"Life Expectancy" Doesn't Measure How Long You're Expected To Live • Hacker News Board

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#71

Post by SageRaven » Tue, Sep 11, 2012, 10:17 PM UTC

hack_edu wrote: post #59

SageRaven wrote: post #51

Earlier quoted context omitted.

I'd hazard a guess it's due to two things, each not necessarily independent. First, males in many countries are prone to societal "honor" and may kill themselves in times of great shame (poor Indian farmers loosing everything to shady Monsanto salesmen and then drinking pesticide). And second, women are often mothers, and while a suicidal man tends to not "think of the children" women (being mothers and all) do consi…

Plain and simple, across and countries and all historical periods, males act more dangerously. They put themselves in physically dangerous situations more often than women, and die in mid-life at a much higher rate. Male children are more likely to live until adolescence, but after their 20s their portion of the population falls back in line with that of females.

I buy that. However, we're talking about suicide, not dangerous behavior in general.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#72

Post by Retric » Tue, Sep 11, 2012, 10:27 PM UTC

tptacek wrote: post #65

Retric wrote: post #61

Earlier quoted context omitted.

Where do you get those numbers? MRSA is thought to have caused 1,652 deaths in 2006 in UK up from 51 in 1993.[104] http://en.wikipedia.org/wiki/Methicillin-resistant_Staphyloc... Still, for those numbers to be useful the rate of infection, detection, treatment, death, AND linking deaths to MRSA must be considered before you can compare those healthcare systems as well as a near constant rare of infection.

Sorry, I got Clostridium confused with MRSA. But 1,652 normalized for population is still higher than the US MRSA fatality number! I'm not sure what the second sentence means. If you're saying we don't know how to properly attribute deaths to MRSA, what does any MRSA statistic say about health care? You have a long row to hoe with the overall argument you're making. It is, for instance, not hard to link deaths to hea…

Yes, I am saying in many cases we don't know cause of death. In most of the US we do a crap job of discovering cause of death in many cases. When you dig into the numbers specific coroners often have different old guy died in sleep dumping grounds. 'Hart disease' often ends up as a grab bag for any number of quiet killers such as: http://en.wikipedia.org/wiki/Pulmonary_Embolism.

PS: Perhaps the most humorous being http://en.wikipedia.org/wiki/Fan_death, but the sadist and most blunt is probably: http://en.wikipedia.org/wiki/Sudden_infant_death_syndrome which is literally 'death without obvious cause'.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#73

Post by makomk » Tue, Sep 11, 2012, 11:03 PM UTC

gojomo wrote: post #20

tptacek wrote: post #4

This is a great post. Because I'm a nerd, I'm compelled to make an orthogonal point: Life expectancy is not entirely medical and is not a particularly good way to compare countries. Consider that among the top causes of death in the US are "accidents" (predominantly motor vehicles) and suicide, both of which are anomalously high in the US. Consider also that if you go to the top US cause of death (heart disease, clea…

You may mean homicide rather than suicide: the US doesn't seem especially high in this ranking of suicide deaths -- http://en.wikipedia.org/wiki/List_of_countries_by_suicide_ra... -- below many other rich or large countries, and not far from culturally/developmentally similar countries (like Canada/NZ/UK). The US does stick out among its usual developmental peers on the homicide rates -- http://en.wikipedia.org/wiki/…

Surely the rate of death from both accidental injuries and violent crime is affected by access to emergency medical care, though? You can't disentangle the two that easily.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#74

Post by refurb » Tue, Sep 11, 2012, 11:11 PM UTC

danielweber wrote: post #55

refurb wrote: post #17

Earlier quoted context omitted.

This is true and a huge annoyance to me when people say "When social security was first put in place, most people didn't live to collect it!" This is of course false. Back in the early 1900's when life expectancy was only around 60, if you survived your childhood, you'd likely live to 70 or 80.

Back in the early 1900's when life expectancy was only around 60, if you survived your childhood, you'd likely live to 70 or 80. This didn't seem right so I checked. A 20 year old in 1900 could expect to live to 62. In 1939 (4 years after SS was first put in place) a 20 year old would live to 67. Interpretted as a median age of death, you are right that more than 50% of 20 year-olds collected at least 1 check, but a…

Thanks for looking up actual numbers!

I guess my point also has to do with what "averages" mean. In 1939, a 20 year old might _on average_ live to 67, but that means a number would die at 47, but a similar amount would live to 87.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#75

Post by yummyfajitas » Wed, Sep 12, 2012, 12:42 AM UTC

tptacek wrote: post #32

Retric wrote: post #29

Earlier quoted context omitted.

Your statistics are simply wrong. Which is why they numbers don't seem to add up correctly. US has a mixed heath-care system with some people reviving enough treatment that it actually lowers there chances of survival and others getting little to no treatment. PS: It's hard to get good data. Japan has twice the US suicide rate and a longer life expectancy. However, some of their numbers are off due to people not repo…

Is there data to back up your argument? What you're saying seems to amount to this: If you're wealthy, the US health care system is so good that not only does it outdo Europe's system at handling heart disease and cancer, but it does so much better than Europe's that the effect is evident from mortality statistics even though 75MM people in the US make less than $22,000/yr. At the same time, you're saying that regard…

The problem is that the US health care system routinely bankrupts patients.

This is unclear as well. This stylized "fact" only became a talking point in the last election, and is drawn almost exclusively from a deeply flawed study by Elizabeth Warren.

http://www.theatlantic.com/business/archive/2009/06/elizabet...

http://www.theatlantic.com/business/archive/2010/12/will-hea...

Among other flaws, the study doesn't measure causation or even correlation.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#76

Post by Camillo » Wed, Sep 12, 2012, 1:28 AM UTC

tptacek wrote: post #9

tesseractive wrote: post #8

Earlier quoted context omitted.

I haven't studied the data, but I would be surprised if motor vehicle deaths were "anomalously" high. My hypothesis would be that it is an entirely expected outcome given the comparative lack of public transportation in this country relative to other industrialized nations such as Japan and those in Europe. More driving miles (or, perhaps, more hours spent driving) per capita should lead to more motor vehicle acciden…

It's easier to maintain a dense public transportation system when the system's goals are (for instance) to move 80MM people around in an area the size of Colorado. Colorado, by comparison, has a population of 5MM. But yes, I was making the latter point. Does life expectancy tell us something about the differences between life in the United States and Finland? Yes... but what if all it's telling us is "the United Stat…

Do most people in Colorado commute from a corner of the state to the other? I would expect most people to live in or near the city where they work, just as in Europe. Having hundreds of miles of desert or farmland around a city does not make it any more difficult to build a metro system, for instance.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#77

Post by tptacek » Wed, Sep 12, 2012, 2:25 AM UTC

yummyfajitas wrote: post #75

tptacek wrote: post #32

Earlier quoted context omitted.

Is there data to back up your argument? What you're saying seems to amount to this: If you're wealthy, the US health care system is so good that not only does it outdo Europe's system at handling heart disease and cancer, but it does so much better than Europe's that the effect is evident from mortality statistics even though 75MM people in the US make less than $22,000/yr. At the same time, you're saying that regard…

The problem is that the US health care system routinely bankrupts patients. This is unclear as well. This stylized "fact" only became a talking point in the last election, and is drawn almost exclusively from a deeply flawed study by Elizabeth Warren. http://www.theatlantic.com/business/archive/2009/06/elizabet... http://www.theatlantic.com/business/archive/2010/12/will-hea... Among other flaws, the study doesn't mea…

Here is a list, I feel like it's fairly representative, of conditions that will generate an "automatic decline" for a regional health insurer. I chose it because it was the first on the Google SERP; I can be more rigorous if I need to be:

http://echealthinsurance.com/health-insurance-advisor/wp-con...

The fun stuff starts on age 18.

A huge number of Americans have conditions with a "D" in the right-hand column, which is "automatic decline coverage". Many of those people cannot get insurance on the private market at any cost.

Why do you have a hard time believing that our health care system needlessly bankrupts people?

Is it something along the lines of, "there is a savvy way to negotiate this system without having health insurance"? I'm prepared to concede that someone knows someone who's mom paid pennies on the dollar for care by playing hardball with providers. I just don't think that's a viable solution to the problem overall; providers will more often than not just send the bills to collections.

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#78

Post by lsc » Wed, Sep 12, 2012, 2:32 AM UTC

Camillo wrote: post #76

tptacek wrote: post #9

Earlier quoted context omitted.

It's easier to maintain a dense public transportation system when the system's goals are (for instance) to move 80MM people around in an area the size of Colorado. Colorado, by comparison, has a population of 5MM. But yes, I was making the latter point. Does life expectancy tell us something about the differences between life in the United States and Finland? Yes... but what if all it's telling us is "the United Stat…

Do most people in Colorado commute from a corner of the state to the other? I would expect most people to live in or near the city where they work, just as in Europe. Having hundreds of miles of desert or farmland around a city does not make it any more difficult to build a metro system, for instance.

There are very real economic reasons to build out rather than up, when you have suitable land nearby. Especially in areas like Colorado where land is cheap and regulation is light, building nice big cheap (in terms of construction costs) single family homes sounds pretty good, vs. building expensive (per square foot of usable space) high-rise condos. Construction costs are lower, and you end up with a bunch more living space, a garage, etc, etc. And from a buyer's perspective, you have a lot more control over a single family home.

And yeah; you can have public transit in the 'burbs? but it's not going to be popular. Because you have so much more living space than a city dweller, you are likely to get more utility out of the hauling capacity of a car. And having that extra living space also dramatically lowers the cost of owning the car; You don't have to pay for parking, and you can do basic work in the garage. (you can save a giant wad of cash doing basic stuff like swapping rotors yourself.)

Personally, I think the economic realities of the suburbs mean that only the poorest of the poor are going to not own personal vehicles; because of this, public transit is built for and associated with the poor in all but the most built-up parts of America. "Domestic help" is not fashionable here, either, so for the middle class, there isn't a lot of upside to letting poor people into their neighbourhoods. (I'm wondering if this is going to change with the rise of in-home elder-care. There certainly are plenty of Americans willing to do that sort of work for wages the middle-class could pay.)

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#79

Post by lotharbot » Wed, Sep 12, 2012, 5:44 AM UTC

tptacek wrote: post #77

yummyfajitas wrote: post #75

Earlier quoted context omitted.

The problem is that the US health care system routinely bankrupts patients. This is unclear as well. This stylized "fact" only became a talking point in the last election, and is drawn almost exclusively from a deeply flawed study by Elizabeth Warren. http://www.theatlantic.com/business/archive/2009/06/elizabet... http://www.theatlantic.com/business/archive/2010/12/will-hea... Among other flaws, the study doesn't mea…

Here is a list, I feel like it's fairly representative, of conditions that will generate an "automatic decline" for a regional health insurer. I chose it because it was the first on the Google SERP; I can be more rigorous if I need to be: http://echealthinsurance.com/health-insurance-advisor/wp-con... The fun stuff starts on age 18. A huge number of Americans have conditions with a "D" in the right-hand column, which…

I submit that the system does needlessly bankrupt some people, but there are also a number of alternatives which allow a large percentage of the uninsured to avoid such a fate.

If I may submit two personal stories in place of rigorous data:

my incredibly poor sister recently injured herself and was facing nominal charges of about $40,000. She was able to get that written down to a few grand and then get donations from family, friends, and charities to cover her bills. She didn't have to "play hardball"; she just explained her situation and the hospital bent over backwards to help her. The hospital staff treated it as a routine occurrence.

My wife and I do not have health insurance at all. We use something called "Christian Healthcare Ministries" [0] which is not insurance, and (at our level of participation) doesn't cover routine visits or small problems, but covers us in case of conditions that might otherwise bankrupt us. So while I personally cannot get insurance on the open market, and routinely get counted in the "not insured" category, I still have coverage.

(Note that I'm not defending the US health care system overall, just introducing some information about alternatives that help people avoid bankruptcy.)

[0] https://www.chministries.org/

Re: "Life Expectancy" Doesn't Measure How Long You're Expected To Live

#80

Post by barry-cotter » Wed, Sep 12, 2012, 8:36 AM UTC

makomk wrote: post #73

gojomo wrote: post #20

Earlier quoted context omitted.

You may mean homicide rather than suicide: the US doesn't seem especially high in this ranking of suicide deaths -- http://en.wikipedia.org/wiki/List_of_countries_by_suicide_ra... -- below many other rich or large countries, and not far from culturally/developmentally similar countries (like Canada/NZ/UK). The US does stick out among its usual developmental peers on the homicide rates -- http://en.wikipedia.org/wiki/…

Surely the rate of death from both accidental injuries and violent crime is affected by access to emergency medical care, though? You can't disentangle the two that easily.

That's right. If trauma medicine was still at the levels of the 70's the US murder rate would be about five times higher than it is.