The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries.
Pointer from Tyler Cowen.
The paper is very readable, and the tables are very clear. For example, the ratio of specialist physician pay to the mean wage in the U.S. is 5.3 in the U.S. compared with 3.9 in the next-highest country. For general physicians, the ratio is 3.6 in the U.S. compared with 3.3 in the next-highest country.
The study contradicts most of what I believe about comparative health care spending. It also contradicts the findings of Random Critical Analysis. I think that the probability that the study is mostly accurate is less than fifty percent, but greater than zero.
A challenge is that data are very shaky in many areas. The authors write,
Even when data were collected from the same source, issues of comparability remain because of fundamental differences in how systems are organized and, in turn, how care is categorized. Two areas of particular concern are outpatient spending and the primary care workforce. We attempted to address limitations in the workforce data by utilizing a functionality-based approach to identifying who provides primary care services in each country and by cross-referencing resulting numbers with country experts.
Random Critical Analysis used different data on the health care work force and got very different results.