Tuesday, September 22, 2009

To Explain Longevity Gap, Look Past Health System

John Tierney:

If you’re not rich and you get sick, in which industrialized country are you likely to get the best treatment?

The conventional answer to this question has been: anywhere but the United States. With its many uninsured citizens and its relatively low life expectancy, the United States has been relegated to the bottom of international health scorecards.

But a prominent researcher, Samuel H. Preston, has taken a closer look at the growing body of international data, and he finds no evidence that America’s health care system is to blame for the longevity gap between it and other industrialized countries. In fact, he concludes, the American system in many ways provides superior treatment even when uninsured Americans are included in the analysis.

“The U.S. actually does a pretty good job of identifying and treating the major diseases,” says Dr. Preston, a demographer at the University of Pennsylvania who is among the leading experts on mortality rates from disease. “The international comparisons don’t show we’re in dire straits.”

No one denies that the American system has problems, including its extraordinarily high costs and unnecessary treatments. But Dr. Preston and other researchers say that the costs aren’t solely due to inefficiency. Americans pay more for health care partly because they get more thorough treatment for some diseases, and partly because they get sick more often than people in Europe and other industrialized countries.

An American’s life expectancy at birth is about 78 years, which is lower than in most other affluent countries. Life expectancy is about 80 in the United Kingdom, 81 in Canada and France, and 83 in Japan, according to the World Health Organization.

This longevity gap, Dr. Preston says, is primarily due to the relatively high rates of sickness and death among middle-aged Americans, chiefly from heart disease and cancer. Many of those deaths have been attributed to the health care system, an especially convenient target for those who favor a European alternative.

Read the whole thing.

According to this article, Americans have different health outcomes because we have a more heterogeneous population and more unhealthy habits (such as smoking and obesity) than many other parts of the developed world, not because our healthcare system is fundamentally broken.


Shawn said...

"But Obama wants to fix the problem."

There, I said it first.

thinking said...

Well that settles it...aside from the 45 million uninsured, the 45,000 who die each year due to lack of insurance, the exploding costs, the bankruptcies and financial ruin many families experience due to healthcare costs, the low ranking in other factors such as infant mortality, etc...everything is peachy.

There are also issues of stability and security...of families not being afraid of losing their insurance if someone loses a job, or if an insurance company finds a technicality to deny coverage.

Wendell Potter, a former insurance company executive who now speaks out against the insurance company tactics, movingly describes how he saw a scene in Virginia where medical volunteers were giving health care to people lined up in animal stalls...it looked like a refugee camp. At that point he realized that this issue was about real human beings and not numbers.

There's no denying the amazing achievements of the US healthcare system and industry. There's also no denying that if the population makes some simple life style changes, such as eating healthier and abandoning smoking, that will have significant impact.

But what's proposed in no way undercuts that...it only seeks to expand coverage and get a handle on costs. Maybe then so many people won't have to go to animal stalls for treatment.

Anecdotally, I've talked to a few people from Canada who also have lived hear and no one favors the US system. I've spoken with a couple from Brazil, where one was injured in the leg while here in the US, and they scoffed at the US system vs Brazil's.

In fact, Canadians, Britains, etc...those who live in countries with some form of universal health care, generally do not want to change and take great pride in their health care systems. Sure there are problems, but overall the outcomes are better for much lower costs.

And they don't have to worry about losing their health insurance, getting wiped out financially, or being denied coverage.