IESET.
Hypotheses·healthcare·universal_healthcare_cost_outcome_oecd

Universal healthcare systems across OECD produce lower per-capita health spending than the US multi-payer system at equal or better outcome measures.

SUPPORTEDengine/runs/universal_healthcare_cost_outcome_oecd

SUPPORTED — coef=-0.5691 (sign matches claim -), p=1.91e-11

confidence cueThis is a clear pass for the claim as written. It still applies only to this sample, period, and method.

policy briefNeeds review

In ordinary language

Does the healthcare rule being tested improve access, cost, or outcomes for patients, or does it mainly shift pressure around the system?

plain answer

The data clearly moved in the predicted direction. coef=-0.5691 (sign matches claim -), p=1.91e-11

why it matters

This matters because healthcare claims should change belief only when they survive a pre-declared empirical test.

how the test works

It compares 23 country or place units from 2010 to 2023, using a panel fe design, with fixed effects for year.

what was measured
What changed
  • Universal healthcare indicator
  • Bismarckian subtype indicator
What we checked
  • Health expenditure per capita usd
  • Health expenditure share income
  • Life expectancy at birth
what this does not prove

A single test is not the whole truth. It narrows the claim under a specific sample, time period, and method. Strong policy conclusions need the pattern to survive nearby tests, alternative data, and serious objections.

verification

0 input datasets, 0 unresolved missing series, provenance status: no input vintages recorded.

Results

engine/runs/universal_healthcare_cost_outcome_oecd
1007550250201020172023USAGBRFRADEUITAESPNLD
illustrative sketch · run pending
No coefficients yet. When the model fires, this chart will show health_expenditure_per_capita_usd across 23 sampled countries over 2010–2023.
The shapes above are stylised — none of the lines are real data.
Placeholder for universal_healthcare_cost_outcome_oecd. Published chart will be generated from engine/runs/universal_healthcare_cost_outcome_oecd/chart_data.json.

Who has skin in the game — schools predicting on this

1 school list this hypothesis as a test of their position. The chips below are school-level scoreboard outcomes, not a second hypothesis verdict.

hypothesis verdict vs scoreboard outcome

The banner verdict judges this hypothesis as written. The scoreboard asks whether each school's polarity-corrected prediction was right. Raw status is not a school win: SUPPORTED supports schools that needed SUPPORTED, but refutes schools that needed REFUTED.

Social Democraticwins if SUPPORTEDschool supported

Pre-registration

pre-registered
first-spec commit bae09ab · 2026-04-29T22:09:42Z
run generated · 2026-06-29T17:53:11Z

Universal healthcare systems across OECD produce lower per-capita health spending than the US multi-payer system at equal or better outcome measures.

Falsification criterion — what would disprove this

set before the run · honoured after

This hypothesis is considered falsified if:

The hypothesis is falsified if universal-system coverage is associated with higher OECD health spending after controls, or if the USA-versus-universal-system cost gap is below 40% at comparable outcome levels. It is partial if the cost direction is favourable but the outcome or subtype checks remain incomplete.

formal test & threshold
test:      Cross-country regression of per-capita health spend on outcome metrics across OECD ex-USA vs USA; supported if USA spend residual is >40% above peer regression line at 2010-2023 mean.

Method

Template
panel_fe
Fixed effects
year
Clustering
country
Sample
23 countries · 2010 – 2023
Evidence type
associational

Cross-country OECD-year regression for 2010-2023, matching the USA-vs-OECD residual framing in the falsification test. Country fixed effects are intentionally omitted because the universal-healthcare indicator is a country/system design contrast and would be absorbed. Bismarckian-subtype indicator separates universal-system heterogeneity. Caveat: ignores within-system access and waiting-time differences; innovation-output channel not measured.

Data

VariableSourceTransform
health_expenditure_per_capita_usd
outcome
world_bank_wdi:SH.XPD.CHEX.PC.CDtier 2
log
health_expenditure_share_gdp
outcome
world_bank_wdi:SH.XPD.CHEX.GD.ZStier 2
level
life_expectancy_at_birth
outcome
world_bank_wdi:SP.DYN.LE00.INtier 2
level
amenable_mortality_per_100k
outcome
oecd:OECD.ELS.HDtier 2
log
universal_healthcare_indicator
treatment
constructed:indicator = 1 for OECD countries with universal coverage (single-payer or Bismarckian); 0 for USA pre-ACA multi-payer retier 5
indicator
bismarckian_subtype_indicator
treatment
constructed:among universal-coverage countries, indicator = 1 for Bismarckian (DEU, AUT, CHE, FRA, BEL, NLD), 0 for Beveridgean (GBRtier 5
indicator
log_gdp_per_capita_ppp
control
world_bank_wdi:NY.GDP.PCAP.PP.KDtier 2
log
log_population
control
world_bank_wdi:SP.POP.TOTLtier 2
log
old_age_dependency_ratio
control
world_bank_wdi:SP.POP.DPND.OLtier 2
level

● ready  · ● pending  · ● reconstruct-needed

Detailed result card

Result card — universal_healthcare_cost_outcome_oecd

Verdict: SUPPORTED — coef=-0.5691 (sign matches claim -), p=1.91e-11

Pre-registration

  • Claim: Universal healthcare systems across OECD produce lower per-capita health spending than the US multi-payer system at equal or better outcome measures.
  • Falsification rule: The hypothesis is falsified if universal-system coverage is associated with higher OECD health spending after controls, or if the USA-versus-universal-system cost gap is below 40% at comparable outcome levels. It is partial if the cost direction is favourable but the outcome or subtype checks remain incomplete.
  • Falsification test: Cross-country regression of per-capita health spend on outcome metrics across OECD ex-USA vs USA; supported if USA spend residual is >40% above peer regression line at 2010-2023 mean.

Estimate

  • Method: linearmodels.PanelOLS
  • Coefficient (treatment): -0.5691
  • Std error: 0.0816
  • p-value: 1.91e-11
  • Observations: 322, countries: 23
  • Within R²: 0.00921
  • Fixed effects: entity=False, time=True
  • Clustering: country

Variables resolved

  • world_bank_wdi:SH.XPD.CHEX.PC.CD → health_expenditure_per_capita_usd (outcome, publisher=world_bank_wdi, n=5617)
  • world_bank_wdi:SH.XPD.CHEX.GD.ZS → health_expenditure_share_gdp (outcome, publisher=world_bank_wdi, n=4811)
  • world_bank_wdi:SP.DYN.LE00.IN → life_expectancy_at_birth (outcome, publisher=world_bank_wdi, n=14443)
  • oecd:OECD.ELS.HD,DSD_HEALTH_STAT@DF_AMENABLE_MORT,1.0 → amenable_mortality_per_100k (outcome, publisher=oecd, n=997)
  • constructed: indicator = 1 for OECD countries with universal coverage (single-payer or Bismarckian); 0 for USA pre-ACA multi-payer regime. → universal_healthcare_indicator (treatment, publisher=constructed, n=322)
  • constructed: among universal-coverage countries, indicator = 1 for Bismarckian (DEU, AUT, CHE, FRA, BEL, NLD), 0 for Beveridgean (GBR, SWE, NOR, DNK, etc.) — separates universal-system heterogeneity. → bismarckian_subtype_indicator (treatment, publisher=constructed, n=322)
  • world_bank_wdi:NY.GDP.PCAP.PP.KD → log_gdp_per_capita_ppp (controls, publisher=world_bank_wdi, n=8325)
  • world_bank_wdi:SP.POP.TOTL → log_population (controls, publisher=world_bank_wdi, n=14447)
  • world_bank_wdi:SP.POP.DPND.OL → old_age_dependency_ratio (controls, publisher=world_bank_wdi, n=16935)

Generated by scripts/run_panel_fe.py at 2026-06-29T17:53:11+00:00

Notes

Stub seeded from a social-democratic school prediction about OECD universal vs US multi-payer performance. Needs human review of how universal-system heterogeneity is treated (single-payer vs Bismarckian).

Authored framework. Read the transparency note.