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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?

#71

Post by ddingus »

voodootrucker wrote: post #61
xwdv wrote: post #6

Earlier quoted context omitted.

Which half made you happier?

Due to work, I spent: - 3 months in Japan - 3 Months in Germany - 3 months in the US - 3 months in India The transition was alarming. I see bits of both Germany and India in the US. Unfortunately (having grown up in America) I see the trend as towards India. I don't mean this as a cultural slight, but as a cultural observation. I've seen high-trust vs low-trust societies brought up many times on HN. Traffic was most…

I found your take thought provoking. HN is always a surprise.

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

#72

Post by pseudoramble »

quicklime wrote: post #35

I also thought it was interesting to see when the US branched away from the rest of the rich countries. For example: 1. All the other rich countries have steadily increased health expenditure per capita, and for some reason this really accelerated in the US around the early '80s. But the money looks like it mostly went to things that didn't increase life expectancy. Maybe this was a Reagan thing? 2. The US had the hi…

About point #2, I wonder if the deaths caused by smoking remains high in the US because it's measured effect can be really delayed. Even if sales of cigarettes went down in the mid-70's, they were probably still high for quite a while. On top of that, the effects of smoking can take decades to appear. I could imagine somebody starting smoking in the mid 70's and not seeing effects until recently.

EDIT: It turns out reading even not-so-carefully results in fruit! From the article:

> But the chart also shows that smoking peaked earlier in the US. Since there is a lag of two to three decades between the peak of smoking and the peak of smoking mortality, this should be positive news for the US going forward. The country is over this mortality peak and we should expect the decline in lung cancer death rates in the US to continue in the coming years.

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

#73

Post by medium_burrito »

TuringNYC wrote: post #25
xwdv wrote: post #6

Earlier quoted context omitted.

Which half made you happier?

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 worries is the ultimate luxury.

Alternatively, if I lived in California where the weather is mild perhaps I would just go full Diogenes.

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

#74

Post by wang_li »

troupe wrote: post #55
JimTheMan wrote: post #31

Earlier quoted context omitted.

Your employer picks a plan for you, which isn't what you need. You go to your doctor, who then tries to treat you. But then has to fight an insurance company who wants treatment that isn't in your best interests or isn't covered by the employer plan. You get home and discover your Doctor is out of network. Pay up. You spend a million years fighting the insurance company. OR your insurance is good, so the doctor says,…

I recently had a surgery done and we weren't sure it was going to be covered by insurance. I wanted to make sure I knew how much of a liability I was taking on by moving ahead before knowing about insurance. I was told the insurance was going to be billed $150k, but if they didn't pay, they would only charge me $15k as the cash price. I was ok with that since the surgery was important and insurance did pay, but that…

There are places where they don’t use insurance, it’s cash only. The Surgery Center of Oklahoma does cash only and will tell you the cost before you even contact a surgeon or specialist. It’s on their website.

You can also get mri images done for very low cost of you pay cash.

https://surgerycenterok.com/

https://affordablemri.com/

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

#75

Post by Barrin92 »

missedthecue wrote: post #50
JimTheMan wrote: post #11

"It's a poor nation with rich people in it."

Yet the median disposable income per person, after adjustments for government provided healthcare and education is enormously higher than any other nation, according to the OECD. https://data.oecd.org/hha/household-disposable-income.htm

that is precisely one reading of the original quote. Americans are rich, but even rich Americans often life in perpetual financial insecurity. THe average American is rich but cannot cough up a thousand bucks for an emergency, which in the US, can be life threatening.

It's a new sort of poverty, affluent and insecure at the same time, and it's probably not a stretch (given the content of the article we're commenting on) to say it's bad for health.

The average Dutch citizen might take less money home, but they also work 30% less, they won't face the threat of not having healthcare or a roof over their head, and they don't need to inhale car exhaust on a highway for an hour per day but take the bike instead. More money is evidently not the solution to everything. American society seems to be optimised around creating economic activity for its own sake.

edit: not really sure what the reflexive downvotes are for, the links between precarity, inequality, stress and biological harm in populations are well documented, see Sapolsky: https://www.scientificamerican.com/article/how-economic-ineq...

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

#76

Post by [deleted] »

Retric wrote: post #12
admiralspoo wrote: post #10

Comparing ethnically homogenous countries to the US is meaningless and downright deliberately misleading at best. There is significant variation in every state by race. https://en.wikipedia.org/wiki/List_of_U.S._states_and_territ...

West Virginia is 92% non-Hispanic white (2018) and has the lowest life expectancy of any US state (74.8). Which clearly disproves that common hypothesis. https://en.wikipedia.org/wiki/List_of_U.S._states_and_territ... Life expectancy and overall heath in the US is strongly correlated to wealth. It’s a feedback loop, being poor directly results in worse access to healthcare etc, but also because it’s much harder for s…

[deleted]

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

#77

Post by bryan11 »

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.

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 between a doctor visit or a car repair. Preventative checkups are gone and insurance is only something one uses with an emergency room visit or major health issue.

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

#78

Post by free_rms »

Apocryphon wrote: post #52
free_rms wrote: post #38

Earlier quoted context omitted.

Not to mention squads of clerks at every single doctor's office doing battle with entire armies at the insurers in a many-to-many clusterfuck of epic proportions over every single bit of care delivered.

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.

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

#80

Post by quicklime »

julienb_sea wrote: post #43
perardi wrote: post #30

Wow, the difference between the US and Canada is a surprise, in particular the opioid overdoses and road accidents. I am a US->Canada transplant, and the cultural and economic differences here just don’t seem that stark. Yes, there is universal health care, obviously…but there is definitely not an abundance of easily available mental health care here, especially outside the major metro areas. And the health care in t…

There are dramatically more high density, high risk driving environments in the US versus Canada. I could also make some questionable generalizations about Canadian drivers versus US drivers.

Is this true? It seems like Canadians drive less than Americans do, which I'm guessing is because Canadians live and drive in higher-density environments where they can make shorter trips and kill fewer people along the way:

https://internationalcomparisons.org/environmental/transport...

Just eyeballing it, it looks to me like the death rate from road accidents in each country correlates strongly with vehicle-kilometers driven per capita. Americans die at a higher rate because they spend more time on the roads covering more distance.

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