform on the wrong path: government-controlled health care • Governor Mitch Daniels: “Smart decisions always start with clarity about the facts”