HEALTHCARE AND LIFE EXPECTANCY….Should we have a national healthcare plan? Tyler Cowen says no, but in the course of his argument suggests that increased spending on healthcare has no net effect on actual health. Matt Yglesias made the same claim yesterday.

In both cases, it turns out that the actual claim is that higher aggregate spending on healthcare doesn’t do much to increase aggregate life expectancy. This may well be true, and I think it’s a useful thing to know. If I remember the data correctly, for example, Americans spend wildly more than the French do in the final six months of life, and this spending is almost entirely useless. A more rational approach to end-of-life spending would probably cut down our healthcare bill a lot.

But there’s more to healthcare spending than life expectancy. In a paper Tyler links to, which summarizes the results of a famous RAND study from the 70s, we learn that “Those with free care consumed on average about 25-30% more health care, as measured by spending, obtained more eyeglasses, and had more teeth filled.” None of that increased anyone’s life expectancy, but it’s still a good thing to be able to see properly and to be able to chew hard food.

Or take my torn meniscus. I’m sure glad I got that repaired. It wouldn’t have killed me, but it certainly hurt a lot. Likewise, a few years ago I injured my back, and I really wish there were something I could do about it. This isn’t going to kill me either, but it hurts, it keeps me from participating in a wide variety of sports, and it’s limited my lifting capacity to approximately the weight of one large cat.

As it happens, end-of-life healthcare is already nationalized in the United States via Medicare, so a broader national health plan would almost certainly have only a tiny effect on life expectancy. Tyler is therefore right that liberals shouldn’t obsess about that. But that doesn’t mean that national healthcare wouldn’t have plenty of other important health benefits ? not to mention a wide variety of tangential benefits and efficiencies as well. If we can get all that and spend no more than we do now, as seems likely, why shouldn’t we do it?

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