- Hot, Flat, and Crowded: Why We Need a Green Revolution – and How It Can Renew America. Thomas L. Friedman. Farrar, Straus & Giroux, $27.95. [Previous rank: 1]
- The War Within: A Secret White House History, 2006-2008. Bob Woodward. Simon & Schuster, $32.00. [Previous rank: 2]
- The Limits of Power: The End of American Exceptionalism. Andrew C. Bacevich. Metropolitan Books, $24.00. [Previous rank: 6]
- The Post-American World. Fareed Zakaria. Norton, $25.95. [Previous rank: 5]
- The Devil We Know: Dealing With the New Iranian Superpower. Robert Baer. Random House, $25.95. [New Listing]
- The Shadow Factory: The Ultra-Secret NSA From 9/11 to the Eavesdropping on America. James Bamford. Doubleday, $27.95. [New Listing]
- America and the World: Conversations on the Future of American Foreign Policy. Zbigniew Brzezinski and Brent Scowcroft with David Ignatius. Basic Books, $27.50. [Previous rank: 12]
- The Ayatollah Begs to Differ: The Paradox of Modern Iran. Hooman Majd. Doubleday, $24.95. [New Listing]
- The Strongest Tribe: War, Politics, and the Endgame in Iraq. Bing West. Random House, $28.00. [Previous rank: 7]
- From Colony to Superpower: U.S. Foreign Relations Since 1776. George C. Herring. Oxford University Press, $35.00. [New Listing]
- The Way of the World: A Story of Truth and Hope in an Age of Extremism. Ron Suskind. Harper, $27.95. [Previous rank: 3]
- The Dark Side: The Inside Story of How the War on Terror Turned Into a War on American Ideals. Jane Mayer. Doubleday, $27.50. [Previous rank: 4]
- The American Way of War: Guided Missiles, Misguided Men, and a Republic in Peril. Eugene Jarecki. Simon & Schuster, $26.00. [New Listing]
- Tell Me How This Ends: General David Petraeus and the Search for a Way Out of Iraq. Linda Robinson. PublicAffairs, $27.95. [Previous rank: 15]
- Left in Dark Times: A Stand Against the New Barbarism. Bernard-Henri Levy. Random House, $25.00. [New Listing]
Glenn A Knight
In my study
Sunday, August 23, 2009
Foreign Affairs Bestsellers - January/February 2009
Health Care Costs - A Blast from the Past
After my previous post on this subject, on July 27, 2009, a friend wrote to point out that the US pays much more for healthcare than does France, and yet our measures of health outcomes are worse than those of the French. Is this a sign of a bad healthcare system?
As I pointed out in my earlier post, a lot of the cost factors are due to internal processes within the healthcare system. I also noted that universal insurance would, by increasing demand, tend to increase the price of healthcare.
In the comparison with France, we see another factor driving demand.
As regards the better health outcomes in other countries, such as France, a lot of people use that figure as if it were due to the health care system. Actually, a lot of that effect is due to people's behavior which keeps them out of the health care system altogether. For example, we don't have more people with diabetes because the medical care system treats diabetes patients badly. We have lots of diabetes patients because people pursue patterns of eating and exercise which lead to Type 2 diabetes. If they didn't do so, they wouldn't get into the health care system at all.
I tend to look at the medical care system in conventional economic terms, although I'm aware that there are some interesting anomalies in that system. If demand for services goes up, then the price will also rise. If, therefore, people in country X have a healthy lifestyle, avoid obesity, eschew risky behavior, their demand for medical services will be low, and the price of these services will also tend to be low. If the people in country Y eat too much, exercise too little, and subject themselves to chronic diseases, then they will end up demanding lots of medical services, and the price of medical service will rise.
I might also note that 80% of medical costs are attributable to a rather small number of elderly people. Thus, the miserable health outcomes numbers, and the high price of medicine, are due to people smoking, drinking, eating too much, eating the wrong things, and living sedentary lifestyles in the 1950s and 1960s. Lacking a reliable time machine, there isn't a whole lot we can do to remedy that situation.
Going forward, I might note, the health care system, as presently constituted, is not responsible for stopping us from eating fried chicken, which may be, with smoking, the single largest risk factor for diabetes, high blood pressure, and high cholesterol, which are, in turn, risk factors for heart attacks and strokes. Maybe the department of Health and Human Services should take on that task, including the fight with the department of Agriculture which is busy promoting the sale of unhealthy food. But the medical system isn't going to solve our social problems.
As I pointed out in my earlier post, a lot of the cost factors are due to internal processes within the healthcare system. I also noted that universal insurance would, by increasing demand, tend to increase the price of healthcare.
In the comparison with France, we see another factor driving demand.
As regards the better health outcomes in other countries, such as France, a lot of people use that figure as if it were due to the health care system. Actually, a lot of that effect is due to people's behavior which keeps them out of the health care system altogether. For example, we don't have more people with diabetes because the medical care system treats diabetes patients badly. We have lots of diabetes patients because people pursue patterns of eating and exercise which lead to Type 2 diabetes. If they didn't do so, they wouldn't get into the health care system at all.
I tend to look at the medical care system in conventional economic terms, although I'm aware that there are some interesting anomalies in that system. If demand for services goes up, then the price will also rise. If, therefore, people in country X have a healthy lifestyle, avoid obesity, eschew risky behavior, their demand for medical services will be low, and the price of these services will also tend to be low. If the people in country Y eat too much, exercise too little, and subject themselves to chronic diseases, then they will end up demanding lots of medical services, and the price of medical service will rise.
I might also note that 80% of medical costs are attributable to a rather small number of elderly people. Thus, the miserable health outcomes numbers, and the high price of medicine, are due to people smoking, drinking, eating too much, eating the wrong things, and living sedentary lifestyles in the 1950s and 1960s. Lacking a reliable time machine, there isn't a whole lot we can do to remedy that situation.
Going forward, I might note, the health care system, as presently constituted, is not responsible for stopping us from eating fried chicken, which may be, with smoking, the single largest risk factor for diabetes, high blood pressure, and high cholesterol, which are, in turn, risk factors for heart attacks and strokes. Maybe the department of Health and Human Services should take on that task, including the fight with the department of Agriculture which is busy promoting the sale of unhealthy food. But the medical system isn't going to solve our social problems.
Saturday, August 1, 2009
Commentary's Books: February 2009
By the way, Commentary has a Web site: commentarymagazine.com.
The five books which were reviewed in Commentary's February 2009 issue are listed here.
Outliers: The Story of Success. Malcolm Gladwell. Little Brown. 320 pp. $27.99. Reviewed by Brian C. Anderson.
Innocent Abroad: An Intimate History of American Peace Diplomacy in the Middle East. Martin Indyk. Simon & Schuster. 512 pp. $28.00. Reviewed by Dean Godson.
So Damn Much Money: The Triumph of Lobbying and the Corrosion of American Government. Robert G. Kaiser. Knopf. 416 pp. $27.95. Reviewed by Dan DiSalvo.
Sex in Crisis: The New Sexual Revolution and the Future of American Politics. Dagmar Herzog. Basic Books. 320 pp. $26.95. Reviewed by Justin Shubow.
Emily Post: Daughter of the Gilded Age, Mistress of American Manners. Laura Claridge. Random House. 544 pp. $30.00. Reviewed by Jonathan Kay.
In addition, Terry Teachout's article "The Trouble with Alfred Hitchcock" relies on a book by Donald Spoto, Spellbound by Beauty: Alfred Hitchcock and His Leading Ladies (Harmony, 352 pp., $25.95) to support Teachout's opinion that Hitchcok was "a sexually frustrated man whose view of women was - to put it mildly - unattractive."
The five books which were reviewed in Commentary's February 2009 issue are listed here.
Outliers: The Story of Success. Malcolm Gladwell. Little Brown. 320 pp. $27.99. Reviewed by Brian C. Anderson.
Innocent Abroad: An Intimate History of American Peace Diplomacy in the Middle East. Martin Indyk. Simon & Schuster. 512 pp. $28.00. Reviewed by Dean Godson.
So Damn Much Money: The Triumph of Lobbying and the Corrosion of American Government. Robert G. Kaiser. Knopf. 416 pp. $27.95. Reviewed by Dan DiSalvo.
Sex in Crisis: The New Sexual Revolution and the Future of American Politics. Dagmar Herzog. Basic Books. 320 pp. $26.95. Reviewed by Justin Shubow.
Emily Post: Daughter of the Gilded Age, Mistress of American Manners. Laura Claridge. Random House. 544 pp. $30.00. Reviewed by Jonathan Kay.
In addition, Terry Teachout's article "The Trouble with Alfred Hitchcock" relies on a book by Donald Spoto, Spellbound by Beauty: Alfred Hitchcock and His Leading Ladies (Harmony, 352 pp., $25.95) to support Teachout's opinion that Hitchcok was "a sexually frustrated man whose view of women was - to put it mildly - unattractive."
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