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Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for t

Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country.

chimeracoder 8y ago
> Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country. The population survival rates for cancer in the US are higher than any other OECD country. That already includes people who don't have insurance or otherwise can't afford treatment.
- davvolun 8y ago
  Yes, but let's say in the U.S. the numbers are 100% survival for the richest 50% and 0% survival for the other 50%. Clearly the average survival rate is 50%. Now let's say the Netherlands has a flat survival rate of 50%. If I don't consider wealth, it doesn't matter which country I get care in. If I'm at 49.999% of wealth in the U.S., the difference is 0% survival vs 50%. We know healthcare quality and healthcare cost are correlated, e.g. http://www.pnhp.org/news/2016/july/wealthy-get-more-health-care-than-other-americans http://www.pnhp.org/news/2016/july/wealthy-get-more-health-c... , I think we can intuit that ability to bear cost and wealth are correlated. Outliers aside, I don't think you're going to argue to me that a homeless man in Detroit has a chance of getting the same quality of care as Jeff Bezos. Simpson's paradox -- how you split up those percentiles matter, the question is how much.
  - chimeracoder 8y ago
    > Yes, but let's say in the U.S. the numbers are 100% survival for the richest 50% and 0% survival for the other 50%. Clearly the average survival rate is 50%. Now let's say the Netherlands has a flat survival rate of 50%. If I don't consider wealth, it doesn't matter which country I get care in. If I'm at 49.999% of wealth in the U.S., the difference is 0% survival vs 50%. Instead of just making up numbers that could hypothetically mean something, take a look at what's already been linked in this thread and you'll see that's not the case.
    - davvolun 8y ago
      Do any of those numbers refute my point? Instead of saying "take a look at what's already been linked" either link something that refutes my point or make a clear argument that does so. The statement was: > To play devil's advocate, looking at 5-year survival rates by country, you'd be 15-20% more likely to survive in the US after you contract cancer than in the Netherlands. YMMV. I asked "Did you factor wealth into that?" and then backed it up with a hypothetical that shows how it could matter. I see no comments regarding whether the numbers given factor wealth in or if anyone can clearly show it doesn't matter. You want to challenge my claim that quality of healthcare is correlated with ability to pay, fine, but "look it up" isn't an argument.
jandrewrogers 8y ago
It is for the entire population. I personally know people on welfare that received advanced new treatments and survived "terminal" cancer to this day. The overall cancer survival rate in the US for males is around 67%, which is extremely high even by developed world standards. It wouldn't be possible to have a survival rate that high if a large fraction of the population was excluded from treatment.
- Arbitrary4657 8y ago
  Anecdote != data. Do you have a source for that survival rate?
  - jandrewrogers 8y ago
    That survival rate came from a study in Lancet Oncology. It is not controversial that the US has exceptionally high cancer survival rates. This is attributed to two factors: much more testing/screening than in most countries, which detects cancer at earlier and more treatable stages (though at high cost), and most new cancer-related treatments are developed and available in the US first so any resulting reductions in mortality show up in that population first. As an example, my "anecdote" was cured of terminal cancer by an experimental drug therapy in late trials. Several years later it is FDA approved and becoming available in the rest of the world but at the time the only people receiving that treatment were in the US and it was correlated with a material increase in survival rates for that kind of cancer.
    - davvolun 8y ago
      What study? Did it break down other factors for survival or are you arguing that the 350 million Americans all have exactly the same chance of surviving cancer? I don't know why you're quoting "anecdote," you gave a textbook example of anecdotal evidence, which is not data. My uncle Bob survived testicular torsion, therefore all uncle Bobs will survive testicular torsion. How many people in the U.S. with that exact same cancer did not receive that particular experimental drug therapy? Did that one person, or even all the people included in the trial, change the survival rates in America during that time period?

Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country.

chimeracoder 8y ago

> Did you factor wealth into that? I would hazard a guess that the bottom 20%-40% in the U.S. would have a considerably lower survival rate than the average for the rest of the country. The population survival rates for cancer in the US are higher than any other OECD country. That already includes people who don't have insurance or otherwise can't afford treatment.

davvolun 8y ago
Yes, but let's say in the U.S. the numbers are 100% survival for the richest 50% and 0% survival for the other 50%. Clearly the average survival rate is 50%. Now let's say the Netherlands has a flat survival rate of 50%. If I don't consider wealth, it doesn't matter which country I get care in. If I'm at 49.999% of wealth in the U.S., the difference is 0% survival vs 50%. We know healthcare quality and healthcare cost are correlated, e.g. http://www.pnhp.org/news/2016/july/wealthy-get-more-health-care-than-other-americans http://www.pnhp.org/news/2016/july/wealthy-get-more-health-c... , I think we can intuit that ability to bear cost and wealth are correlated. Outliers aside, I don't think you're going to argue to me that a homeless man in Detroit has a chance of getting the same quality of care as Jeff Bezos. Simpson's paradox -- how you split up those percentiles matter, the question is how much.
- chimeracoder 8y ago
  > Yes, but let's say in the U.S. the numbers are 100% survival for the richest 50% and 0% survival for the other 50%. Clearly the average survival rate is 50%. Now let's say the Netherlands has a flat survival rate of 50%. If I don't consider wealth, it doesn't matter which country I get care in. If I'm at 49.999% of wealth in the U.S., the difference is 0% survival vs 50%. Instead of just making up numbers that could hypothetically mean something, take a look at what's already been linked in this thread and you'll see that's not the case.
  - davvolun 8y ago
    Do any of those numbers refute my point? Instead of saying "take a look at what's already been linked" either link something that refutes my point or make a clear argument that does so. The statement was: > To play devil's advocate, looking at 5-year survival rates by country, you'd be 15-20% more likely to survive in the US after you contract cancer than in the Netherlands. YMMV. I asked "Did you factor wealth into that?" and then backed it up with a hypothetical that shows how it could matter. I see no comments regarding whether the numbers given factor wealth in or if anyone can clearly show it doesn't matter. You want to challenge my claim that quality of healthcare is correlated with ability to pay, fine, but "look it up" isn't an argument.

jandrewrogers 8y ago

It is for the entire population. I personally know people on welfare that received advanced new treatments and survived "terminal" cancer to this day. The overall cancer survival rate in the US for males is around 67%, which is extremely high even by developed world standards. It wouldn't be possible to have a survival rate that high if a large fraction of the population was excluded from treatment.

Arbitrary4657 8y ago
Anecdote != data. Do you have a source for that survival rate?
- jandrewrogers 8y ago
  That survival rate came from a study in Lancet Oncology. It is not controversial that the US has exceptionally high cancer survival rates. This is attributed to two factors: much more testing/screening than in most countries, which detects cancer at earlier and more treatable stages (though at high cost), and most new cancer-related treatments are developed and available in the US first so any resulting reductions in mortality show up in that population first. As an example, my "anecdote" was cured of terminal cancer by an experimental drug therapy in late trials. Several years later it is FDA approved and becoming available in the rest of the world but at the time the only people receiving that treatment were in the US and it was correlated with a material increase in survival rates for that kind of cancer.
  - davvolun 8y ago
    What study? Did it break down other factors for survival or are you arguing that the 350 million Americans all have exactly the same chance of surviving cancer? I don't know why you're quoting "anecdote," you gave a textbook example of anecdotal evidence, which is not data. My uncle Bob survived testicular torsion, therefore all uncle Bobs will survive testicular torsion. How many people in the U.S. with that exact same cancer did not receive that particular experimental drug therapy? Did that one person, or even all the people included in the trial, change the survival rates in America during that time period?