My mission, should I choose to accept it, is to explain why we're spending all this money on medicine and getting sick and dying more and sooner than the countries that spend half as much. First, we need to take a step back and consider the actual determinants of health. The Kaiser Family Foundation has offered a convenient picture:
You'll notice that the so-called "Health Care System" appears in two of the six columns, but on the leftmost, it's actually negative -- medical bills and debt harm people's health. Only in the rightmost column does it have positive value, and even then it's unevenly distributed. So what it really comes down to is actually two questions:
- Why do we spend so much on medicine?
- Why don't we spend enough on the other, more important determinants of health?
And note that as regards the latter question, the other wealthy countries do indeed spend more than we do, and that's probably a pretty good explanation of why they're healthier. So I am going to offer an explanation, which has two parts, both pertaining to our political culture. One I'm going to call Economics 101, the other the Rule of Rescue. I'll take on Economics 101 next.
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