The Right Path but the Wrong Direction

Get a good education, work hard, and good things will happen, that’s the American Dream. But it may be fading as we let stagnant earnings continue as they have. This post, which is about work, earnings, higher education, and inflation, also portends an American Dream for some, but not for the majority who find themselves going backwards.

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On Ending a Health Care Fallacy

Here it’s argued that we need to retire the health care fallacy, “We spend more on health care than other rich countries but have worse outcomes.” The fallacy implies U.S. health care is deficient in spite of being costly. Indeed our health care costs too much, but there is little evidence that our care is less effective than care in other countries. On the other hand, there’s plenty of evidence that our social determinants of health are worse.

The argument segues off a recent article by Victor Fuchs. The case is presented by using a simple linear model to explore how life expectancy might change when we substitute the numbers of other countries’ determinants of health for U.S. numbers. After making these substitutions and holding health care spending constant the model predicts U.S. life expectancy is right there with the other OECD countries, 81.6 years compared to their average 81.4 years. This what-if modelling makes clear what should be obvious but the fallacy hides, that health care is only one part of population health.
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Risk Pushed Down onto Us

Within a day I was twice alerted to Bruce Schneier’s recent essay, “Our Newfound Fear of Risk.” Schneier meaningfully and regularly contributes on security issues. He deserves our appreciation. However, I disagree with his connotation that “Our Newfound Fear of Risk” is our fault, for that’s how the essay reads: “We’re afraid of risk”, “We’re bad at accurately assessing risk”, “We need to relearn how to accept risk.” The examples given about our implied overreaction to risk are policing, control and, terrorism. Continue reading

A Fresh Look at Health Care Cost Growth

In this post I recast the visual display of international health care expenditures. For select OECD countries, this clearly shows the growth of average costs has been moderating while U.S. cost-growth has been accelerating. The graph methodology is discussed along with a caution about marginal thinking. A conjecture is presented as to why the OECD cost-growth is moderating followed by a couple thoughts for action. Continue reading

Hold that Health Care Shibboleth

“We spend far more on health care than other peer countries yet have worse outcomes. Why is U.S. health care so expensive?” I’m sure you’ve encountered similar statements, maybe even expressed it yourself. It occurs often, including by knowledgeable people and health-related institutions. However, it’s a fallacy because it confuses health care with population health. Continue reading