Monday, July 22, 2013

Health Care Satisfaction and Finance Source

This is not a full post, just a quick data note for a Facebook conversation I am having, regarding the issues around universal payer health care systems vs. health care satisfaction rankings. The data comes from two sources: health care financing comes from OECD data, and satisfaction comes from Commonwealth Fund. The former has data from 34 OECD (basically high income) countries, while the latter has survey results from 11 of those countries from 2010. The satisfaction measure asked how much change their health care system needs, ranging from very little change, a moderate level of change, to "rebuild completely."

For the financing data, I looked at 4 different programs: Individual health programs, Individual health + all medical goods, and Total health expenditure, averaging the US$ PPP per capita expenditurefor 2003-2012 for each country. The correlations with satisfaction were almost identical for all three measures--I present the results for Total Expenditure. The financing number I show in the table represents "public financing/private financing." Therefore the higher the number, the greater the proportion of public funding vs. private financing. Public financing represents federal and local sources, and private financing includes private insurance and out of pocket expenses. In this case, Australia has a value of 2.2, meaning that, on average, the government spends just over 2x per person what the individual spends on health care, while the 0.9 value for the U.S. indicates that the government spends less than individuals do for health care. The country that spend the most, Norway, has government expenditure more than 5x what individuals spend privately on health care.

For the countries surveyed, individuals with greater government contribution were strongly more likely to be satisfied with their health care system, with a correlation of 0.61. Typically, correlations above 0.3 indicate moderate relationship, and above .6 indicate a strong relationship. In the table below, the data is ordered based on financing agent, with the lowest public financing at the top, and the greatest public financing at the bottom.

CountryTotal Health Care Expenditure, Public vs. Private in US$PPPRebuild health care system completely, % of those surveyed
United States0.927
United Kingdom4.13
New Zealand4.511