As one of the richest countries in the world, the United States is compared with other developed countries on a variety of measures. It is well-known that on a per capita basis we almost certainly have the highest health care spending in the world. It is often pointed out that despite that high spending, on a number of measures our quality of care and our health is not that good, with one common measure being life expectancy at birth. This argument regarding poor comparative outcomes is used to justify calls for changes to the system. A Health Affairs article summarizes research that demonstrates that the analysis is not that simple; that an indicator such as life expectancy is seriously misleading if various adjustments for other factors are not made. (HA Article) In 2007, a newly born American male could expect to live 75.6 years and a female for 80.8, both very low among seventeen high-income countries. The issue, however, is almost exclusively found among age cohorts below 50 years of age. In cohorts above that, the United States actually is almost the best performer. And why do younger people die more in this country than in others? The primary differential causes are noncommunicable diseases, like heart disease, which likely are due to poor diet and exercise regimens, homicides for males, transport injuries, i.e., car accidents, and non-transport injuries, like drug overdoses. In other words, we don’t take good care of ourselves and we are careless. Our health system may not be the greatest, but it is really our culture which is responsible for what appears to be the poor performance of our health system, and the behavior resulting from that culture is likely one of the primary drivers of our high spending.
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About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
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