Health is a lot more than health care
This is a crucially important point. The best way to improve the health of a population, and to reduce health care costs, is to keep people from getting sick in the first place. Sick populations are going to be expensive to care for, no matter how efficient the delivery of care.An American’s life expectancy at birth is about 78 years, which is lower than in most other affluent countries. Life expectancy is about 80 in the United Kingdom, 81 in Canada and France, and 83 in Japan, according to the World Health Organization.
This longevity gap, Dr. Preston says, is primarily due to the relatively high rates of sickness and death among middle-aged Americans, chiefly from heart disease and cancer. Many of those deaths have been attributed to the health care system, an especially convenient target for those who favor a European alternative.
But there are many more differences between Europe and the United States than just the health care system. Americans are more ethnically diverse. They eat different food. They are fatter. Perhaps most important, they used to be exceptionally heavy smokers.
To this end, another policy debate is in the news. Tax on Sugary Beverages Debated - NYTimes.com:
To me this seems like an excellent idea. Just as increasing the tax on tobacco products makes a great deal of sense, so would taxing soft drinks. This is economics 101; it's a means of internalizing the true cost of a product. It will have the desirable effects of (1) reducing the consumption of the now more expensive less-healthy products and (2) raising funds to be used in the health care system to help offset the costs of people who are made less healthy by the products.The tax would apply to soft drinks, energy drinks, sports beverages and many juices and ice teas, but not sugar-free diet drinks. President Obama has said it is worth considering. The chief executive of Coca-Cola calls the idea outrageous, while skeptics point to political obstacles and question how much of an impact it would really have on consumers. But a team of prominent doctors, scientists and policy makers says it could be a powerful weapon in efforts to reduce obesity, in the same way that cigarette taxes have helped curb smoking.
The group, which includes the New York City health commissioner, Thomas Farley, and Joseph W. Thompson, Arkansas surgeon general, estimates that a tax of a penny an ounce on sugary beverages would raise $14.9 billion in its first year, which could be spent on health care initiatives. The tax would apply to soft drinks, energy drinks, sports beverages and many juices and iced teas — but not sugar-free diet drinks.
I don't pretend that you can exactly measure these numbers, or that this type of taxation will be an exact or accurate internalization of the costs. It's a pretty blunt instrument. Still, it seems to me to be a good step to take. But don't stop at soft drinks. We should impose an excise tax on all food and drink, differentiated on the basis of relative nutritional value and health impact.
I like the idea of a tax on soft drinks, etc., too. But I have to take a shot at the NYTimes article's statement about Americans being heavy smokers compared to Europeans. The implication is that Europeans weren't and aren't. Is that true? My impression is that in at least some European countries, much of the population were (and maybe still are) very heavy smokers.
ReplyDeleteSo I took a few minutes to Google this question, which was apparently more time, creativity and/or research skills then the NYT presently possesses. I immediately found one Gallup poll
http://www.gallup.com/poll/28432/smoking-rates-around-world-how-americans-compare.aspx
from about two years ago. It indicates that U.S. smoking rates two years ago were maybe slightly less than European rates. Is that true for the last few decades? I'll leave that question for another day, though I won't be expecting anything solid from the NYT on that information anytime soon.
Whatever the facts are, it looks like the NYT didn't have the editing skill or the inclination to find out. A simple, unacknowledged assumption of what the facts are will do. And this is the level of fact-checking they do for the point they consider "Perhaps most important..."
Geez.....I guess I've been ticked off at the NYT ever since it's sloppy drumbeat leading up to the Iraqi war. I know I got WAY off-track here....but it felt good!
I don't disagree in the slightest about the Times' terrible failure leading up to the Iraq war.
ReplyDeleteThat said, the article does say that Americans "used to be" very heavy smokers. I think that is true.
Now, it seems to me that the incidence of smoking in the US is less than in most parts of Europe. Certainly, exposure to second hand smoke is less, given what seems to be a real lack of smoking controls in public spaces in most of Europe. It will be interesting to see if that has an impact on relative longevity in the next couple of generations.
Of course, that doesn't address the obesity issue.