John Tierney explains why those promoting socialized medicine should stop ignorantly (if not duplicitously) claiming that it is the cause of greater longevity in countries that have it. If you want to argue that we should be more like Europe, find a better argument, or you’ll just continue to make yourselves look foolish.
11 thoughts on “Health Care And Longevity”
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Advocates of universal health coverage should instead talk about how nearly 45,000 deaths annually in the U.S. are associated with lack of health insurance. Click my name for the study details.
Well, they won’t be able to “talk about” so much as “parrot a meme” because Jim’s link contains no study details. (Text of the study is proprietary) However you can read the abstract by clicking my name. No mention of why they were uninsured or if they failed to take advantage of options which already exist for the uninsured — information critical for any public policy discussion (save for UHS zealots).
America does alright in the average longevity stakes, ranked 50th – which is similar to Denmark where happiness and socialized medicine run high . But I continually hear these arguments of if were not for this effect or if it were not for that effect average longevity in the US would be much higher. It comes across as excuse making, as if other countries do not also have their excuses – even some really good excuses like they spend far less money on health…
Other countries smoke, other countries have obesity problems, short life expectancy is a life style choice for people in other countries too and other countries also have large proportions of the population that die young. Other countries could be selective about their use of statistics too.
The average life expectancy of Maori and Pacific Islanders in New Zealand is near ten years less than everyone else – similar to the black population in the US, and yet average longevity is still two years above the US (excluding them it would be close to four years higher, similar to Australia).
One can argue about the theoretical average longevity just as one can argue about the theoretical safety of Ares I – but demonstrated longevity kind of means something.
It does not seem to be about public or private health care – other countries use both, though a base health safety net (public or private) likely warrants better implementation. It seems to be about organizational incompetence, like tying health care to employment and excessive malpractice law suits. Embracing such inefficiencies and not thinking that average longevity will seriously suffer as a consequence is, well, foolish. There is probably a good reason why large proportions of the population who can afford health insurance do not get it – poor value for money.
I frequently point people at some research that was reported three years comparing the health of ethnically similar people in the US and UK. They spend about half as much per capita on health care as we do. They drink more than we do. They smoke more than we do. So why are they healthier in midlife than us? Why do they live slightly longer than us? Don’t look at the health care system. Look at lifestyles. The English get more exercise as part of their regular lives. They walk more. They get sufficient amounts of sleep. They have more time for friends and family. These things are important.
Well, I wish we were more like Europe and had 10% structural unemployment. Oops, looks like my wish is granted …
I’ve lived in Europe. Interesting place, and I enjoyed it while I was there, but if I wanted to live in Europe forever, I would have stayed there.
I moved back home for a reason….
As you might reasonable expect from the fact that Jim uses it, the use of life expectancy to criticize American health care is one of the more vicious and dishonest arguments out there. There are all kinds of reasons why life expectancy per se does not directly reflect the quality of what we think of when we think “health care.” Here are just a few:
(1) The influence of lifestyle. Remember all the fuss about the “Mediterranean diet” for heart health? How if you control for all other factors, people who eat a diet similar to those found in Mediterranean countries, rates of heart disease are significantly lower? But what does diet have to do with “health care?” That’s right, nothing at all. So far, at least, it’s not something Obamacare can help you with. Nor will it do anything about the relative rates of obesity or smoking. Nor will it change the fact that Americans die in auto accidents at rates far higher than Europeans because, duh, we drive a lot more. Et cetera.
(2) The influence of genes. Sad fact, folks. If your grandparents all died before 55 of heart disease, you’re not likely to get past 70, even with the best possible health care and eating only fruits and nuts and exercising like crazy. There’s a certain amount of your health that is simply wired into your DNA. And, as for the individual, so for the nation. There is a certain amount of longevity (or short-timer syndrome) wired into the DNA of ethnic groups, and even if we all followed identical lifestyles and had ObamaWorldCare, identical health care, we would still have nontrivial differences in lifespan, because we are genetically distinct. (You can tell by the different color of our skins, different shapes of our eyes, et cetera, you know.)
(3) Funky statistics keeping. For example, in the United States if a 23-week-old fetus is born breathing, it’s a person, and every effort is made to save its life. 80% of the time it doesn’t work, unfortunately. So that’s a certain number of people born with a lifespan of days or weeks, which kind of brings down the average. In most of the rest of the world, a 23-week-old fetus may well be technically breathing when it gets out, but nothing will be done, it will stop breathing shortly, and will be recorded as a stillbirth — not a person at all, no effect on longevity statistics.
And so on.
But the bottom line is: if you are comparing the quality of health care, why use longevity, which is, at best, only indirectly linked to health care quality? Why not simply compare apples to apples, and compare health care outcomes in different countries?
I mean, let’s say you’re diagnosed with Stage I breast cancer, pretty curable stuff. What are your odds of being alive in 10 years if you live in the US, versus Canada, versus Germany, and so on? Or let’s say you have COPD, or a stroke, or adult-onset diabetes, or an MRSA infection, or eclampsia in pregnancy, and so forth. What are your odds? Where are they better? Where can you expect better outcomes? These statistics would have nothing to do with lifestyle, and you could easily control for genetics.
So why don’t we hear comparisons of health-care outcomes in the US and elsewhere? You can guess, can’t you? Because they are far better in the US than anywhere else in the world. We pay the most for our health care because we get the world’s best, and it shows in the outcomes. This is, of course, exactly what the Jims of the world don’t want you to notice. So you can expect them to continue to focus on iffy indirect measures, like life expectancy, where the numbers come out the way they’d like, instead of the direct and obvious measures (like health care outcomes) because those numbers they don’t like.
No mention of why they were uninsured or if they failed to take advantage of options which already exist for the uninsured — information critical for any public policy discussion (save for UHS zealots).
So if they could have insurance, but don’t, it’s their fault if they die as a result, and we shouldn’t be concerned?
The trivial answer for why there were uninsured is that it’s possible in the U.S. to be uninsured. That isn’t the case in the rest of the developed world.
And of course there are millions of uninsured people who want coverage, and are willing to pay for it, but simply can’t get it. Over 12 million Americans have been discriminated against by insurance companies in the last 3 years because of pre-existing conditions (click my name for the citation). One in ten cancer patients can’t get insurance.
Carl, so you are saying that the US has very different life style influences than all other countries, very different genes than all other countries and much funkier statistics than all other countries. And that these overt differences all happen to cause the understatement of the effectiveness of health care in the US and that there are no significant differences that cause overstatement…
So if they could have insurance, but don’t, it’s their fault if they die as a result, and we shouldn’t be concerned?
No, we should all follow your example: log on and thrash absurd straw men while ignoring pertinent facts which might point to realistic solutions.
And of course there are millions of uninsured people who want coverage, and are willing to pay for it, but simply can’t get it. Over 12 million Americans have been discriminated against by insurance companies in the last 3 years because of pre-existing conditions (click my name for the citation).
You know, that’d be a good use of Medicare not insurance.