Comment by oli5679 | Hacker News Reader

Comment by oli5679 | Hacker News Reader

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If anyone wants some interesting correlational data on life expectancy vs. wealth and health expenditure per capita ourworldindata is a good source. At a country-level the correlational relationships are weaker than many people think.

- Costa Rica $14k GDP per capita (2018) $1.1k health expenditure (PPP 2011)

has a higher life-expectancy and healthy life-expectancy than

- Saudi Arabia $50k GDP per capita (2018) $2.5k health expenditure (PPP 2011)

Overall, there is a weak relationship between wealth and health expenditure vs. outcomes beyond $30k GDP/capita and $1.5k expenditure.

Many Europeans and North-Americans would expect significantly worse health outcomes using the system of Costa-Rica, Barbados, Uruguay or Turkey, but the data shows similar aggregate outcomes.

Of course there are more complexities in understanding the individual data-points.

https://ourworldindata.org/grapher/life-expectancy-vs-gdp-pe...

https://ourworldindata.org/grapher/healthy-life-expectancy-v...

Are those directly comparable though? From what horrors I have heard of the US healthcare system, one can easily pay $5000 for a procedure that someone in my country can easily get just by walking into a private clinic and paying $50 out of pocket. So outstanding health expenditure per capita in the US can just be the symptom of how uniquely bloated their healthcare system is, and not the sign that US citizens use health services so much more.

Yes, there are lots of factors like this when comparing any two countries. USA does have uniquely high expenditure supporting your bloat claim.

The point is other countries e.g. France, Switzerland, Canada, UK, there are also not significant differences vs. countries with lower GDP per capita.

I'm not saying this proves a relationship but it's a useful indicative signal, and the randomised studies cited by Hanson, combined with the health outcomes of American Amish all together make more more sceptical of the benefits of health expenditure.

I'm not certain though and would love more info. If anyone has any evidence pointing in the opposite direction then would be really interested to see it.

Mean numbers are likely misleading here. I'd expect a massively different distribution of wealth between these two countries. The richest in SA probably have terrific health outcomes.

I have never been to Saudi Arabia, but my friends were, and according to them, SA is a pretty unhealthy country.

Many people do not engage in any physical exercise at all, overeating is common, consumption of sweetened beverages very high, illicit drugs are way more common than they theoretically should be.

Medical care isn't magic and cannot completely neutralize accumulated consequences of such bad lifestyle decisions.

Yeah I think there is lots of nuance about individual datapoints. Does the overall distribution match your mental model?

To me it's surprising there aren't at more high spending countries with significantly better outcomes measured by these metrics.

Can you think of a country with more equal health expenditure than Saudi Arabia that has much better health outcomes than countries with GDP per capita around $30k?

> Overall, there is a weak relationship between wealth and health expenditure vs. outcomes beyond $30k GDP/capita and $1.5k expenditure.

Because healthcare is labor intensive, you probably want to at least adjust per capita spending by PPP, and it might even be better to look at per-GDP spending (really, relative healthcare costs is the goal, but you can't easily get that directly.) So, Saudi Arabia has worse outcome but plausibly is lower on the relevant spending measure, as well, compared to Costa Rica. Otherwise, the effect of healthcare consumption is being masked by differences in the cost of healthcare.

(Of course, even looking at per GDP spending, and compared to other advanced nations so that there are fewer confounding factors, the US proves it's possible to spend a lot extra with no result, if you design the system badly enough.)

The link is PPP adjusted already

Yeah, I missed that, but as I said (perhaps overly tersely) upthread PPP understates and GDP is probably closer, given the kind and degree of labor intensity of health care services and how the relevant labor costs tend to trend with other economic measures (in general, a nurse in a richer country doesn't have the same cost, even at PPP, as one in a poorer country.)

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