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Why is life expectancy in the US lower than in other rich countries?

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Re: Why is life expectancy in the US lower than in other rich countries?

#111

Post by nraynaud »

OJFord wrote: post #59
troupe wrote: post #47

Last time I looked closely at infant mortality in the US, it looked like the US was doing horribly. However, after talking with some doctors at a neonatal ICU I found out that in the US, we will often identify an unborn child that is in trouble and get it out of the mother in an attempt to save it. Since these types of cases are considered a birth, they count against the mortality rate whereas in some other countries…

That's interesting, but for 'life expectancy' my understanding is that it's the expectation for an X year old, where X is something like 12 or 20 that I can't remember - designed to eliminate such effects, and instead indicate the environmental impact. Edit: apparently I'm wrong, Wikipedia states that 'life expectancy at birth (LEB) is the most commonly used measure'.

Just to confirm, if it's not qualified, it's implied "at birth".

Re: Why is life expectancy in the US lower than in other rich countries?

#112

Post by socialdemocrat »

TuringNYC wrote: post #5

There really are two Americas - wealthy america and the rest of america. I'll bet if you split America into two sets of counties, the graph would be much different -- one would be a super-outlier and the other a super-laggard. I know this personally, as I've spent 21yrs of my life in one half, and another 20 in the other half. I've also lived overseas for several years, and they also have stratas, but much less prono…

But even that isn't even true. The US system doesn't even benefit the wealthy. For profit health care means a lot of over-treatment which causes several problems in US health care which kills people:

- Something like 2x as much surgery done in the US than in other countries, because it is profitable, not because it is needed. So perfectly health people are cut open, because they got a good insurance which can pay for it.

- Opioid crisis. Again having health insurance is a problem, not a benefit in this case. That turns you into a money bag, they can push opioids on.

- Antibiotic resistance. America is all about getting more of everything. Quantity over quality, which unfortunately also means excessive use of antibiotics making Antibiotic resistance a major problem.

The US system really isn't working for anyone. It means those who cannot pay get too little treatment, and those who can pay get too much. If only there was a way to even it out...

Re: Why is life expectancy in the US lower than in other rich countries?

#113

Post by gwright »

plandis wrote: post #56

I am always curious how data are compared between countries which will pretty much always have different reporting standards. For example, how does one doctor in Germany attribute a death to smoking vs. a doctor in the US? The reason why I bring this up is I know of at least one metric where the definitions being used are quite disparate: child mortality. The US is very inclusive in counting pre-mature births as infa…

This is something I've seen called out before when these comparisons are trotted out but I don't see it mentioned in this article.

Here is a blurb I found quickly (from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4856058/)

> First, many countries also have reporting requirements related to birth weight and may not report infants under 500 grams as live births (MacDorman and Mathews 2009). Second, the presence of assisted reproductive technologies has increased the frequency of multiple births, which have higher mortality rates.

Re: Why is life expectancy in the US lower than in other rich countries?

#114

Post by gleb »

socialdemocrat wrote: post #109
troupe wrote: post #47

Last time I looked closely at infant mortality in the US, it looked like the US was doing horribly. However, after talking with some doctors at a neonatal ICU I found out that in the US, we will often identify an unborn child that is in trouble and get it out of the mother in an attempt to save it. Since these types of cases are considered a birth, they count against the mortality rate whereas in some other countries…

As far as I recollect discussing this before one will actually save younger children in most of Nordic countries e.g. than in the US, and infant mortality rate is still much lower. There are several reasons the US rate is so much higher than in other developed countries. The US does not have universal health care, which means large sections of the US population does not get adequate follow up during pregnancy. If you…

Except that US does have universal healthcare for pregnant women. Most pregnancies and births in United States are covered by Medicaid. And Medicaid pays well for that.

Re: Why is life expectancy in the US lower than in other rich countries?

#115

Post by socialdemocrat »

I lived about 1.5 years in the US several years ago. Ironically I had planned on settling but instead came to realize what a great country I came from, Norway. America has many qualities but I had to see America to realize all the qualities of my own home country.

Health care was one of them. I never really liked health care in Norway. I didn't think doctors was all that eager to help often. In the US I kind of experience the opposite, but I slowly realized there was a very dark side to this. All too often I saw that it was just a show to please the "customer."

Basically in the US I saw little patient and health thinking and much more of a profit and customer thinking in health care. So often suggestions and procedures where obviously followed for pure profit motive. I discovered on may occasions how I would be given useless drugs and suggestions just to drive profits.

I think all health care systems are flawed in some way. Norwegian health care is no exception. But in the US I saw that it was possible to do much worse. The sad irony of this is that this happened while US doctors from my impression are exceptionally skilled. Problem is that they are in a system which push them to think about money rather than health care.

A US system where incentives go realigned to serve people rather than profits could quite possibly turn into one of the best health care systems in the world.

Re: Why is life expectancy in the US lower than in other rich countries?

#116

Post by trefoiled »

rsynnott wrote: post #82
julienb_sea wrote: post #48

Earlier quoted context omitted.

Well, the US has better outcomes for employed, insured and non-overweight folks; dramatically lower wait times, better cancer survival rates and less competition for care. Expense is also a nonissue on employer insurance. Unfortunately the US aggregate outcomes are dragged heavily down by an unhealthy population and high barriers to care for the uninsured.

> Expense is also a nonissue on employer insurance. My impression was that many if not most Americans would have to pay an excess (not sure of the American term; money paid by an insured party on using insurance) for any medical care with their work insurance. Is this not the case?

This is true but complex. It depends on the type of service you receive. As a general rule, you'll need to pay a yearly deductible before receiving insurance benefits for non preventative care. This can be anywhere from $500 to $8000. High deductible plans are commonly referred to as "catastrophic" plans, because the deductible is so high, and the kind of people who purchase them are typically not wealthy, that their owners would only seek care in a true emergency where the service would exceed the cost of the deductible. After paying your deductible you will often also have a "co-pay" which is typically a flat rate based on the type of service. Something in the realm of $25 to $500. After that, many plans have something called "co-insurance" which is a percentage of the bill you are responsible for even if you have met your deductible. Say, 20%.

Add all these charges and fees up, you'll keep paying them until you hit your "maximum out of pocket." So as an example, I was hospitalized a few years back in December while on what would be considered a "good" healthcare plan. I paid my $1000 deductible, a $250 co-pay for emergency room care, and co-insurance of several hundred dollars. I stayed a single night in the hospital and received a CT scan. I was given Tylenol, released the next day, and referred to a specialist. I wound up seeing the specialist in January, so my deductible reset. I was given another CT scan, so I had to pay my $1000 deductible again. The total bill for the entire process pre-insurance was in the realm of $80,000. After insurance, I paid $5000, which was my entire life savings at the time. I didn't hit my maximum out of pocket for either year, so I got lucky in a way. I could have had to pay double what I did.

Re: Why is life expectancy in the US lower than in other rich countries?

#118

Post by mr_luc »

roenxi wrote: post #102

This is an interesting study, but there are so many influences that the article can't cover (probably due to its length) that it is a struggle to even draw questions from it. Everyone dies of something. The fact that US people die from things at a different ratio from other countries is interesting, relevant and uninformative on the topic of life expectancy. Picking out obesity - the fact that US obesity rate deaths…

It does a good job. It asks “why?” and then shows the causes, with numbers for each cause.

Of course, there’s a deeper and more contentious kind of “why?” and it doesn’t go as deeply into that, other than to show some things that seem to correlate.

But I think it is useful, because one can’t defensively say the US doesn’t have a problem compared to other rich countries. The Nordic countries save early, sickly babies and nurse them along just as much as the US does, for instance.

The only thing I wish they’d have changed would be to indicate relative weight of the causes. Because obesity is an order of magnitude more lethal than homicide, for instance.

Re: Why is life expectancy in the US lower than in other rich countries?

#119

Post by jcims »

nostromo wrote: post #44
kinkrtyavimoodh wrote: post #13

Earlier quoted context omitted.

Coastal America and rest of America might be a better way to cut it.

I know a few multi-millionaires in Idaho and Utah that live very nicely. In SF or LA they'd be middle-class. It's not just about wealth in dollars, it's about purchasing power.

Hell of a lot of farmers buying $75k diesel trucks for cash, rotating quarter million dollar equipment through the inventory, sitting on 100 head of cattle and 1000+ acres and wearing carhartts, wranglers and beat up boots. Every now and again a friend of a friend posts a pic on facebook from their 40' boat up on the lake.

Re: Why is life expectancy in the US lower than in other rich countries?

#120

Post by MeinBlutIstBlau »

julienb_sea wrote: post #51
TuringNYC wrote: post #5

There really are two Americas - wealthy america and the rest of america. I'll bet if you split America into two sets of counties, the graph would be much different -- one would be a super-outlier and the other a super-laggard. I know this personally, as I've spent 21yrs of my life in one half, and another 20 in the other half. I've also lived overseas for several years, and they also have stratas, but much less prono…

For healthcare, you can probably segment America a little more generously into insured vs uninsured. If you are insured in America, your healthcare is reasonably good. Lower quality plans may have more restrictive networks or higher deductibles and maximums, but these are manageable and neither are truly barriers to care.

I would rather be uninsured and take my chances than work a low waged job and pay for Obamacare. $500/month for a single person, highest deductible plan is ludicrous. Thats fucking 80-90% rent for many people where I live...if not 100%+.
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