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Life expectancy in America has declined for two years in a row

economist.com

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Re: Life expectancy in America has declined for two years in a row

#71

Post by AnthonyMouse »

majormajor wrote: post #55
AnthonyMouse wrote: post #49

Earlier quoted context omitted.

> If nothing is done, the number of Americans with health insurance is expected to decline by millions this year (due to the repeal of the health care tax (I forget the term they used) in the new tax law). This is a bad metric. We should be worried about healthcare costs, not insurance coverage. You can have "universal coverage" and still be wrong, because people are paying $5000+/year in insurance premiums they can'…

> If it didn't cost a hundred thousand dollars to get sick then it wouldn't be a problem for people to not be insured against it. This is a dicey one. One of the things that drives treatment costs up is more advanced technology. Should we go back to 70s/80s-era cancer treatments, HIV treatments, surgical outcomes? We need a lot more national discussion about where the real opportunities to save money are, and what sh…

The problem is that we keep trying to pretend that it both is and isn't a market.

In theory you can actually have a free market for healthcare. You get cancer, there are multiple competing providers of cancer treatment products and you choose one based on effectiveness and price. A better treatment can charge more, but if it's only 5% better and costs a hundred times as much then most people won't use it. Which will bring the price of the best treatment down to something most people can afford.

The alternative to that is that the government imposes prices regulations, sets low prices for everything and then funds medical R&D with tax money instead of having high margins for medical procedures. The main problem with that is that the government may not fund the right things in the right amounts, either failing to fund very effective research or wasting money on ineffective research.

What we actually have is a bastardized hybrid that doesn't work at all, because when the insurance is paying for it but there are no price regulations, people will always choose the treatment which is 5% more effective but costs a hundred times as much, and then the provider obviously has no incentive to lower the price. So the price of everything gets completely out of control.

Re: Life expectancy in America has declined for two years in a row

#72

Post by majormajor »

geomark wrote: post #70
majormajor wrote: post #55

Earlier quoted context omitted.

> If it didn't cost a hundred thousand dollars to get sick then it wouldn't be a problem for people to not be insured against it. This is a dicey one. One of the things that drives treatment costs up is more advanced technology. Should we go back to 70s/80s-era cancer treatments, HIV treatments, surgical outcomes? We need a lot more national discussion about where the real opportunities to save money are, and what sh…

"One of the things that drives treatment costs up is more advanced technology." It's not so much the technology as it is the setting in which the technology is deployed. Compare US costs to costs for the same procedures and technology in top medical tourism destinations. Quality of care and outcomes are much better at a fraction of US costs. It's the big morass of stuff around the US health care environment that adds…

This is part of where I don't know where to find the numbers I want to find. :)

Are one-off procedures amenable to medical-tourism destinations a major part of US total healthcare costs? Or is it expensive, often-for-rest-of-life, prescriptions and treatment courses for certain conditions? Or just the simple requirements of keeping an ever-larger/ever-older aging population alive through falls/heart attacks/kidney failures/whatever?

Pointers to the data would be appreciated, here. :)

Or numbers around research budgets: what does the international research profile around, say, lab-grown replacement organs look like compared to the in-US one?

What I have found so far is that even within the US, quality of care and outcomes vary wildly (doctors and nurses are only human, too, after all) and you can generally figure out where you should go for what condition, but it's not very easy. And it's problematic at a certain point to say that it should be easier: the best 10% of practicioners for a certain condition likely can't see 100% of the patient load. How do you decide who gets the crappy doctors? (International medical tourism is a slightly different can of worms, but one I understand less because my experience is that most health coverage doesn't give you much internationally, so domestic medical tourism seems much more attractive.)

Re: Life expectancy in America has declined for two years in a row

#73

Post by decebalus1 »

matte_black wrote: post #68
decebalus1 wrote: post #62

Earlier quoted context omitted.

> Is there a way to measure “Life expectancy of people most similar to you”? Wow.. whenever someone asks me why the US doesn't have humane social services and still regards drug addiction as a crime in need of punishment, I'll point them to this comment.

I don't get why this is a big deal. We already serve up content based on people similar to you or making similar choices as you, why not health forecasts? If I eat healthy, exercise, get the proper amount of sleep and am not addicted to drugs, why not show me how other people with similar habits as me are doing, instead of averaging in people who treat their body like a dumpster? Showing me the life expectancy averag…

> Showing me the life expectancy averaged across an entire country of 300 million doesn't motivate me to do anything.

This is not the point of life expectancy statistics. It's not to motivate people. And It's not about you. Just because you're thinking it's about you and that it's not relevant to you to be put in the same bucket with others proves my point.

This is an intentionally nation-scale barometer which is used to asses the Human Development Index. It's more tied with Income inequality than with your diet and exercise regimen.

Re: Life expectancy in America has declined for two years in a row

#74

Post by dredmorbius »

matte_black wrote: post #9

Is there a way to measure “Life expectancy of people most similar to you”? Seems like that would be a more meaningful metric for an individual, rather than lumping them in with every drug addict.

Discussions of "risk factors" tend to take this into account.

Age, sex, and socioeconomic status dominate.

There are a number of conditions linked to genetics -- types of anemia, heart disease, Tay-Sachs syndrome, off the top of my head.

Environmental exposures map strongly to socioeconomic status, though there are of course regional variations.

Weight, "body mass index" (a horrible measure), body fat percentage (far more useful, but harder to obtain), and various specific exposures and behaviours will cover much else: drink, smokes, injectable drugs, unprotected sex, other high-risk activity.

This is pretty much the life work of epidemiologists, public health statisticians, and actuaries.

Re: Life expectancy in America has declined for two years in a row

#75

Post by refurb »

biohax2015 wrote: post #33

It’s very frustrating to watch America decline and not being able to do anything about it. Has democracy failed? Is it time for a rekindling of the study of comparative politics? It seems the Chinese have a viable solution to the problem of a largely uneducated and passive populace.

Did it occur to you that the reason why things seem so rosey in China is because the state controls the media?

It's easy to show your country is doing well when you don't have free press?

Re: Life expectancy in America has declined for two years in a row

#76

Post by make3 »

majormajor wrote: post #65
make3 wrote: post #57

Earlier quoted context omitted.

there is no legitimate reason the us should be praying at least an order of magnitude more for the same treatments

I certainly don't like the US having higher prices than elsewhere in the world, but what I would like to see more discussion of there is "where does the funding for the development of the treatments come from" rather than just comparison of absolute cost. I suspect we're subsidizing (especially at the top of the market) a lot of research that the rest of the world is also benefiting from. This isn't necessarily the w…

afaik the pharmaceutical industry is one of the industries with the highest profit margins. I am skeptical of your claims.

Re: Life expectancy in America has declined for two years in a row

#77

Post by refurb »

decebalus1 wrote: post #62
matte_black wrote: post #9

Is there a way to measure “Life expectancy of people most similar to you”? Seems like that would be a more meaningful metric for an individual, rather than lumping them in with every drug addict.

> Is there a way to measure “Life expectancy of people most similar to you”? Wow.. whenever someone asks me why the US doesn't have humane social services and still regards drug addiction as a crime in need of punishment, I'll point them to this comment.

Calm down.

It's a reasonable question. Is there life expectancy data for different segments of the population?

Re: Life expectancy in America has declined for two years in a row

#78

Post by matte_black »

decebalus1 wrote: post #73
matte_black wrote: post #68

Earlier quoted context omitted.

I don't get why this is a big deal. We already serve up content based on people similar to you or making similar choices as you, why not health forecasts? If I eat healthy, exercise, get the proper amount of sleep and am not addicted to drugs, why not show me how other people with similar habits as me are doing, instead of averaging in people who treat their body like a dumpster? Showing me the life expectancy averag…

> Showing me the life expectancy averaged across an entire country of 300 million doesn't motivate me to do anything. This is not the point of life expectancy statistics. It's not to motivate people. And It's not about you. Just because you're thinking it's about you and that it's not relevant to you to be put in the same bucket with others proves my point. This is an intentionally nation-scale barometer which is use…

What is your point exactly? That I don’t care about other people because I’m more concerned about myself? How is that unusual? Seems like most people are that way.

Re: Life expectancy in America has declined for two years in a row

#79

Post by refurb »

llamataboot wrote: post #5
refurb wrote: post #3

Life expectancy is a very blunt tool when measuring citizen's well being. A few ways life expectancy can go down: - babies that other would have died and not counted live long enough with modern medicine that they drag the average down - refugees or immigrants in poor health increase, dragging the average down - a change in methodology in how life expectancy is calculated

It may be blunt, but it's also pretty striking. Along most measures of wellbeing and health, the US lags behind most other industrialized countries.

Have an unbiased source? Most surveys I've seen have the US in the top half of western countries.

Re: Life expectancy in America has declined for two years in a row

#80

Post by tensor »

sumedh wrote: post #64
biohax2015 wrote: post #33

It’s very frustrating to watch America decline and not being able to do anything about it. Has democracy failed? Is it time for a rekindling of the study of comparative politics? It seems the Chinese have a viable solution to the problem of a largely uneducated and passive populace.

> Has democracy failed? An outsider was elected even though he was running against establishment candidates with huge money backing them. I say democracy won.

You say that as though Trump doesn't have huge money backing him, not to mention foreign governments with equally deep pockets.
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