Are our health care expenditures worth it?

"A big question in determining where to direct money to improve lives is how effectively we can get people to change their behavior," said Anupam Jena, doctor and economist who conducts research at Harvard Medical School. . "It may be true that diet and exercise have a big impact on health, but sometimes it's sometimes much harder to get people to change their lifestyle than to force them to do it. to take a pill or undergo a procedure. "

Another limitation of studies like this is that they are based in part on assumptions and estimates. But careful work can help us to be sure that it is not the engine of results. For example, according to a study by David Cutler and his economists at Harvard, the reduction of smoking rates and other changes known to have significant effects on mortality – such as a decrease in the number of deaths due to road accidents – can explain only 21% of the increase in longevity recorded for almost eight years between 1960 and 2000. It is therefore not unlikely that the health system can explain a fairly large share of the rest of this gain.

Dr. Cutler's work has also compared the benefits of a long life in the health care system with the cost. In total, each year of additional life between 1960 and 2000 attributed to the health system cost nearly $ 20,000. When we focused on the same gain for the 65 years, the average cost was about $ 85,000.

Both figures are lower than typical amounts that the company is willing to spend to earn a year of life. There is no perfect way to determine the willingness to pay for a healthy year of life, of course – and this is a fairly controversial topic, as you can imagine – but the estimates extend to less $ 150,000.

It is these discoveries that have led some scholars to argue that health care is so valuable that we should be prepared to spend even more.

Since 2000, we have certainly. According to Dr. Cutler's study, getting this extra year of an extra year of life in the health care system for a 65-year-old man cost nearly $ 160,000.

"What we really want to know, is how much an extra dollar spent on health care is buying us today?" Said Dr. Jena. "Just as you can do too much with exercise – jogging six days a week will not bring you much more benefits from jogging five days a week – you can do it with care. health." Studies are mixed on this point: Some suggest that spending more provides a substantial additional benefit; Some suggest that this is not the case.