Why is life expectancy in the US lower than in other rich countries? • Hacker News Board

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

#121

Post by MeinBlutIstBlau » Tue, Nov 24, 2020, 3:20 AM UTC

medium_burrito wrote: post #73

TuringNYC wrote: post #25

Earlier quoted context omitted.

TLDR: i'd take unhappy-rich over hungry-poor any day. But the best thing would be the happy medium where you are comfortable enough to afford food/schooling but not in a social class where there are obscene social expectations to spend -- so your question is a fair one. I think the key thing was getting past the lower rungs of the Maslow hierarchy. It is very difficult to concentrate on schooling (or anything) when y…

Yeah, that's exactly it- once you have safety, food, shelter and good health and the expectation those will remain, that's amazing. Personally I've decided to forgo as many personal luxuries as possible (ie don't fly first class, no boat besides a shitty canoe, no peasant steel case rolex, no car worth > $20k in an effort to retire with a few million in liquid assets on top of my house by my early 40s. Having no worr…

My goal is to retire to Germany and become a German citizen if I can't get rich here. At least I won't die in my 60's because I can't afford healthcare.

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

#122

Post by toomanybeersies » Tue, Nov 24, 2020, 3:21 AM UTC

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…

Another statistic that's difficult to compare is homelessness.

On first glance, New Zealand (0.94%) and Australia (0.48%) top the OECD for rate of homelessness, as they include people living in temporary accomodation (sleeping on a couch, motels, etc.) or cars as homeless. Whereas Japan (with the 0.00%) only counts people sleeping rough). Comparing unemployment rates has similar issues.

Comparing these kinds of rates between countries on an absolute basis is largely useless. However, the change in these rates can give insight on how events (political, economic, etc) have changed the demographics and socioeconomic status of countries.

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

#123

Post by danans » Tue, Nov 24, 2020, 3:23 AM UTC

MeinBlutIstBlau wrote: post #120

julienb_sea wrote: post #51

Earlier quoted context omitted.

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%+.

> I would rather be uninsured and take my chances

So you won't seek medical treatment at a hospital if you get injured or become severely ill? Or do you plan to go to the hospital and pay out of pocket? Or, like some other voluntarily uninsured people, will you ask for medical treatment and then just not pay?

> than work a low waged job and pay for Obamacare.

Why would a "low waged" job be a requirement, unless that's the only job you can get? You can pay for Obamacare with a middle or high wage job too. You can also pay for it if you are self employed (which is a lot of people on Obamacare).

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

#124

Post by rayiner » Tue, Nov 24, 2020, 3:31 AM UTC

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…

Re: universal healthcare. Latinos in the US have the highest rates of lacking health insurance (20% versus 5% for non-Hispanic whites). But they have the second highest life expectancy (81.8 years—longer than people in Denmark). And they have the lowest maternal mortality rates: https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-...

> If you look at health care for the poor in the US, it is generally geared towards emergency care. They will stitch you up if you are about to die. However it generally does not cover regular doctor visits and checkups. Hence in the US a lot of expensive effort goes into saving babies when born, when the problem could far more easily have been resolved early in the pregnancy with better checkups.

That’s absolutely false. Medicaid covers preventative services: https://www.kff.org/medicaid/issue-brief/coverage-of-prevent...

CHIP also covers pregnant women and children under 19 and covers pre-natal checkups and delivery.

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

#125

Post by freeone3000 » Tue, Nov 24, 2020, 3:37 AM UTC

Thorentis wrote: post #108

bryan11 wrote: post #77

Earlier quoted context omitted.

You could segment them in three sets: well insured, people with catastrophic health plans, and uninsured. Many employers are switching to high deductible health plans and that deductible may be thousands of dollars, i.e. catastrophic plans. When going to a doctor for a simple diagnosis or bloodwork can easily cost $400 to $1000, many put off doctor visits unless it's an emergency. It can easily become a choice betwee…

$400 for just a bloodtest at a GP? That's insane. All free in Australia, from the initial visit, to the blood taking, to the follow up.

This isn't inflated, really -- Quebec doctors are allowed to charge about the same to the province (depending on several factors, but it's within 2x even for the cheapest option), so it's a reasonable approximation of the costs involved, it's just who pays for it and when.

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

#126

Post by Blahah » Tue, Nov 24, 2020, 3:44 AM UTC

rayiner wrote: post #124

socialdemocrat wrote: post #109

Earlier quoted context omitted.

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…

Re: universal healthcare. Latinos in the US have the highest rates of lacking health insurance (20% versus 5% for non-Hispanic whites). But they have the second highest life expectancy (81.8 years—longer than people in Denmark). And they have the lowest maternal mortality rates: https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-... > If you look at health care for the poor in the US, it is generally geared…

IIRC both higher life expectancy and lower infant mortality are considered likely to be due to community support systems being much better and more pervasive in Latinx communities in the USA. Home births among Latinx are much safer than among most other subpopulations - reduced medicalisation and strong preservation of cultural knowledge about birth are major factors.

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

#127

Post by pavlov » Tue, Nov 24, 2020, 3:49 AM UTC

rayiner wrote: post #124

socialdemocrat wrote: post #109

Earlier quoted context omitted.

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…

Re: universal healthcare. Latinos in the US have the highest rates of lacking health insurance (20% versus 5% for non-Hispanic whites). But they have the second highest life expectancy (81.8 years—longer than people in Denmark). And they have the lowest maternal mortality rates: https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-... > If you look at health care for the poor in the US, it is generally geared…

According to the link, the maternal mortality rate for Hispanics in US is 11.5, which is almost 4x higher than in Finland.

For non-hispanic black women, the death rate is a staggering 40.8 — that's over 13x higher than Finland!

Large parts of America are a third world country.

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

#128

Post by Blahah » Tue, Nov 24, 2020, 3:49 AM UTC

gleb wrote: post #114

socialdemocrat wrote: post #109

Earlier quoted context omitted.

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.

It really isn't the same though. In most developed countries you don't have to worry about turning up to a hospital, for pregnancy or any reason. When a pregnant woman turns up to hospital in the UK (for example) she is absolutely not stressed about the potential cost of the care. If something goes wrong, she gets world class care at no cost to her. If some other medical problem is discovered while she's there, it will be diagnosed and treated and she doesn't have to stress about the cost.

Not so in the US. It would be surprising if that alone didn't account for a significant number of adverse outcomes.

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

#129

Post by gorbachev » Tue, Nov 24, 2020, 3:53 AM UTC

free_rms wrote: post #78

Apocryphon wrote: post #52

Earlier quoted context omitted.

Also America is the most litigious society in the world [0], making medical malpractice suits an ever-present threat in everyone's minds; but tort reform does not help taxpayers, and hurts patients [1]. [0] https://statmodeling.stat.columbia.edu/2015/12/03/why-us-lit... [1] https://www.citizen.org/wp-content/uploads/medical_malpracti...

I'm not super educated on this but I thought that malpractice insurance basically "handled" the problem at a reasonable overhead compared to other gross inefficiencies.

The costs of malpractice insurance vary a lot based on specialty and location:

https://www.leveragerx.com/blog/medical-malpractice-insuranc...

A few years back I was reading articles on how doctors were changing specialties or retiring entirely due to the high cost of malpractice insurance. I'm not sure if the situation has changed since, however.

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

#130

Post by im3w1l » Tue, Nov 24, 2020, 4:00 AM UTC

danans wrote: post #123

MeinBlutIstBlau wrote: post #120

Earlier quoted context omitted.

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%+.

> I would rather be uninsured and take my chances So you won't seek medical treatment at a hospital if you get injured or become severely ill? Or do you plan to go to the hospital and pay out of pocket? Or, like some other voluntarily uninsured people, will you ask for medical treatment and then just not pay? > than work a low waged job and pay for Obamacare. Why would a "low waged" job be a requirement, unless that'…

I think he is saying that for many people it's just too much money. And that if they would be denied care, then so be it.

This is where it gets uncomfortable, isn't it? That their lives are so miserable, that they would gladly trade away years and years of expected lifespan for higher quality of life.