A tale of two covariates: Why OWID and company are wrong about US healthcare

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        A tale of two covariates: Why OWID and company are wrong about US healthcar
        The shape of the curve
        Diminishing returns are evident cross-sectionally (spatial)
        And they are evident over time (temporal)
        The slope is even more predictable
        Better approximating the marginal effects
        Obesity
        The elephant in the room
        Regional disaggregation
        Individual-level data show large effects

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        Striking as such plots may be, the apparent slope for the United States can be readily predicted based on the relationship observed in other high-income countries with nothing more than time series for health expenditure and life expectancy.
        Truth be told, the average marginal effect of health expenditure for high-income countries in recent years is likely pretty close to zero (particularly as pertains macro-level indicators like life expectancy).
        The rapidly diminishing returns to health spending found cross-sectionally implies the still higher level of expenditure observed in the United States does not predict higher life expectancy than the average high-income country.
        Even if the signal from the true effects of ever-higher health spending on broad measures such as life expectancy was somehow being confounded (e.g., lifestyle factors offsetting gains) such patterns are themselves informative for what we might expect from even higher spending countries like the United States.
        Said differently, the rightward shift in the BMI distribution implies large net increases in mortality risks for most countries of at least moderately high-incomes today, particularly given the increased variance and right skew that accompanies the general rightward trend.
        This is not to suggest all countries have exactly the same mean, variance, and skew conditional on the obesity rate, but the underlying forces appear to be similar enough to make reasonably strong inferences about the general nature of the BMI distribution in lieu of extensive micro-data, particularly as it relates to those with BMIs much higher than optimal, which drives BMI-related mortality risk.
        Conditional on health spending and year fixed effects, the US mortality rate is about 10% higher than comparable countries in OECD panel data


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