Cornell economist Robert Frank compares Sweden's state-run healthcare system with healthcare in...

Cornell economist Robert Frank compares Sweden's state-run healthcare system with healthcare in the U.S. and finds that while the latter country spends over double the amount of money, "outcomes are far better in Sweden along virtually every dimension." Opponents of Obamacare should focus on improving it, not trying to repeal it. "Because of pervasive market failures in private health care markets, this may be the sector that benefits most from collective action," writes Frank.

Comments (17)
  • Bret Jensen
    , contributor
    Comments (14469) | Send Message
    Apples vs oranges comparison typical of left leaning economists. Taking a small (~9mm people), homogeneous population with a high fish diet and comparing it with a huge diverse behemoth is a ridiculous comparison. Comparing the U.S. to France or all of Europe makes much more sense. The truth is if you compensate for the difference in murder and auto fatalities (Which I think we can agree are not health care related), the average American lives 1.3 years longer than the average European.
    16 Jun 2013, 09:25 AM Reply Like
  • txbeekeeper
    , contributor
    Comments (325) | Send Message
    "Apples vs oranges comparison typical of left leaning economists"


    Congratulations, you just committed the number one behavioral mistake that investors make - confirmation bias. And you put it so well by first labeling the economists as left leaning in your opinion showing why you reject their data and then begin to cite the data you prefer and ridicule their data because it does not confirm your bias. I have no idea who is right about the healthcare topic but I take delight in seeing investors make this mistake because it means I am betting against a group who will consistently make judgement errors when presented with a set of data points.


    If the perspective was to be debated fully then I would have expected to hear about the high alcoholism rate in Sweden and not lifespan numbers minus murder and auto fatalities which have nothing to do with evaluating health care outcomes.
    16 Jun 2013, 10:04 AM Reply Like
  • Brian Barbour
    , contributor
    Comments (1321) | Send Message
    the World Health Organisation disagrees with you...type in life expectancy on google wikepedia with the source being WHO shows most european countries have a higher life expectancy than the US.


    Im from the UK and i always find it funny when people from the US call our NHS system "communist" or "socialist". Not too sure if this is the result of some sort of scare mongering to the public or what. The NHS is one of the best things with living in the UK, no matter what your income you will be guaranteed treatment. There is private as well which obviously is speedier and better quality equipment used but this comes at a cost.
    16 Jun 2013, 10:29 AM Reply Like
  • joabe17
    , contributor
    Comments (198) | Send Message
    I wish we could at least admit that our free market approach to healthcare is unworkable. There is no free market if you can't say no. It may work with eye glasses, but not while on the way to the hospital in an ambulance. There is a reason everyone else in the world has abandoned the system some in this country still hold so dear.
    I have friends in the UK who love their healthcare.
    16 Jun 2013, 10:42 AM Reply Like
  • pagingdrlack
    , contributor
    Comment (1) | Send Message
    The European health care system is very skewed against preventative health care and screenings. For example, the death rate from malignant melanoma in Europe is twice the rate in the United States. Your comment regarding better dietary habits in Sweden is correct.
    16 Jun 2013, 01:18 PM Reply Like
  • bgold1955
    , contributor
    Comments (2351) | Send Message
    Agree, look at the number of deaths by infections in US and you will see that we are more likely to die of preventable infections than, UK, CAN, SWE, GER, ISR, AUS, NEW Z, JAPAN. Now that hospitals get penalized for infections that cause re-hospitalization they have dropped dramatically from just 2 years ago. Kinda sad how that works. Especially when you have had more than 1 in your immediate family suffer, at a great cost, due to prior processes.
    16 Jun 2013, 01:19 PM Reply Like
  • Bret Jensen
    , contributor
    Comments (14469) | Send Message
    Is that why the waiting list for hip replacement in UK is four years or survival way for many cancers is in the 50% to 65% rate where it is 85% to 90% in the U.S. It is all about trade offs.
    16 Jun 2013, 03:28 PM Reply Like
  • joabe17
    , contributor
    Comments (198) | Send Message
    Forget the UK, let's try to emulate the Canadian system.


    By an overwhelming margin, Canadians prefer the Canadian health care system to the American one. Overall, 82% said they preferred the Canadian system, fully ten times the number who said the American system is superior (8%)....from a Harris-Decima poll (.pdf), July 2009. .


    The vast majority of Canadians, 91 per cent, felt that Canada's health care system was better than the United States...CTV, a Canadian television network, Jun. 29 2008, reporting on a survey, conducted by the Strategic Counsel for CTV and The Globe and Mail.


    Even right leaning economists would find numbers like these tough to dismiss Bret.
    16 Jun 2013, 07:16 PM Reply Like
  • Thought Crime
    , contributor
    Comments (60) | Send Message
    And high suicide rate...
    17 Jun 2013, 05:39 AM Reply Like
  • OptionManiac
    , contributor
    Comments (3498) | Send Message
    US is ranked 34th, the UK 38th in the suicide rate. Number one is Greenland. Go figure.
    17 Jun 2013, 07:00 AM Reply Like
  • bob adamson
    , contributor
    Comments (4560) | Send Message


    I can’t cite some authority for this but it is my understanding that suicide rates increase significantly in populations residing near 60 degrees north latitude or higher. (The same would apply to populations residing below around 60 degrees south latitude but few live there).


    Essentially, people become somewhat manic when daylight hours approach 20 hours a day or more for months on end but somewhat depressive when they diminish to 5 or 6 hours a day or less for like periods. I certainly found that to be the case for myself and colleagues when teaching in a small community in north western British Columbia 45 years ago. For a small portion of such populations these mood swing sufficiently compound pre-existing dispositions thereby increasing the propensity for clinical depression and resulting suicide in mid to late winter.
    17 Jun 2013, 12:53 PM Reply Like
  • OptionManiac
    , contributor
    Comments (3498) | Send Message
    That doesn't surprise me at all. I see Alaska has the highest suicide rate among the 50 states. Mix having a gun around doesn't help, even though it is a necessity in a lot of the outback areas.
    18 Jun 2013, 06:49 AM Reply Like
  • Remyngton
    , contributor
    Comments (343) | Send Message
    2008 WHO statistics list Sweden as 23 best system .
    Is that supposed to be a good model to compare the US to ?


    Sweden doesn't make the top 10 in MRI's or CT Scans


    and ,


    they've closed 14% of all beds or hospitals over the last 20 years


    Maybe the economist should live in Malmo , Gothenburg , or Karlskrona for a few years , instead of using statistics from Stockholm to cherry pick his findings


    The average Swedish doctor earns
    just €€ 40,000 per year ($53,000), compared to
    $156,000 for primary care physicians and
    $278,000 for specialists in the United States.


    Think AMA or its lobby will push for cuts here ???


    .... CHIMP
    16 Jun 2013, 02:28 PM Reply Like
  • alf2011
    , contributor
    Comments (542) | Send Message
    Let's begin by admitting that the private healthcare marketplace in the US is broken. The reasons for this are mostly cultural, the tradition of employer-provided health insurance, the expectation that medical insurance should cover routine care, and the lack of up-front prices by hospitals and doctors. This has been blessed and compounded by a tax code which provides incentives for keeping things the way they are.


    When faced with a market that does not work, reasonable people have essentially two possible reactions. One is advocate more regulation or maybe even government takeover. The other is, find ways to increase competition in that market. Based on the historical evidence, everyone should choose where they stand.


    When it comes to the Scandinavian countries and Germany one should not forget that there are cultural factors there that are not easy to export. One is acceptance of (relatively) low salaries for doctors, another is the expectation of low corruptibility, high standards, and low pay for public employees.


    While we are at it, let's mention Obamacare. The good thing about it is that it acknowledges that there is a problem. The bad is that, besides throwing some mandates and money at it (which is only going to make things worse) it does not even begin to fix the problem.
    16 Jun 2013, 02:36 PM Reply Like
  • bob adamson
    , contributor
    Comments (4560) | Send Message
    Bret Jensen,


    Your 9:25 AM post raises several issues that I’d like to address:


    1. Apples and Oranges:


    There are striking differences in life expectancy within the US. Arguably these are as much or more due to lifestyle and cultural issues as to the quality and availability of health care services. By way of illustration, here is an interesting article of a couple of years ago from The Washington Post:



    A similar range of life expectancies exist within Canada (arguably for similar lifestyle and cultural differences) which are of particular note in our discussion as the public health care plans in each of Canada’s Provinces and Territories are broadly similar one to another. See the following Statistics Canada chart for details on the range of life expectancies.



    2. Big countries vs. Small Ones


    If you truly want to compare similar jurisdictions, consider the life expectancies in each of Canada’s Provinces with those in corresponding US States bordering the Province in question. Note that there is roughly a two year higher life expectancy in the Canadian Province in most cases.
    As noted earlier, it would be wrong to attribute these differences solely to the differences in health care service delivery. However, arguably, differences in health care systems play a significant role.


    3. How different are health care delivery systems between countries anyway?


    Arguably there many different models of health care delivery within North America and within Europe and little is therefore gained by trying to compare some generic ‘US style health care’ with some ‘European style’. For example, within the US
    (a) The serving military experience the benefits (and many of the problems) of an overly bureaucratic universal health care system;
    (b) By contrast, some senior executives of the largest corporations receive an almost ideal rendition of private health care (i.e. personal top notch physicians of choice who will make house calls, immediate access to leading facilities and specialists as needed, all ancillary pharmaceutical and health care treatments and services as needed etc.) but their corporation picks up the tab;
    (c) Management and Unionized employees at many leading corporations enjoy access to good company plans that provide a broad array of needed services that, while not matching in detail those described in point (b), compare very favorably with what is available in Canada or much of Europe;
    (d) Then there is the broad array of HMO plans that range from the quite good to the questionable in terms of cost and quality and access to services as needed;
    (e) Not to be forgotten is the 50 million or so (and growing) Americans that until recently lacked medical health insurance.


    Within Europe (and Canada) there are also a range of plans. These vary significantly from country to country but generally share two features that differentiate them from US plans (even after Obamacare is fully implemented these differences (universal access as a matter of right and control over the cost growth of drugs and services) will continue to some degree to exist.


    Some of these European plans allow a private fee paying system for the wealthy to exist in parallel to the Universal plan (the UK is an example) while others generally discourage such a private parallel system (Canada is an example). Some of these countries centralize the service delivery within public bodies (i.e. agencies of government or largely controlled by government) while others restrict the government role to mandating for-profit (or not-for-profit) private sector insurance schemes where (sometimes with government subsidy and in other countries not) universal care is funded. In some countries the individual citizen pays a premium for coverage or fee for service (geared to the ability to pay) while in other countries, the plans are fully funded through government.


    In short, the real difference for purposes of our discussion is the fact that in almost all advanced and affluent countries except the US, there is universal coverage, a general mechanism for cost control and an acknowledgement that the government as the agent and with the consent of the electorate has a major responsibility to ensure that universal access to quality health care services is available at prices affordable to both the country and each citizen is maintained and continually improved.


    For interests sake, here is an interesting article reporting upon a comparative study of health care services in the US and Canada.

    16 Jun 2013, 06:35 PM Reply Like
  • OptionManiac
    , contributor
    Comments (3498) | Send Message
    Hospital CEO's in this country get paid multi-million bonuses for getting more and more people into their hospitals for multiple services. The incentive should be to have fewer people have the need to enter hospitals. My brother worked at a cardio do'cs office until he found out the MO was to get a patient to get on a med and then schedule regular visits so the doc could rake in the dough. Let's face it, when the goal is too spend the least on medical expenses, it just doesn't fit into a true capitalistic system, where the goal is to make the most money.
    16 Jun 2013, 08:14 PM Reply Like
  • SmashFinance
    , contributor
    Comments (34) | Send Message
    "Because of pervasive market failures in private health care markets, this may be the sector that benefits most from collective action," writes Frank...


    I don't know of any true, free market health-care system... Every healthcare system in the world can be, at a minimum ,said to be heavily STATE influenced! It seems a little naïve to suggest market failures, when at every corner gov'ts impede the market.
    16 Jun 2013, 09:53 PM Reply Like
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