Anecdotal Evidence That at Least One of My Theories is Right

Health care correlations I wish to explain:

1. There is a positive relationship between health care (access & outcomes) and income in the U.S., Canada, and Britain.
   
2. In Canada, income appears to be more important than in the U.S., and the best evidence suggests it is an absolute (not relative) effect. In Britain, income effects in children are statistically insignificant from 0-4, but become significant afterward and increase with age.
   
3. Health care expenditures do not seem to have much of a relationship with outcomes.
   

#3 seems to contradict #1 & #2, so what could be going on? It makes sense, for the most part to have a income effect in the U.S., but why does it exist in England and appear larger in Canada?

I have hinted on this blog before, that I suspect that the reason the Canadian and English Health Care Systems have an income effect is due to capitalization in the housing market. Everything I could tell about these two health care systems seems to ration their services geographically, just like the U.S. does with its public school system. Therefore, people who care about access to the better hospitals will bid up the price of housing in those areas. This creates the appearance of an income effect without the expenditure effect. Now, this story appears in the U.K. Telegraph:

New figures seen by the Daily Telegraph illustrate for the first time how Government changes in the way the NHS is run have fundamentally altered the way care is provided.

Data from Dr Foster, an independent health care information company, published today (MON) reveals that more than a third of the NHS hospital trusts in England suffered a fall in the number of routine operations they performed last year.

Many hospitals have witnessed a sharp fall in income as a result of health care reforms, including the introduction of a Payment by Results system.

Patients are now able to choose where they are treated, with many snubbing the traditional visit to their local hospital and opting for units with the best treatment records, facilities and, crucially, cleanliness and infection control.

GPs can also choose where to send their patients. Crucially, hospitals no longer receive a guaranteed block grant and are paid according to the number of patients they treat.

Bold emphasis added by me.