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Maybe the Cubans and the Spaniards have some magic genes on them, but I think is more probably that you vision of those countries is distorted. Personally, and

Maybe the Cubans and the Spaniards have some magic genes on them, but I think is more probably that you vision of those countries is distorted. Personally, and this is my intuition talking, I think that the most important fact is primary care. If you need open heart surgery you probably would be better (marginally) in the States than Cube (assuming you can afford it), but what really makes a difference is to get diagnosed in the early states of a illness or, for old people, constant follow up by a doctor. Interesting, it seems that both Italy and Spain have primary care totally public, that means, the doctors work for the National Health System. It would be interesting to check if this the case for the other top countries in the list.

matt4077 8y ago
I agree, and would add „lifestyle“ to the relevant factors. Cuba has a lot more „communal“ life. Eating alone, as but one example, just doesn’t happen. Even something like watching TV is more of a group activity. Even if the cause of that is an inability to afford your own TV, chances are it could have an impact on psychological well-being. Physical activity is also far higher. Again, this may be a result of relative poverty. But walking or taking public transport to work just happens to also be healthy. Interestingly, these are factors somewhat shared across Cuba, Spain and Italy, even though there is no similar economic pressure in those countries. On the other side of the divide, I live in Germany. We have universal insurance that is functionally equivalent to government-run healthcare (I, and everyone else, can visit a GP any time without paying). Yet outcomes here, and in Britain and Canada, are closer to the US.
- RobertoG 8y ago
  Out of curiosity, are primary care German doctors employed directly by the state, or are they private business that invoice later to the public health budget?
  - matt4077 8y ago
    They are independent businesses. Most people have public health insurance. These are still entities distinct from the general budget. You can chose between different insurances, which have some minor differences in terms of extra services they offer. Rates also differ, but only very slightly. It’s around 12% of income. There are also private insurances. They offer flat rates (not indexed to income) and are attractive to high earners and some young people.

matt4077 8y ago

I agree, and would add „lifestyle“ to the relevant factors. Cuba has a lot more „communal“ life. Eating alone, as but one example, just doesn’t happen. Even something like watching TV is more of a group activity. Even if the cause of that is an inability to afford your own TV, chances are it could have an impact on psychological well-being. Physical activity is also far higher. Again, this may be a result of relative poverty. But walking or taking public transport to work just happens to also be healthy. Interestingly, these are factors somewhat shared across Cuba, Spain and Italy, even though there is no similar economic pressure in those countries. On the other side of the divide, I live in Germany. We have universal insurance that is functionally equivalent to government-run healthcare (I, and everyone else, can visit a GP any time without paying). Yet outcomes here, and in Britain and Canada, are closer to the US.

RobertoG 8y ago
Out of curiosity, are primary care German doctors employed directly by the state, or are they private business that invoice later to the public health budget?
- matt4077 8y ago
  They are independent businesses. Most people have public health insurance. These are still entities distinct from the general budget. You can chose between different insurances, which have some minor differences in terms of extra services they offer. Rates also differ, but only very slightly. It’s around 12% of income. There are also private insurances. They offer flat rates (not indexed to income) and are attractive to high earners and some young people.