From: jwh@citi.umich.edu (Jim Howe)
Subject: Re: The Decline of America: Health Care
Date: Mon, 28 Sep 92 10:27:09 EDT
Organization: IFS Project, University of Michigan
Reply-To: jwh@citi.umich.edu

In article <1992Sep25.194947.26165@vexcel.com>, dean@vexcel.com (Dean Alaska) writes:
|> In article <Mcy-cX+@engin.umich.edu> jwh@citi.umich.edu writes:
|> >In article <1992Sep24.173634.705@vexcel.com>, dean@vexcel.com (Dean Alaska) writes:
|> >|> In article <h-y-6L-@engin.umich.edu> jwh@citi.umich.edu writes:
|> >|> >
|> >|> >I have seen research which examined government intervention in health
|> >|> >care from both the cost and quality perspective.  The conclusion was
|> >|> >that government intervention neither reduces costs nor improves the
|> >|> >quality of care.  At the same time, it wasn't found to particularly
|> >|> >hurt it either.  On the issue of infant mortality statistics, the
|> >|> >researchers examined data from several OECD countries and found, after
|> >|> >controlling for factors such as education, GDP, availability of
|> >|> >care, etc., that 'other' factors were the reason for the higher
|> >|> >rate in the U.S.  They didn't elaborate on what the 'other' factors
|> >|> >might be.
|> >|> >
|> >|> If it finds that govt intervention didn't help or hurt, and if
|> >|> unspecified factors were the cause of the differenc in health care
|> >|> statistics, then it seems that this study doesn't have too much to
|> >|> offer to the debate about national health care.
|> >
|> >How do you figure?  People are saying that we need a new government
|> >program to 'improve' health care and control costs.  This report
|> >casts doubt on the ability of the government to either improve
|> >care quality or control costs.  If so, what is the point of creating
|> >a program that isn't likely to achieve its stated goal?
|> 
|> A study that hasn't determined what the factors are that are leading to
|> much better health statistics in one country over another does not have
|> much credibility when it claims that one major factor (government) is
|> not the cause of the difference.  You say they didn't elaborate on
|> what the causative factors are or might be.  This is pretty vague.
|> If they know and aren't saying, why?  If they don't know, then how
|> can they be sure that they haven't overlooked something?  Without
|> seeing the report, its just speculation.  I would like to check it out.
|> Who performed the study?  Do you know how I can get a copy?

The study looked at areas of government influence on health care, 
particularly government spending.  The goal of the research was not
to find out the causes of improved health care but to examine the
effects of government intervention on both cost and quality.  It
did examine various factors which are thought to influence quality
of care, such as Read GDP, Medical Services (Real Health Care Expenditures,
Physicians per Capita), Urbanized Population, Female Labor Force Particpation
Rate and Education.  It found positive correlation with some of the
factors, but government spending on health care was not one of them.
The fact that they didn't (or couldn't) identify the reasons behind
the lower U.S. IMR does not invalidate their research or conclusions,
IMHO.  It simply means that further research is indicated in order to
find out what 'other' factors may be involved.  The study was done by
Rexford E. Santerre, Stephen G. Grubaugh, and Andrew J. Stollar.  The
authors are professors in the Dept. of Economics at Bentley College.
The study was published in the Cato Journal, Vol 11 No. 1 under the
title: "Government Intervention in Health Care Markets and Health Care
Outcomes: Some International Evidence".


James W. Howe                  internet: jwh@citi.umich.edu
University of Michigan             uucp: uunet!mailrus!citi.umich.edu!jwh
Ann Arbor, MI   48103-4943