NEJM’s Fundamentals of U.S. Health Policy, Part 3: Do We Spend Too Much?

I admire Dr. Christensen’s posts, and thank him for featuring this series from New England Journal of Medicine! The NEJM authors claim — that some services have higher value than others — was the central thesis of Fixing U.S. Healthcare blog. My blog has highlighted the Oregon Health Plan of 1994, which used cost-benefit analysis to guide public policy in a tight-budget atmosphere. I will point out that Gov. John Kitzhaber (M.D.) began this plan as a purely economic project, but soon encountered the political reality that citizens assigned some values based on non-monetary (ethical, social) criteria! I invite you and your followers to check out “The Big Fix” and “The Problem of Diminishing Marginal Benefits in Healthcare.”

Clear Thinking on Healthcare

Photo by Scott R on

This next part in The New England Journal of Medicine’s fundamentals of health policy series is written by my favorite health policy writing duo–Drs. Baicker and Chandra. They both do amazing research independently, but when they work together to write an article, it seems to be extra insightful and interesting.

Their task with this article is to help people think deeper than the simplistic sentiment, “The U.S. spends way more than every other country on healthcare; we need to cut back, and any increase in spending is wasteful!”

Key insight: Only looking at the aggregate number obscures many important facts about our healthcare spending; digging a little deeper totally changes the conversation.

Here are my favorite examples of this from their article:

  • As nations grow richer, they spend more on healthcare. So, based on that alone, the U.S. would be expected to spend more…

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