Doing Better and Feeling Worse: The Political Pathology of Health Policy

Abstract

According to the Great Equation, Medical Care equals Health. But the Great Equation is wrong. More available medical care does not equal better health. The best estimates are that the medical system (doctors, drugs, hospitals) affects about 10 percent of the usual indexes for measuring health: whether you live at all (infant mortality), how well you live (days lost due to sickness), how long you live (adult mortality). The remaining 90 percent are determined by factors over which doctors have little or no control, from individual life-style (smoking, exercise, worry), to social conditions (income, eating habits, physiological inheritance), to the physical environment (air and water quality). Most of the bad things that happen to people’s health are at present beyond the reach of medicine.