Life Expectancy In The United States: We’re Number 1

A little while ago I posted that health care in America may be getting a bad rap.  That perhaps we might have the BEST system in the world, not the abysmal system that is often reported in the reports today:

The fact that America can deliver this service is a miracle in and of itself.  And the fact that we are such a wealthy nation that we can afford it is yet another miracle.

Now, to be sure, my case here is that our system is advanced and can be expensive.  However, we are a very wealthy nation and can afford the care.  However, in the comments, shenanigans was called and we discussed how the United States might be ranked #1, not #19-#29 or #47.

In my past reading on this I have found that the concept of measuring a health care system by life expectancy might not be the most accurate measure.  One such study:

Two University of Iowa researchers, Robert L. Ohsfeldt and John E. Schneider, reviewed the data for the nations of the OECD to statistically account for the incidence of fatal injuries for the member countries. The dynamic table below presents their findings, showing both the average life expectancy from birth over the years 1980 to 1999 without any adjustment (the actual “raw” mean), and again after accounting for the effects of premature death resulting from a non-health-related fatal injury (the standardized mean).

Now, before the chart, the lead up.  See, reports say that America is performing poorly because we are unable to nurse our citizens into old age.  However, the methods used to come to this conclusion aren’t sound.

Okay, now the chart:

By adjusting the data to more accurately reflect reality, the United States moves to #1.  In this depiction of the stats, the system that the United States uses is the best in the world.

But will anyone acknowledge this?

No.

2 responses to “Life Expectancy In The United States: We’re Number 1

  1. In comments to your previous post, I wrote: “Now, you’ve linked in the past to info about how maybe we lost more people than average to violent deaths in the 1990s. Which is something, but every single comprehensive study I’ve come across, that looks at more than just life expectancy, has found that we’re underperforming, even aside from the fact that we spend about 2.5 times the OECD average per capita.”

    Well, now you’ve reproduced that one chart. That’s nice, but it doesn’t really answer the point that I made. We’re spending 2.5 the OECD average per capita on spending– light years more than anyone else– and we’re not getting better results, when you look at comprehensive studies. Your chart from 2007 suggests that in 1999, we might have been getting a third of a year more life expectancy than Switzerland. Which is better than the alternative, but it doesn’t address the point.

    (Also, there’s some more recent data that contradicts that story: “We’re #1! … In youth mortality. Note that our deaths due to “other” causes alone [excluding traffic accidents, violence, and suicide] would put us around all deaths in Germany, Switzerland, and Japan.”)

    As I wrote in comments to the previous post:

    Re: the studies discussed at this link: the one that put us 7th out of 7 examined quality, access, efficiency, equity, productive lives, and expenditures; we never did better than 4th in any category. The study that said we got a failing grade examined health outcomes, access, equity, quality and efficiency. The study that put us 37th, that the WSJ article said should have put us 15th, examined responsiveness, fairness of financial contribution, overall level of health, distribution of health in the population, and distribution of financing. There are, so far as I am aware and you have been able to produce, zero studies anywhere concluding that we’re getting better results in exchange for spending 2.5 times the level of other OECD countries.

    That remains the case. Even if the more recent data on youth deaths is overwhelmed by the way we die when we’re not young, there are zero studies anywhere concluding that we’re getting better results overall in exchange for spending 2.5 times the level of other OECD countries.

  2. Well, now you’ve reproduced that one chart. That’s nice, but it doesn’t really answer the point that I made. We’re spending 2.5 the OECD average per capita on spending– light years more than anyone else– and we’re not getting better results, when you look at comprehensive studies.

    I think that the issues surrounding medical care delivery in the United States is pretty complicated. And trying to bite off an attempt to create an over-arching statement is a hard thing to do.

    The critique of our system, as you’ve pointed out, is that:

    1. We pay too much
    2 We get not better results

    And we use the following to show that our results are worse:

    1. Life Expectancy
    2. Infant mortality rate

    In my recent posts I’m just making the point that our life expectancy numbers aren’t being measured in a way and manner that reflects reality. And that reality is that a large number of deaths in the United States occur due to causes that have nothing to do with medical care delivery.

    We’re spending 2.5 the OECD average per capita on spending– light years more than anyone else

    I suspect that the measure of spending has some of the same problems as we see in measuring life expectancy. For example, are we counting lasic as a cost? Or braces? Or plastic surgery? Or IVF?

    What I won’t argue with you about is that I think the cost of medical care is too high; it could be less expensive. However, if we are counting costs that are largely seen to be features, that may not be reflecting reality again.

    We’re spending 2.5 the OECD average per capita on spending– light years more than anyone else– and we’re not getting better results, when you look at comprehensive studies.

    But I just pointed out that we ARE getting better results. We live longer than people in other countries. Now, you may have a point that the small gains aren’t worth the 2.5 multiplier; but we DO get better results.

    Now, as far as infant mortality, I haven’t seen any data that would suggest that “We’re Number 1” yet, but I have seen the studies that move us up the charts when the same type of normalizing occurs.

    For example, the United States performs more C-section births. This is due to the fact that our families, and doctors too, wanna schedule the birth and have the baby a little bit early. As a result, we see more premature births and babies born with low birth rates. Not a good thing, premies and LBW babies are at a much higher risk than other babies. So, as our proportion of those births climbs, so too does our IMR decline. Never mind the fact that the United States does better in keeping both premies and LBW babies alive.

    All I’m saying is that the studies being conducted and quoted are closer to back of the envelop studies than real adjusted studies.

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