Vice President Cheney's heart transplant over the weekend brought to mind a 2005 New York Sun editorial, America's Heart. The Sun commented on the news from the Centers for Disease Control and Prevention that "Between 1950 and 2002, the latest year covered in yesterday's release, mortality from heart disease declined by 59%," and concluded:
the news this week reaffirms an aphorism first uttered, at least within our hearing, by the longtime editor of the Wall Street Journal, Robert Bartley, who said, "On a net basis, modernity is good for you." Politicians and patients may dwell on the problems of the American medical system, but the numbers are in and they suggest that for all the complaining, American ingenuity, innovation, free markets, and capitalism are driving real improvements in health.
The CDC has updated the data since then. Here is what they show for white men age 65 to 74, the group into which Mr. Cheney, who is 71, falls:
| Year | Deaths from heart disease per 100,000 resident population |
|---|---|
| 1950 | 2,309.4 |
| 1960 | 2,297.9 |
| 1970 | 2,177.2 |
| 1980 | 1,729.7 |
| 1990 | 1,230.5 |
| 2000 | 877.8 |
| 2006 | 636.6 |
| 2007 | 603.0 |
The trends for the entire population, regardless of race or sex, in the 65-74 age group are similarly positive:
| Year | Deaths from heart disease per 100,000 resident population |
|---|---|
| 1950 | 1,857.2 |
| 1960 | 1,740.5 |
| 1970 | 1,558.2 |
| 1980 | 1,218.6 |
| 1990 | 894.3 |
| 2000 | 665.6 |
| 2006 | 490.3 |
| 2007 | 462.9 |
One can attribute this to "free markets and capitalism," as the 2005 Sun editorial did, or one can attribute it to the rise of cigarette taxes and government-mandated warnings, together with the expansion of Medicare, including the Bush administration's prescription drug benefit. The truth is, if one charted government health-care spending over this period, one would probably see an increase that roughly tracks the decrease in heart-disease-related mortality. But remember too that a lot of these stents and cholesterol-lowering medications are produced by private-sector companies, and that at least some of the heart surgeons and cardiologists are not employees of the non-profit hospitals or medical schools but rather small businessmen who operate their own private medical practices. The mixed system, to judge by the heart disease mortality numbers, has delivered pretty good results, though, on the other hand, if you tracked increases in computer chip power over this period, you'd almost certainly see even more dramatic improvement with even less government involvement.
It'd be interesting to see some analysis on how much of the reduction in the death rate for diseases of the heart is related to behavior modifications such as improved diet, smoking cessation, and exercise, and how much is related to medical interventions such as open heart surgery, cardiac catheterizations, statins, and the like. It seems like that would be a hard thing to analyze.
