Hi, Adam,
Referring to the health econ. literature:
Refined figures on survival rates for any particular disease are generally, as far as I know, not computed based on type or degree of insurance coverage but on treatment differences: stage of entry into treatment, kind of therapy employed, etc. This is of course likely to be correlated to some degree with insurance coverage. There is an extensive health economics literature on survival rates on patients with various diseases. David Cutler, et al. have studied survival rates, in particular for heart disease patients but also for cancer patients, under different treatment regimes.
Here are a couple of illustrative examples.
A review article:
Cutler, David, "Symposium; Health Care: Are we finally winning the war on cancer?" Jouranl of Economic Perspectives, vol 22, (4) pp 3-26, Fall, 2008.
Lichtenberg, Frank, "The Expanding Pharmaceutical Arsenal and the War on Cancer", NBER Working Psaper 10328 (2004).
Yo, Binbing, et al., "Modelling Population-Based Cancer Survival Trends by Using Join Point Models for Grouped Survival Data", Journal of the Royal Statistical Society, vol. 172 (2) April, 2009---------------despite the location of the article, this deals with the U.S.
However, a recent study that does try ot assess the effects of Medicare:
Card, David, et al., "Does Medicare Save Lives?" Quarterly Journal of Economics, vol. 124, (2) May, 2009. pp. 597-636.
And a book I think is fairly sound:
Medical Care Output and Productivity, eds. Cutler, McClellan, and Newhouse (Boston, NBER and Harvard U., 2004).
Best,
Shirley
----- Original Message -----
From: Adam Oliver <[log in to unmask]>
To: [log in to unmask]
Sent: Sat, 15 Aug 2009 06:42:30 -0400 (EDT)
Subject: Question
Hi
I have a question that I was hoping that some of you might be able to
throw some light on. It is often said (and shown) that the US has much
better health outcomes than other countries (5 year cancer survival for
various types of cancer etc.). I can't quite square these figures in my
head. Basic process indicators in health care in the US seem no better
than anywhere else (but these might not be correlated very well with
health outcomes). Medical errors seem no better in the US either. And we
hear that the uninsured often receive very poor primary care services,
putting off seeing their doctor until it is 'too late'.
Are the uninsured included in the measurement of the outcome figures? A
few commentators here are saying that, if they fell sick, there is
nowhere they would rather be than the US (that said, the experience and
knowledge of some of these commentators leaves much to be desired, and
they shouldn't really be appearing in the national media, for their own
reputation and for the sake of others). But behind a Rawlsian veil of
ignorance, where one could be anyone in society (rather than expecting
to be someone with very good health insurance), is this type of comment
(i.e. the 'nowhere they'd rather be point' really very valid?
Anyway, I would appreciate your thoughts, because this is not something
that is clear to me.
----- Original Message -----
From: Adam Oliver <[log in to unmask]>
To: [log in to unmask]
Sent: Sat, 15 Aug 2009 06:42:30 -0400 (EDT)
Subject: Question
Hi
I have a question that I was hoping that some of you might be able to
throw some light on. It is often said (and shown) that the US has much
better health outcomes than other countries (5 year cancer survival for
various types of cancer etc.). I can't quite square these figures in my
head. Basic process indicators in health care in the US seem no better
than anywhere else (but these might not be correlated very well with
health outcomes). Medical errors seem no better in the US either. And we
hear that the uninsured often receive very poor primary care services,
putting off seeing their doctor until it is 'too late'.
Are the uninsured included in the measurement of the outcome figures? A
few commentators here are saying that, if they fell sick, there is
nowhere they would rather be than the US (that said, the experience and
knowledge of some of these commentators leaves much to be desired, and
they shouldn't really be appearing in the national media, for their own
reputation and for the sake of others). But behind a Rawlsian veil of
ignorance, where one could be anyone in society (rather than expecting
to be someone with very good health insurance), is this type of comment
(i.e. the 'nowhere they'd rather be point' really very valid?
Anyway, I would appreciate your thoughts, because this is not something
that is clear to me.
Best,
Adam
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