Better than Greece, Turkey

Facts have a liberal bias.

Seeking to make the case for less government involvement in health care, a brief analysis (PDF) by the Joint Economic Committee’s ranking Republican, Senator Sam Brownback of Kansas, in September compared the rate of health care spending growth in the United States with the 29 other countries in the Organization for Economic Cooperation and Development from 1997 to 2006. The analysis noted that on average the rate of growth was lower in the United States than in countries in the O.E.C.D.

Since the United States is one of the few nations with a largely private health care system, Mr. Brownback’s memorandum concluded that countries with primarily government-run systems often do a worse job controlling cost growth than does the United States. The conclusion is that giving government more control over health care here would be a big mistake.

It is an idea with wide appeal, but these data, at least, do not support it. “They extrapolate from one statistic to make conclusions about how comparative systems work that are at odds with what the broader evidence shows,” said Richard Saltman, a professor of health policy at Emory University, who has published an online critique of Mr. Brownback’s memorandum.

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The 5.9 percent rate of spending growth in the United States is below the O.E.C.D. average of 6.6 percent, but the 30 countries in that group represent a broad continuum of economic development. Many of the nations with higher spending growth rates, like Greece and Turkey, are poorer countries that until recently spent very little on health care, said Gerard Anderson, a professor at Johns Hopkins Bloomberg School of Public Health. Those countries are trying to make up for their lack of investment.

The picture looks quite different when one compares our growth rate with that in countries similar to ours, with higher incomes and higher costs but more government involvement. Health care spending in these countries — France, Germany, Japan and Switzerland, among others — actually grew more slowly than in the United States. “Economically competitive countries are able to control their costs better than we can,” Mr. Anderson said.

Republicans need to try harder.