I find Prof. Blanchard's post on infant mortality intriguing. First, one wonders what is the precise complaint. Usually the complaint is that Americans spend too much money on health care. But the complaint Ken addresses is that we don't spend enough. Perhaps people ought to get their play books straight before complaining.
I did something other bloggers apparently did not do: research. It was really hard. What I am to link to below took me all of five minutes to find. First, there is this story I found off the Health and Human Services page that says premature birth accounts for about one-third of our infant mortality. It is hard to say if this is a good thing or a bad thing. For example, due to our almost miraculous technology and, it must be said, extraordinary compassion, we spend a great deal of money on babies with serious health problems. In fact, we treat them quite aggressively in utero. If a baby is born who would have been a miscarriage, say, ten years ago, and then the baby dies two weeks later, that is an infant mortality statistic, but is it therefore a reason to adjust our public policy? I don't know.
How about health care budgets. This one is a bit ponderous, but go here for the 2008 Bush administration budget. On page 133 you see that in the first Bush budget (FY 2002), we spent $280.8 billion on "means tested entitlements," which includes Medicaid and State children's health insurance. There is an increase every year and in the last year of hard numbers (2006) we spent $354.3 billion, for an increase of 26%. To be sure, from 2005 to 2006, spending is almost stagnant, but this is hardly enough to create a crisis in infant mortality and spending is then set to take off again and 2012 estimates are to spend $468.9 billion, or an increase of 32% over 2006 budgets. For Medicaid alone, go to pages 141 and 142. In FY 2002 we spent $147.5 billion on Medicaid. In 2006 it was $180.6 billion, an increase of about 22%. Again, to be sure from 2005-2006 Medicaid spending is essentially stagnant, but as as noted above, it is unlikely this would cause a sudden increase in infant mortality. Spending is again set to take off and in 2012 it is estimated we will spend $270.2 billion, an increase of 49.6% over 2006.
This article states that there are about 47 million Medicaid recipients. That means we spend about $3,800 in federal dollars for each recipient ($180.6 billion divided by 47 million). This does not count any other federal or state health program. States pay a large portion of the Medicaid bill, and the numbers quoted above only pertain to the federal commitment. It is impossible to say what "enough" money is for public health, but it is difficult to say that the Bush administration or American society is parsimonious when it comes to public health. I conclude with snippets from the USA Today article:
Today, a family of four can earn as much as $40,000 a year in most states and get government health insurance for children. The nation's median household income was $43,318 in 2003, the Census Bureau says...
More children insured. The portion of children without insurance fell from 14.8% in 1997 to 11.7% in 2004, the Health and Human Services Department reports. The rate of young children being vaccinated has increased from 72% in 2000 to a record 81% in 2004.
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