Per Capita Spending and Life Expectancy
With the Iowa Caucuses tonight, its as good a time as any to ask, what is wrong with this picture?
Via UCSC
Health Care Spending and Life Expectancy
10/23/2003
http://ucatlas.ucsc.edu/modules/teach_1.html
Thursday, January 03, 2008 | 04:56 PM | Permalink
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Comments
Avg. life expectancy in the U.S. lags that of many, if not most, industrialized nations. As Larry Kudlow might say, this is the most embarrassing story never told. Even more embarrassing is that no one seems to care.
I happen to believe that government would be most effective if its stated priority was to maximize the life expectancy of its citizens, similar to a corporation maximizing profit.
Posted by: Adam | Jan 3, 2008 5:09:29 PM
This graph is misleading. Japan, San Marino, etc. are not nations of immigrants. If you take only the US born population(in order to make a good comparison to countries like Switzerland) I would think the numbers would not be so awful. Well, the obesity epidemic also contributes to shorter life expectancy of course--junk food is abundant and cheap=hear attacks, diabetes etc are abundant and expensive:-)
Posted by: Nurit | Jan 3, 2008 5:09:50 PM
Sorry but I don't get it. Why include San Marino and exclude Russia. Someone has an ax to grind methinks.
Posted by: Ross | Jan 3, 2008 5:09:51 PM
1. There is no ax to grind. Go research the numbers on any independent website: the U.S. trails many, many nations in this important statistic.
2. Even sadder: many current reports contend that, due to child obesity, the current generation of U.S. grade school students could be the first generation in centuries to live shorter than their parents. How could anyone argue that, if true, this does not mean we are headed in a very wrong direction?
Posted by: Adam | Jan 3, 2008 5:15:38 PM
Someone should sell T-Shirts with that graph on the back.
Posted by: Trainwreck | Jan 3, 2008 5:16:48 PM
I'd be much more interested to see this as a regression. The fact that it isn't displayed that way makes me suspicious.
As a scientist, what I see here is mostly an absence of trend, even when you exclude the US. This becomes more obvious when you appropriately scale the left hand variable. Eyeballing it, it appears that the expenditure of ~200 international dollars (whatever those are) per capita gets you about a year of life expectancy. Also the intercept is about 69.
In other words, if you spend nothing on healthcare, your life expectancy will be 69, and you can buy a year for 200 a person. All a gross simplification, of course, but much less of a gross simplification than the graph shown.
It's also hard for me to care about 4 years. Out of 75.
Posted by: F | Jan 3, 2008 5:27:41 PM
What the chart suggests is that life expectancy has no correlation to health care spending.
It is obvious that life expectancy has a lot to do with ethnicity & culture, to wit, genetics & how you behave.
For instance, if you did the stats for North Dakota rather than the US as a whole it would look different.
Posted by: algernon | Jan 3, 2008 5:28:07 PM
What's wrong is that we're the only western nation that doesn't guarantee its citizens the right to buy health insurance. It's interesting that the most vocal opponents of universal healthcare are the ones protected from medical underwriting by their employers.
Posted by: Deborah | Jan 3, 2008 5:28:33 PM
To be clear, the shameful part to me is who inefficient we are with the amount we are spending. In my opinion, we should be spending less, rather buying a few years of life expectancy.
Posted by: F | Jan 3, 2008 5:29:04 PM
Nurit wrote:
"This graph is misleading. Japan, San Marino, etc. are not nations of immigrants."
But France and Germany and the UK are nations of immigrants. Or maybe these countries are too small to serve as valid examples? Or do all of their immigrants come from healthful environs?
It is a widely held belief among my SoCal brethren that illegal immigrants are the cause of our health care woes, and any effort to increase access to health care (even when spearheaded by a Republican Governor) faces serious opposition because of this view.
Posted by: zero529 | Jan 3, 2008 5:31:16 PM
1) Life expectancy is gamed by all countries but the US excluding births of <1kg infants as "live births." Disproportionate effect on life expectancy.
2) Murders. The US has a higher murder rate than all developed countries. Murder disproportionately effects life expectancy as it is a young man's cause of death. No matter what your politics I think we can agree that murder should not cast an indictment on the health care system.
3) When you look at life expectancy of those over 65, the US is #3 in the world after Japan and Switzerland and similarly ranked in terms of disability-free life expectancy. This is really the true test of a health care system.
Can the US do better? Of course. But in the metrics that matter (less disability and long life span) we do quite well.
Posted by: david | Jan 3, 2008 5:31:16 PM
To put it bluntly take out the terrible statistics from African-Americans (murders, drug useage, AIDS, etc) and these numbers get normalized.
Posted by: Norman | Jan 3, 2008 5:33:41 PM
I didn't know healthcare was a right. Sounds swell.
The US sure pays too much for its healthcare as is, so let's attack the cost side of it before writing a blank check to buy votes.
Posted by: Lloyd | Jan 3, 2008 5:33:57 PM
When accounting for accidental deaths the US citizens live longer than anyone else(or at worst, a little lower than Japan).
http://tinyurl.com/3d2mkd
Not to say that our healthcare system shouldn't be reformed, I think it should(and not in a way that moves it towards more government) but lets at least get the facts right.
When discussing health-care quality this MUST be taken into account. It is simply dishonest not to.
Posted by: Syphax | Jan 3, 2008 5:35:04 PM
Forward that to the AARP for a cover shot.
Posted by: D H | Jan 3, 2008 5:37:46 PM
One nephew, when provided this info, told me it was a waste of money keeping old farts alive when younger folks needed their jobs. He'd rather have a new car. I intend to live better, if not longer, and leave nothing to nephew. Take that.
Posted by: OldVet | Jan 3, 2008 5:40:44 PM
When I was a wee lad, the doctor had a nurse in a small house that served as an office. Paid cash.
Now the doctor has 50 insurance processors and is in a pool with 4 or 5 other doctors in a big office. They have enormous "liability" policies to support the lawyer leeches and they fall right into the income bracket where the AMT eats them alive.
Insurance is not the answer. IT IS THE PROBLEM.
If we removed the pools of money where the leeches feed, extracted the useless middleman from the transaction stream and returned to a TRUE market system there wouldn't be such ridiculous inflation.
I'm not holding my breath.
Posted by: LividLipid | Jan 3, 2008 5:43:42 PM
Adam says, I happen to believe that government would be most effective if its stated priority was to maximize the life expectancy of its citizens...
Is that really the government's "priority"? Yikes!
David hits it on the head with his 3 points. The statistical difference between the the life expectancies among western nations is negligible; the graph is drawn to depict some huge difference which does not exist.
Posted by: Grodge | Jan 3, 2008 5:46:01 PM
Either the graph is crap or it shows Americans live longer and spend more until the day they die.
Over the long run, you can't spend what you don't have ... unless the nature of humanity is to max out the plastic when you get your final exit notice. It implies that we are far more affluent than the rest of the world. Thus, we live longer and spend more.
What's the problem? I have no liberal guilt for being affluent.
Posted by: cinefoz | Jan 3, 2008 6:03:00 PM
What is wrong with this picture?
Answer: The "free market".
Getting insurance companies out of the health insurance business would go a long way to remedy the situation.
Single Payer Baby. Single Payer.
Posted by: twistytop | Jan 3, 2008 6:12:54 PM
But it's simply not true. There are many studies of US vs foreign health systems that refute these assertions. For example, US non-Hispanic whites aged 55-64 are significantly less healthy than their British counterparts at every level of the SES (Socio-Economic-Spectrum) and taking into account age and other risk factors.
http://jama.ama-assn.org/cgi/content/abstract/295/17/2037
This result cannot be explained by infant mortality, gunshot wounds, immigration or the other factors cited in previous comments.
There is a large literature comparing how specific conditions are treated and the outcomes of these treatments. The US uses a lot of high-tech gadgets and unnecessary procedures, but I'd rather be treated in France, Germany or a Scandinavian country if I were really sick.
Posted by: Chicago Finance | Jan 3, 2008 6:18:11 PM
Easy. Corporate/individual greed and HMO's.
Posted by: Pat Gorup | Jan 3, 2008 6:20:37 PM
What it means is that more of our spending is for profit of the HC industry and to pay higher administrative costs due to the complexity of the system (as opposed to a single payer system), not to mention the high costs in approving treatment recommended by the doctors so as to deny treatment/payment for insured patients.
It indicates going to a single payer system could cut HC costs by 1/2 at no reduction in quality and access. In fact, it would probably increase both, and so would life expectancy, but at the expense of industry profit.
Most of our doctors working in hospitals went to medical schools overseas, and not the US. The number of graduates from US medical schools has not increased significantly in almost 30 years. So going to a single payer system should not affect the quality of Doctors, if anything, it would mean we would have to produce more Doctors in the US, and import less.
But we know this government see people living longer as a burden to society, and value corporate profits more than citizens health, so we will maintain the status quo.
As for the arguments that adjusting for accidental death (meaning we have MORE accidental deaths or other countries were not also adjusted), and live longer IF we can manage to reach 65 and qualify for medicare, means we are comparable to the longest living countries, I mean, give me a break.
Posted by: PTodd | Jan 3, 2008 6:23:10 PM
To echo twisty -
The problem is that vested interests want to pretend that health care must be delivered through something called the free market.
Other industrialized countries, ones that have most if not all our problems with race, immigration and poverty, have significantly better health outcomes for much less spending.
It's not a matter of "reform".
To support this, I'm going to copy another comment that says it better than I can. It's long but worth it.
from comments at -
http://www.marginalrevolution.com/marginalrevolution/2007/10/how-to-debate-h.html
'American health care outcomes look much better once we adjust for race and other demographic factors'
Ah, the last defense used when defending America's health care system, one which is sadly no more tenable than any of the other excuses for a system which sets world standards in how much is spent on it while returning results that would not make Italy or Portugal envious.
'The researchers who were funded by several US and UK government agencies, set out to look at the social and economic factors affecting health but shifted emphasis when large differences emerged between the two countries. The study looked both at the way people reported their own health and – to guard against any bias from self-reporting – at objective biological markers of disease from blood tests. Altogether there were about 15,000 participants.
Samples in both countries were limited to whites and excluded recent immigrants, so as to control for racial and ethnic factors.
“This study challenges the theory that the greater heterogeneity of the US population is the major reason the US is behind other industrialised nations in some important health measures,” said Richard Suzman, programme director at the US National Institute on Ageing, which co-funded the research.
http://www.ft.com/cms/s/0/6c9dee06-d9ff-11da-b7de-0000779e2340.html?nclick_check=1
To keep quoting from that bastion of British socialism, the Financial Times -
'The researchers are struggling to explain their findings. Their analysis shows that lifestyle factors – particularly the fact that Americans are more obese and take less exercise – cannot account for the whole discrepancy. though they may provide a partial explanation.
Different health systems may also be part of the story. The researchers note that the US spends $5,274 per head on medical care while the UK spends $2,164, adjusted for purchasing power. But Britain’s National Health Service provides publicly funded medicine for everyone, while Americans under the age of 65 have to rely on private insurance.
Prof Marmot suggested that, while the healthcare provided by the British state health service was not superior to the private US system, it provided important psychological reassurance.
As the researchers say in the journal paper: “To a much greater extent England has set up programmes whose goal is to isolate individuals from the economic consequences of poor health in terms of their medical expenditure and especially earnings and wealth reduction.”'
Why let facts intrude on popularly held American beliefs, since as we all know, America has the best health care system in the world, as long as you ignore actually being healthy - shockingly, the British system, the sick man of Europe, so to speak, is returning empirically better results for lower cost.
Posted by: Bruce F | Jan 3, 2008 6:30:55 PM
according to the last LA Weekly article on the issue there are about 500.000 gang members in America , maybe that is a reason of the low US life average
in areas of the US where everyone is from germany or sweden life expectancy is the same as in Germany or Sweden
it is the ethnic group stupid
Posted by: giovanni | Jan 3, 2008 6:37:36 PM
