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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?

#91

Post by braindongle »

For some reason, I have a PhD in Health Policy and clinical practice, so, I'm inclined to look at the healthcare system when thinking about this question.

IMO it's simple (and this is of course a common view): healthcare in the United States is a failed market. It's not about free market fundamentalism vs socialism, it's just that in this case, this market is totally broken. Costs are completely out of control, and accordingly, access, that is, access without incurring crippling debt, is a huge problem.

Obama tried to address both cost and access. He went up against the insurance companies, and lost. He got somewhere on access, but even that is just access to insurance; insurance that may leave you with thousands of dollars to pay out-of-pocket if you walk into the ED with a complaint. So maybe you don't go.

Socialized medicine, it seems, certainly won't fly in this country. But socialized insurance, "Medicare for all"? We, the little people, have many reasons to support a multi-decade experiment with that.

There's no ideology here. It's just insane (unless you're profiting!) given history for us to continue imagine that in this case the Invisible Hand is going to fix things.

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

#92

Post by JohnTHaller »

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.

Even if you're insured in the US, you often can't afford care anymore. My private insurance plan costs $6,000 a year and has a $5,000 deductible. It was very bad pre-ACA. I paid over $8,000 a year on the private market and never let it lapse so my kidney donation wouldn't become pre-existing. Under the ACA it dropped a ton. But it's gotten much worse over the past years as it was weakened.

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

#93

Post by lmm »

viking1066 wrote: post #40

Compare wealth and life expectancy of any ethnicity living in USA with the population living in their previous habitat, and the US population comes out on top. Japanese Americans for example have higher life expectancy than Japanese in Japan, and I expect the same would be true for Ethiopians. This shows the superiority of the American system. I need to second the previous comment that this article is either based on…

Immigrants are a heavily selected group. What's the life expectancy of American-Japanese people compared to Americans in America?

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

#94

Post by lotsofpulp »

jandrewrogers wrote: post #85

If you dig into the statistics, the reason is not what most people assume. The US has anomalously high death rates due to unintentional injury (accidents) in the young adult age groups, which skews the average for the overall population. If young people died in accidents at similar rates to the rest of the world, the average life expectancy would look quite good. This is the 3rd most common cause of death in the US,…

People vastly underprice the mortality/morbidity costs of driving in the US (or mostly anywhere).

I wince when I hear 1 hour commute times. The risk of injury and death from driving 10k miles per year versus 25k miles per year is material in my opinion.

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

#95

Post by perardi »

quicklime wrote: post #80
julienb_sea wrote: post #43

Earlier quoted context omitted.

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-kilomet…

Excellent catch.

And that makes some sense. A huge percentage of the country lives in a fairly narrow band near the US border in large cities. With not a lot of driving to other cities. Because they’re too far away.

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

#96

Post by whiddershins »

Did we lose a smaller percentage of our population in WWII and that somehow goofs up our death rates which then somehow feeds bad data in to life expectancy because the way they calculate it is off?

I’m asking because this is the sort of thing which gets discovered all the time. Even, or especially, because it sounds so implausible.

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

#97

Post by bleepblorp »

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…

Another way to describe the difference between Germany and India is that's the difference between a rich society and a poor society that has (a few) rich people in it. This distinction also correlates with multiple factors of collective well-being, including life expectancy, and income inequality.

America made the choice in the 1980s, with the arrival of Reagan, to transition from being a rich society to being a poor society that has a fair number of rich people in it. Income inequality has deteriorated since then, the quality of public services/public infrastructure has severely degraded, and social trust is rapidly eroding. It's almost certainly too late to change course.

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

#98

Post by [deleted] »

stephen_g wrote: post #63
admiralspoo wrote: post #29

Earlier quoted context omitted.

Genetics are about 2/3s of life expectancy. If you wish to compare ethnically inhomogeneous populations versus those that are homogenous, your comparison is not useful for anything. Urbanized (or rural) Asians in the US live longer than Asians elsewhere. The same is true for Blacks.

That doesn't hold up. A lot of the countries compared aren't that ethnically homogeneous either. In fact, Australia, New Zealand, Spain, Switzerland, Canada, and Sweden all have a higher ratio of migrants per 100k population than the US...

[deleted]

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

#99

Post by Damorian »

viking1066 wrote: post #40

Compare wealth and life expectancy of any ethnicity living in USA with the population living in their previous habitat, and the US population comes out on top. Japanese Americans for example have higher life expectancy than Japanese in Japan, and I expect the same would be true for Ethiopians. This shows the superiority of the American system. I need to second the previous comment that this article is either based on…

It's not just wealth and life expectancy, it's pretty much every metric. Homicide rate and test scores are two big ones in my eyes, given the prevalence of firearms and a (seemingly?) subpar public school system. That being said, I think it's less so the American system, and more that the US "steals" the best of every other country.

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

#100

Post by alexpetralia »

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 love how you described wealth not only in a financial sense, but also in a sense of civic responsibility.
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