OECD Health Report

The Organization for Economic Cooperation and Development has released its 2019 report on health indicators around the world.   (OECD Report)   On average across all countries, life expectancy is at 81 years, but extension of longevity has slowed and it actually decreased in 19 countries.  Opioid abuse is a serious problem not just in the United States but in other countries, and has led to a large number of deaths.  Chronic diseases like obesity and diabetes have hindered progress, and OECD estimates that 3 million deaths occur prematurely due to poor preventive and wellness care.  One in ten adults says they are in poor health and a third have two or more chronic conditions.  Across all OECD nations, 18% of adults smoke and 4% are alcohol dependent.  Air pollution caused about 40 deaths per 100,000 people; but that number is skewed by a rate of 140 per hundred thousand in China and India.  Health spending is a problem everywhere, not just in the United States.  In almost every country health spending is growing faster than GDP.  At least in the United States the two have almost converged.

Even though almost all of these countries have national health insurance and/or health systems, many people report having difficulty accessing care due to cost concerns, obviously particularly for poor people.  A little over 20% of all spending across the nations is borne by individuals.  This is surprising given that most of the population is in a national health insurance system.  Waiting times (which are a thinly-veiled method of rationing) are quite long for some services; for example, in several countries it is over a year for a knee replacement.  Limp around on that.  On the good side, some measures of quality are improving.  Fewer people are dying from heart attack or stroke.  Avoidable admissions stemming from chronic conditions are declining.  Survival rates for most cancers are improving, some dramatically.  Let me just note one fact that helps demonstrate that the US health system is actually pretty excellent; the percentage of the adult population that says it is in poor health is just 2.6%, the lowest across all the OECD countries.  We must be doing something right.