Dangerous repercussions of flawed U.S. health care rankings

In the latest American Enterprise Institute (AEI) Health Policy Outlook, AEI adjunct scholars H.E. Frech, Stephen T. Parente, and AEI visiting scholar John S. Hoff demonstrate that the comparisons of different countries' health care system performances by the Organisation for Economic Co-operation and Development (OECD) do not provide a full picture. The standards used by the OECD are unable to adequately differentiate between health system performance and other confounding factors that determine health. This is particularly relevant for America because these flawed results have been used to call for health care reform in the U.S.

Among the key points:

  • The United States spends substantially more per capita on health care than other developed countries, yet commonly cited reports indicate that the U.S. does not have superior health system performance.
  • The OECD uses mortality metrics to measure health care system performance, but these data do not adequately indicate health status differences and do not accurately judge health care system efficiency.
  • The OECD and other researchers must adjust their methods for measuring infant mortality, life expectancy, and premature mortality and control for confounding factors such as lifestyle to give a more accurate picture of health system performance.

 

H.E. Frech III ([email protected]) is an adjunct scholar at AEI and a professor in the Department of Economics at the University of California, Santa Barbara; Stephen T. Parente ([email protected]) is an adjunct scholar at AEI and a professor in the Department of Finance at the Carlson School of Management at the University of Minnesota; and John S. Hoff ([email protected]) is a visiting scholar at AEI and was health attaché to the U.S. mission to the OECD from 2005 to 2009.

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About the Author

 

John
Hoff

  • From 2005 to 2009, John held the position of Health Attaché of the United States Mission to the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the U.S. Mission to the Organization for Economic Cooperation and Development (OECD). In that capacity, John represented the United States at UNESCO and OECD on health, social, and science policy matters such as the effect of U.S. and European health systems'organizational and reimbursement policies on innovation, quality, and access.


    Prior to his position of Health Attaché, John served as Deputy Assistant Secretary for Planning and Evaluation, in charge of the Office of Disability, Aging and Long-Term Care Policy (DALTCP), U.S. Department of Health and Human Services from 2001 to 2005. While practicing law, with specialty in health law and policy, John represented hospitals, hospital associations, organ recovery organization, doctors, and others in connection with legal issues such as Medicare reimbursement; price controls; health planning and certificate of need; organ donation and recovery; antitrust; fraud and abuse and self-referral; national physician data bank; and physician discipline.


     

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