NCPA - National Center for Policy Analysis


November 6, 2007

The worst misconceptions about U.S. health care are the ones that are true but don't mean what people think they mean, says N. Gregory Mankiw, a professor of economics at Harvard University.

One misconception is that the United States has lower life expectancy and higher infant mortality than Canada because of inadequacy of the American health system.  But in reality, it has more to do with broader social forces, says Mankiw:

  • For men in their 20s, mortality rates are more than 50 percent higher in the United States than in Canada, but accidents and homicides account for most of that gap.
  • Americans are also more likely to be obese, which often involve lifestyle choices, as well as our system of food delivery; not U.S. health care.
  • As for infant mortality, the rate of teenage motherhood is almost three times higher in the United States than it is in Canada, which could lead to lower birth weights and more deaths.

Another misconception is that 47 million Americans do not have health insurance:

  • The 47 million includes about 10 million residents who are not American citizens; even if we had national health insurance, they would probably not be covered.
  • The number also fails to take full account of Medicaid by counting millions of the poor who are eligible for Medicaid but have not yet applied.

The 47 million also includes many who could buy insurance but haven't:

  • The Census Bureau reports that 18 million of the uninsured have annual household income of more than $50,000, which puts them in the top half of the income distribution.
  • About a quarter of the uninsured have been offered employer-provided insurance but declined coverage.

Of course, millions of Americans have trouble getting health insurance, says Mankiw.  But they number far less than 47 million, and they make up only a few percent of the population of 300 million.

Source: N. Gregory Mankiw, "Beyond Those Health Care Numbers," New York Times, November 4, 2007.

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