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Cost of Health Care By Country, as Compared to Life Expectancy

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Re: Cost of Health Care By Country, as Compared to Life Expectancy

#41

Post by lionhearted »

scott_s wrote: post #23
dantheman wrote: post #22

Earlier quoted context omitted.

They trust their doctors. In the rest of the world there are not the restrictions on drugs that are found in the USA. Also, what about all the people that could be saved by a medicine that have nothing to lose if it doesn't work since they have no other options -- right now they SOL. The amount of people that die because they cannot receive medicines that may work is staggering and a great injustice.

Do you have data on the number of people who die because the FDA has not approved a drug that may save their life? Note that this is different from people who die because they can't afford treatment. I would be more comfortable with point 4 if we once again banned prescription drug advertisements.

> Do you have data on the number of people who die because the FDA has not approved a drug that may save their life?

That question wasn't directed at me, but finding out some data wouldn't be too difficult - you'd look up what life saving medicines had come to market since the stricter FDA regulations were enacted, what year the medicine entered trials, how many people died while they were in FDA trials before release. You could come up with some rough numbers for that, but the FDA doesn't post any information on added costs and deaths during trial periods. Obviously the safety trials save some lives, but the efficacy standard the FDA has is extremely high and adds millions and years to costs.

> I would be more comfortable with point 4 if we once again banned prescription drug advertisements.

The tough question is for drugs that people not be aware there's solutions for - erectile dysfunction, for instance. A lot of men just assumed that was something you had to live with when you got older before Viagra came out. Advertising for Viagra was probably a win for everyone involved - it educated doctors and patients that it's available, and obviously men and their partners were quite happy with its effects.

So some advertising definitely has positive benefits, but I see what you're getting at with snake oil claims if the FDA isn't as strict about playing gatekeeper. Something to think more about.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#42

Post by chasingsparks »

Graphs are abused.

Graphs are meant to present data clearly and concisely. The most clear and concise presentation method should be used. If it is not, there are reasons to be skeptical.

This graph is not the best presentation imaginable; it's not even mediocre. It is meant to appeal visually to those who already have reached the conclusions it is meant to illicit; it is graph porn.

Health care spending and quality is very complex. What about adjusting for relative wealth (not merely the health care spending share of GDP), lifestyles, racial composition (if I am correct, there are biological differences in addition to the obvious socio-economic ones), preferences (how much would you spend for an extra month), etc. Asking questions like why other countries spend less on drugs (does the U.S. subsidize medical research by spending more or is it merely the one that allows rent seeking or both?)

After doing so, I believe you will still find evidence suggesting that the U.S. system spends more than it should and there can be clearly identified inefficiencies. That is the distilled information that is interesting -- not the merely manipulative.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#43

Post by scott_s »

hs wrote: post #34

of the three countries that have highest (and surprisingly parallel) slope: japan, south kore, mexico ... it suggests that #visit correlates with LE ... and health coverage is unimportant but there are countries that have less #visit but more expensive (it suggests patients go to doctor not only for consultation) ... so #visit is an unreliable predictor so is cost to me it seems the most predictive is location (yes,…

The slope of the line is an artifact of the visualization choice.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#44

Post by dhume »

walkon wrote: post #27
olefoo wrote: post #3

That's an awesome and persuasive infographic. In fact, it's main fault is that it's trying too hard to be persuasive. Putting the US above the legend detracts from the power of the raw data and strikes me as being unnecessarily editorial.

It's not that awesome when you remember that correlation does not necessarily equal causation.

It's not about showing correlation. It's about showing that we're not getting what we're paying for.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#45

Post by gcheong »

lionhearted wrote: post #41
scott_s wrote: post #23

Earlier quoted context omitted.

Do you have data on the number of people who die because the FDA has not approved a drug that may save their life? Note that this is different from people who die because they can't afford treatment. I would be more comfortable with point 4 if we once again banned prescription drug advertisements.

> Do you have data on the number of people who die because the FDA has not approved a drug that may save their life? That question wasn't directed at me, but finding out some data wouldn't be too difficult - you'd look up what life saving medicines had come to market since the stricter FDA regulations were enacted, what year the medicine entered trials, how many people died while they were in FDA trials before releas…

I think the effect of eliminating the efficacy standard would just be to shift the cost from one that is paid upfront by the company and then borne by the consumer to one that is wholly borne by the consumer. The cost of finding effective treatments would not be reduced, but just more hidden in the cost of having the market weed out more medications, misinformation around claims, etc. Just look at the supplementation market which the FDA does not regulate much. How many people waste their money chasing claims that have little or no effect?

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#46

Post by neurotech1 »

scott_s wrote: post #23
dantheman wrote: post #22

Earlier quoted context omitted.

They trust their doctors. In the rest of the world there are not the restrictions on drugs that are found in the USA. Also, what about all the people that could be saved by a medicine that have nothing to lose if it doesn't work since they have no other options -- right now they SOL. The amount of people that die because they cannot receive medicines that may work is staggering and a great injustice.

Do you have data on the number of people who die because the FDA has not approved a drug that may save their life? Note that this is different from people who die because they can't afford treatment. I would be more comfortable with point 4 if we once again banned prescription drug advertisements.

In life or death cases, the FDA can grant a Humanitarian Use Exemption. eg. Experimental cancer treatment drug.

The key difference is in the "experimental" part, as that drug cannot be marketed until its fully approved.

The doctor would have to get permission from the patient, and their hospitals "Ethics Review Board"

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#47

Post by dschobel »

dhume wrote: post #44
walkon wrote: post #27

Earlier quoted context omitted.

It's not that awesome when you remember that correlation does not necessarily equal causation.

It's not about showing correlation. It's about showing that we're not getting what we're paying for.

This graph basically proves that the bottom end of American society has fall off and says nothing about the quality of care that the majority are getting.

As others have pointed out, life expectancy is only a single facet of the health of a nation and with many sociological factors such as the fact that americans eat too much which leads to heart disease which is not-incidentally the most common cause of death in the USA.

Assuming you have coverage, what you're paying for is word-class care with minimal waiting times.

Re: Cost of Health Care By Country, as Compared to Life Expectancy

#49

Post by jacoblyles »

scott_s wrote: post #23
dantheman wrote: post #22

Earlier quoted context omitted.

They trust their doctors. In the rest of the world there are not the restrictions on drugs that are found in the USA. Also, what about all the people that could be saved by a medicine that have nothing to lose if it doesn't work since they have no other options -- right now they SOL. The amount of people that die because they cannot receive medicines that may work is staggering and a great injustice.

Do you have data on the number of people who die because the FDA has not approved a drug that may save their life? Note that this is different from people who die because they can't afford treatment. I would be more comfortable with point 4 if we once again banned prescription drug advertisements.

I believe this is a question often studied in Economics journals, you may want to look there. If I remember correctly, it is referred to as "Type I vs. Type II" error. One type of error is when a drug is approved prematurely and people are harmed because of it. The other type of error is when people are harmed because a useful drug is kept off the market. Some economists theorize that the second type of error would be more common, because the first kind of error is more visual and visceral. I believe there have been studies attempting to find evidence for the theory, but I'm not an expert and have never kept up with the latest journals in economics.
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