Is It Dumb to Bring Up U.S. Life Expectancy?

One of common arguments for the inefficiency of the US health care system is that we pay more for care than many countries whose citizens live longer. Economist Greg Mankiw jumps all over this argument, calling it "schlocky" and quoting Nobelist Gary Becker, who notes that there are a lot more variables to a country's average lifespan than access to health care, such as obesity. Let's take a look at this assertion...



Becker writes:

A study published in Lancet Oncology in 2007 calculates cancer survival rates for both men and women in the United States, the United Kingdom, and the European Union as a whole. The study claims that the most important determinants of cancer survival are early diagnosis, early treatment, and access to the best drugs, and that the United States does very well on all three criteria. Early diagnosis helps survival, but it may also distort the comparisons of five or even ten-year survival rates. In any case, the calculated five-year survival rates are much better in the US: they are about 65% for both men and women, while they are much lower in the other countries, especially for men. These apparent advantages in cancer survival rates are large enough to be worth a lot to persons having access to the American health system.

On the one hand, I have a kind of gut-sympathy to Becker's point. It seems overly crude to make sweeping statements based on different countries' lifespans. But is the US system really so effective? Consider this graph, from David Leonhardt of the New York Times:

So look, as Ezra Klein notes, this isn't a reason to import Canada's health care system. It's a complicated picture rather than Exhibit A for either side of the debate. We do great, comparatively, with breast cancer, and not so well with colorectal. The graph does not end discussion on the issue of health care effectiveness, but it does complicate the assertion that our cancer survival rate is an argument for the status quo.