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Friday, May 05, 2006

Paul Krugman: Our Sick Society

Paul Krugman stays with the topic of his last column, our health care system. In this column, he wonders why being American appears to be bad for your health:

Our Sick Society, by Paul Krugman, Commentary, NY Times: Is being an American bad for your health? That's the apparent implication of a study just published in The Journal of the American Medical Association.

It's not news that something is very wrong with the state of America's health. ... But it isn't clear exactly what causes this stunningly poor performance. How much of America's poor health is the result of our failure, unique among wealthy nations, to guarantee health insurance to all? How much is the result of racial and class divisions? How much is the result of other aspects of the American way of life?

The new study ... doesn't resolve all of these questions. Yet it offers strong evidence that there's something about American society that makes us sicker than we should be.

The authors of the study compared the prevalence of such diseases as diabetes and hypertension in Americans 55 to 64 years old with ... a comparable group in England. Comparing us with the English isn't a choice designed to highlight American problems: Britain spends only about 40 percent as much per person on health care..., ... Moreover, England isn't noted either for healthy eating or for a healthy lifestyle.

Nonetheless, the study concludes that "Americans are much sicker than the English."... What's ... striking is that being American seems to damage your health regardless of your race and social class. That's not to say that class is irrelevant. ... In fact, there's a strong correlation within each country between wealth and health. But Americans are so much sicker that the richest third of Americans is in worse health than the poorest third of the English.

So what's going on? Lack of health insurance is surely a factor in the poor health ...[and] everyone in England receives health care from the government. But almost all upper-income Americans have insurance.

What about bad habits...? The ... statistical analysis suggests that bad habits are only a fraction of the story. In the end, the study's authors seem baffled by the poor health of even relatively well-off Americans. But let me suggest a couple of possible explanations.

One is that having health insurance doesn't ensure good health care. For example, a ... report on diabetes pointed out that insurance companies are generally unwilling to pay for care that might head off the disease... It's possible that Britain's National Health Service, in spite of its limited budget, actually provides better all-around medical care ... because it takes a broader, longer-term view than private insurance companies.

The other possibility is that Americans work too hard and experience too much stress. Full-time American workers work ... about 46 weeks per year; full-time British, French and German workers work only 41 weeks a year. I've pointed out in the past that our workaholic economy is actually more destructive of the "family values" ... than the European economies in which regulations and union power have led to shorter working hours.

Maybe overwork, together with the stress of living in an economy with a minimal social safety net, damages our health as well as our families. These are just suggestions. What we know for sure is that although the American way of life may be, as Ari Fleischer famously proclaimed back in 2001, "a blessed one," there's something about that way of life that is seriously bad for our health.

Previous (5/1) column: Paul Krugman: Death by Insurance
Next (5/8) column: Paul Krugman: Who's Crazy Now?

    Posted by on Friday, May 5, 2006 at 12:15 AM in Economics, Health Care | Permalink  TrackBack (0)  Comments (34)


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