10 ms·

That looks like a very interesting read, skimming through it, it says that France spends around 10% of GDP on healthcare while the US spends 15%, but yet France

by vmarsy 10y ago

That looks like a very interesting read, skimming through it, it says that France spends around 10% of GDP on healthcare while the US spends 15%, but yet France gets a better health coverage, and a better life expectancy. One of the first tables compares number and there's the most striking one : Obesity in France 9.4%, in the US it's 30.6%. Could it be one reason that, with less obesity, French people are more healthy to start with, so they require less care? Does the book address this? In other words, what if: Life expectancy with 0 healthcare , Life expectancy with healthcare France 50 (made up) , 79.4 USA 35 (made up) , 77.5

cm2012 10y ago
That's weird data. By every measure I've seen France and the USA have almost identical obesity. https://www.google.com/search?ie=UTF-8&client=ms-android-sprint-us&source=android-browser&q=france+obesity+rate https://www.google.com/search?ie=UTF-8&client=ms-android-spr...
- pazimzadeh 10y ago
  France and the USA use a different threshold for obesity, so I'm not sure the comparison is straightforward. Someone who is borderline obese in France would be considered far from obese in the US. I can't whip up a source for this at the moment, but I'm speaking from personal experience (born in France, moved to the US when I was 9).
- vmarsy 10y ago
  The 9.4% was data from 2002. The french wikipedia page says a 2012 study shows that while 32,3 % are (25 ≤ BMI < 30 kg/m2), only 15 % are(BMI≥ 30 kg/m2). If from 2012 to 2014 it jumped from 15 to 23.9 there would be a problem. I'm unable to track down where that 23.9% came from on the English wikpedia, but it looks like those WHO report anything above 25 BMI, whereas the other data is above 30 BMI EDIT: Wikipedia is simply wrong, if you look at http://apps.who.int/bmi/index.jsp http://apps.who.int/bmi/index.jsp and search for BMI adults % obese (>=30.0), then France most recent data is 16.9%, (USA is 33.9) the Wikipedia article claims : Based on World Health Organisation (WHO) data published in 2014, 23.9% of French adults (age 18+) were clinically obese with a body mass index (BMI) of 30 or greater EDIT2: Found an interactive map http://gamapserver.who.int/gho/interactive_charts/ncd/risk_factors/obesity/atlas.html http://gamapserver.who.int/gho/interactive_charts/ncd/risk_f... where it claims 22.0 for 2014 (still not 23.9), but it also claims 18.2% for 2005, but it says 12.4% for 2006 on the table, there's a different in reporting between the two. The interactive maps does an "age standardize estimate" whatever this means :)
- sokoloff 10y ago
  Walking around France and walking around the US, that's not remotely what I see.
- deleted 10y ago
  [deleted]
- maxxxxx 10y ago
  Walk around in France and you will notice the difference. You rarely see obese people.
- deleted 10y ago
  [deleted]
LeifCarrotson 10y ago
Or might it also be that some of France's healthcare, being socialized, has an impact on obesity rates?
athenot 10y ago
It's a combination of factors, of which Obesity is one of them. Part of routine healthcare is to tackle all these smaller issues at the same time before they balloon into larger problems. So it is conceivable that the lower rates of Obesity are a product of the healthcare practice in that country.
- ghaff 10y ago
  That's the theory. And it's certainly something that fits well with the idea that we're all better off with annual physicals and other types of preventative healthcare. From what I read, the evidence is pretty mixed. Sure, have your physical and do other preventative care, but the results are statistically at the margins from what I can tell. (which is, of course, relevant if you're at that margin.)
  - coredog64 10y ago
    Other than some corner cases, the idea that there's a lot of spending on issues that could have been caught sooner is a non-starter. We're already doing most of it and it is reasonably cheap and not all that contentious: Vaccinations, pre-natal vitamins for pregnant mothers, etc. Most of the rest turns into the problem with false positives (and the treatment that entails) outweighing actual early detection.
    - athenot 10y ago
      > We're already doing most of it Population health data suggests otherwise. There are a lot of things that we (readers of HN) do take for granted, but we represent a very biased (dare I say privileged?) cross-section of the population. I live in Altanta but if I look at data in my state but outside of the city, a very different story is taking place. There is a strong correlation with lack of preventative health and certain comorbilities. Disclaimer: I used to work in population health.
  - thisrod 10y ago
    A more plausible model is that doctors help sick people a lot, and are totally useless to healthy people. From that point of view, consider the American system of providing great health care to people with stable lives and good jobs, and sparing no expense on attempts to save people who are beyond help, while denying treatment to the unemployed and to people with "pre-existing", i.e. long term, medical conditions. It's almost like they're trying to exert the most possible effort for the least possible effect; like someone has memorised the triage chapter of a first-aid manual, then set out to do the exact opposite. Oh wait, they make lots of money that way, so it's all good.
teslabox 10y ago
> Could it be one reason that, with less obesity, French people are more healthy to start with, so they require less care? French people eat fine cheese, and other fine foods. Americans are fed imitation cheese, and told that it's better for them because it doesn't have 'bad fat'. The experts call this a "paradox" [1]. I think we're being swindled. [1] https://en.wikipedia.org/wiki/French_paradox https://en.wikipedia.org/wiki/French_paradox
- wil421 10y ago
  I seriously doubt it has to do with the type of cheese people eat. One of the biggest difference is walking. Most cities I've visited in Europe are easily walkable. You can more or less get what you need. People in small and big cities seem to walk much much more. In Atlanta, this simply isn't possible for most people. We've built out more than up and inhibited public transportation but that's another sorry. Savannah is a much more walkable city similar to places in Europe. I wonder if it's the difference beetween old and new cities.
  - ghaff 10y ago
    It might be interesting to do an analysis but it's not obvious that public transportation is an overriding factor. If I look at obesity by US city [1] it's true that a lot of the top southern cities don't have great public transportation AFAIK, but the greater NYC metro area is relatively high up on the list. And Las Vegas is about tied with Boston and San Francisco. I suspect eating habits (the US South is notoriously bad in a lot of ways) and poverty have more to do with it than the state of the local public transit system. [1] https://wallethub.com/edu/fattest-cities-in-america/10532/ https://wallethub.com/edu/fattest-cities-in-america/10532/
    - wil421 10y ago
      I don't like the table but the inforgraph is great. What I really like is % of people overweight. Here's an example using some CDC data and based on metro areas [1]. Atlantic City is the worst and Boston is 1% more than Atlanta. It doesn't really support my walkability claim. http://www.governing.com/gov-data/obesity-rates-by-state-metro-area-data.html http://www.governing.com/gov-data/obesity-rates-by-state-met...

by vmarsy 10y ago

cm2012 10y ago

That's weird data. By every measure I've seen France and the USA have almost identical obesity. https://www.google.com/search?ie=UTF-8&client=ms-android-sprint-us&source=android-browser&q=france+obesity+rate https://www.google.com/search?ie=UTF-8&client=ms-android-spr...

pazimzadeh 10y ago
France and the USA use a different threshold for obesity, so I'm not sure the comparison is straightforward. Someone who is borderline obese in France would be considered far from obese in the US. I can't whip up a source for this at the moment, but I'm speaking from personal experience (born in France, moved to the US when I was 9).
vmarsy 10y ago
The 9.4% was data from 2002. The french wikipedia page says a 2012 study shows that while 32,3 % are (25 ≤ BMI < 30 kg/m2), only 15 % are(BMI≥ 30 kg/m2). If from 2012 to 2014 it jumped from 15 to 23.9 there would be a problem. I'm unable to track down where that 23.9% came from on the English wikpedia, but it looks like those WHO report anything above 25 BMI, whereas the other data is above 30 BMI EDIT: Wikipedia is simply wrong, if you look at http://apps.who.int/bmi/index.jsp http://apps.who.int/bmi/index.jsp and search for BMI adults % obese (>=30.0), then France most recent data is 16.9%, (USA is 33.9) the Wikipedia article claims : Based on World Health Organisation (WHO) data published in 2014, 23.9% of French adults (age 18+) were clinically obese with a body mass index (BMI) of 30 or greater EDIT2: Found an interactive map http://gamapserver.who.int/gho/interactive_charts/ncd/risk_factors/obesity/atlas.html http://gamapserver.who.int/gho/interactive_charts/ncd/risk_f... where it claims 22.0 for 2014 (still not 23.9), but it also claims 18.2% for 2005, but it says 12.4% for 2006 on the table, there's a different in reporting between the two. The interactive maps does an "age standardize estimate" whatever this means :)
sokoloff 10y ago
Walking around France and walking around the US, that's not remotely what I see.
deleted 10y ago
[deleted]
maxxxxx 10y ago
Walk around in France and you will notice the difference. You rarely see obese people.
deleted 10y ago
[deleted]

LeifCarrotson 10y ago

Or might it also be that some of France's healthcare, being socialized, has an impact on obesity rates?

athenot 10y ago

It's a combination of factors, of which Obesity is one of them. Part of routine healthcare is to tackle all these smaller issues at the same time before they balloon into larger problems. So it is conceivable that the lower rates of Obesity are a product of the healthcare practice in that country.

ghaff 10y ago
That's the theory. And it's certainly something that fits well with the idea that we're all better off with annual physicals and other types of preventative healthcare. From what I read, the evidence is pretty mixed. Sure, have your physical and do other preventative care, but the results are statistically at the margins from what I can tell. (which is, of course, relevant if you're at that margin.)
- coredog64 10y ago
  Other than some corner cases, the idea that there's a lot of spending on issues that could have been caught sooner is a non-starter. We're already doing most of it and it is reasonably cheap and not all that contentious: Vaccinations, pre-natal vitamins for pregnant mothers, etc. Most of the rest turns into the problem with false positives (and the treatment that entails) outweighing actual early detection.
  - athenot 10y ago
    > We're already doing most of it Population health data suggests otherwise. There are a lot of things that we (readers of HN) do take for granted, but we represent a very biased (dare I say privileged?) cross-section of the population. I live in Altanta but if I look at data in my state but outside of the city, a very different story is taking place. There is a strong correlation with lack of preventative health and certain comorbilities. Disclaimer: I used to work in population health.
- thisrod 10y ago
  A more plausible model is that doctors help sick people a lot, and are totally useless to healthy people. From that point of view, consider the American system of providing great health care to people with stable lives and good jobs, and sparing no expense on attempts to save people who are beyond help, while denying treatment to the unemployed and to people with "pre-existing", i.e. long term, medical conditions. It's almost like they're trying to exert the most possible effort for the least possible effect; like someone has memorised the triage chapter of a first-aid manual, then set out to do the exact opposite. Oh wait, they make lots of money that way, so it's all good.

teslabox 10y ago

> Could it be one reason that, with less obesity, French people are more healthy to start with, so they require less care? French people eat fine cheese, and other fine foods. Americans are fed imitation cheese, and told that it's better for them because it doesn't have 'bad fat'. The experts call this a "paradox" [1]. I think we're being swindled. [1] https://en.wikipedia.org/wiki/French_paradox https://en.wikipedia.org/wiki/French_paradox

wil421 10y ago
I seriously doubt it has to do with the type of cheese people eat. One of the biggest difference is walking. Most cities I've visited in Europe are easily walkable. You can more or less get what you need. People in small and big cities seem to walk much much more. In Atlanta, this simply isn't possible for most people. We've built out more than up and inhibited public transportation but that's another sorry. Savannah is a much more walkable city similar to places in Europe. I wonder if it's the difference beetween old and new cities.
- ghaff 10y ago
  It might be interesting to do an analysis but it's not obvious that public transportation is an overriding factor. If I look at obesity by US city [1] it's true that a lot of the top southern cities don't have great public transportation AFAIK, but the greater NYC metro area is relatively high up on the list. And Las Vegas is about tied with Boston and San Francisco. I suspect eating habits (the US South is notoriously bad in a lot of ways) and poverty have more to do with it than the state of the local public transit system. [1] https://wallethub.com/edu/fattest-cities-in-america/10532/ https://wallethub.com/edu/fattest-cities-in-america/10532/
  - wil421 10y ago
    I don't like the table but the inforgraph is great. What I really like is % of people overweight. Here's an example using some CDC data and based on metro areas [1]. Atlantic City is the worst and Boston is 1% more than Atlanta. It doesn't really support my walkability claim. http://www.governing.com/gov-data/obesity-rates-by-state-metro-area-data.html http://www.governing.com/gov-data/obesity-rates-by-state-met...