A recent news article compared cost and quality of health care across all the states of our country. We are in the middle of the United States, so it was good to find that our state was near the middle of Medicare spending per beneficiary, and close to the midpoint in terms of the “overall quality of health care.” Of the states that border Missouri, only Iowa was listed as having better quality, and more than half of the other bordering states were found to have both poorer quality and to be more expensive.

That is good to know, but that data was just for the Medicare population, a group that is mostly made up of people over age 65. What about the rest of us? To look at this, it is best to use information about life expectancy. In the medical community the phrase “life expectancy” describes the number of years a person would be expected to live if the current health care system remained as it is now, without any changes for the duration of that person’s life. In 2000, the U.S. Census Bureau said that life expectancy in Missouri was 76.2 years, and since that time it has improved to 76.8. Well, that is pretty good, and it is even better for you and me that it is getting longer. However, in 2009, the average life expectancy for the entire United States was reported to be 78.11. At that same time, in most of the industrialized nations of the world, life expectancy was reported to be 79.0. I guess that means that in Missouri, life expectancy is not as good as in most of the nation’s other states, and life expectancy is poorer than in of most of the industrialized nations of the world.

Why should that be? Could it be something simple, like there being not enough doctors for the number of people who are in need of medical care? That may be. (See my recent report on rural health care in Missouri.) The OECD tells us that in most of the industrialized nations of the world (that is, in the countries where people live longer than we do in Missouri), there are 2.9 practicing physicians per 1,000 people, while in the overall United States, there are only 2.34, and in Missouri there are only 2.24.

Nevertheless, the fact remains that we are spending more for health care than anybody else. Everyone knows that in the United States, we spend more than 16 percent of our Gross Domestic Product for health care, or $7,290 per person, while in Missouri it is $7,709 per person.

So, there you have it. As everyone knows, we are spending more and getting less. This needs to be changed. It may seem simplistic, but wouldn’t we be better off if there were more physicians? That would certainly reduce one complaint about there not being enough physicians to supply the current needs in this country. But, beyond that, wouldn’t an increase in physicians produce more competition among health care suppliers, and a corresponding reduction in fees?