22 ms·

U.S. Life Expectancy Drops for Third Year in a Row (2018)

280 points by EL_Loco 7y ago

tntn 7y ago
HN title is not good. Original title is "U.S. Life Expectancy Drops for Third Year in a Row, Reflecting Rising Drug Overdoses, Suicides." The comparison is between the last three years and 1915-1918, but the Spanish flu was just getting going in 1918. EDIT: folks just arriving, the HN title has changed since I commented. It previously said "worst trend since Spanish flu," or something.
- ilikehurdles 7y ago
  The title is fine, and reflects the factual subtitle immediately below the headline. There is no requirement to post the article headline as-is on HN.
  - tntn 7y ago
    But it doesn't reflect the factual subtitle. The title here says 1918, but the true trend is 1915-1918, which had a bit of a war as well. > There is no requirement to post the article headline as-is on HN. There is. From the guidelines: > Otherwise [i.e. not excessive clickbait] please use the original title, unless it is misleading or linkbait; don't editorialize.
    - ilikehurdles 7y ago
      Apologies, you're correct. I think focusing on the year or years will bury the lede in any case.
      - trentlott 7y ago
        It is commonly known as "the 1918 Spanish influenza pandemic" It's a title, not a series of facts
- spanxx 7y ago
  > Spanish flu of 1918 It was not Spanish. It's origins come from the battlefields of WWI.
  - RmDen 7y ago
    Everyone knows it as the Spanish flu.. it's called like that because the Spanish newspapers didn't censor these deaths like the other countries that were busy with World War I
  - derefr 7y ago
    Hawaiian pizza does not come from Hawaii, and yet that is still its proper name (in English, at least.)
  - tntn 7y ago
    Next you're probably going to tell me about French fries, right?
    - simonh 7y ago
      Freedom Fries
- deleted 7y ago
  [deleted]
- dang 7y ago
  The submitted title was "Drop in US life expectancy trend not seen since 1918 influenza epidemic". A moderator changed it because it broke the site guideline: "Please use the original title, unless it is misleading or linkbait; don't editorialize." https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Submitters: Cherry-picking a detail from an article is editorializing, so please don't do that. If you want to say what you think is important about the topic, please do so in a comment, where your view is on a level playing field with everyone else's. https://hn.algolia.com/?sort=byDate&dateRange=all&type=comment&storyText=false&prefix&page=0&query=by:dang%20title%20level%20playing%20field https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...
ilikehurdles 7y ago
Leaving your 20s and 30s with a career you enjoy, basic benefits such as health insurance, retirement funding, and paid time off, and the ability to afford a reasonably sized home without falling into tremendous amounts of debt seems less and less likely each year. I have a lot of family who have moved from the EU to the US and back to the EU, I have also lived there myself, and I'm intimately familiar with their day-to-day. If the average American knew what the benefits and lifestyle are like for a middle-class German family, all those totally disconnected accolades about job and GDP growth that our oligarchs like to shower upon us would do nothing to prevent work strikes and riots in the streets.
- dv_dt 7y ago
  That reminds me of this twitter thread about our healthcare system. There are absolutely heartbreaking stories on there. The one that really sticks in my mind is the parents who were paying off and earlier ER trip and were literally waiting in the parking lot of the ER again with a fevered child, waiting to see if seizures started or the fever broke. https://twitter.com/AllOnMedicare/status/1124042436345569286 https://twitter.com/AllOnMedicare/status/1124042436345569286
- wickerman 7y ago
  As a south american living in the EU, I grew up hearing people saying "ah, in the US..." and while probably they were thinking back to a time when the US wasn't as terrible as it is now, it's a bit irritating for me to hear that kind of stuff considering that I graduated in the top university of my country with a masters in engineering and had to pay nothing because university is free and for everyone. I've met so many american expats in Europe who basically fled their student debt by emigrating. And that's just one thing, the fact that healthcare isn't free, people avoid calling for ambulances because they cost money, and people are jailed because the prision system has become a very profitable business.
  - supergauntlet 7y ago
    Every day I see headlines like this and I think "surely soon enough it will get bad enough that people will support universal healthcare" or really any "socialist" policy. Every day I am mistaken. If people actually did the research they'd see that these policies are just good common sense for them, but too many of our voters are lied to by the media they consume, so I worry things will never change.
EastLondonCoder 7y ago
I think this has to do with the Great Recession. Prolonged economic insecurity is associated with a poor mental health. And that is in turn associated with self medication with things like alcohol and opioids. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741013/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741013/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151244/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151244/
- zaroth 7y ago
  That would be a quite a laggy effect at this point. The US has been having it’s longest continuous period of economic growth ever.
  - danans 7y ago
    Growth on Wall Street isn't growth on main street, and huge corporate and big investor profits (and associated cash hordes) haven't meant economic recovery in the places and communities hardest hit by the opioid epidemic.
    - refurb 7y ago
      Growth on Wall Street isn't growth on main street Of course it is. Where do you think main streets pensions and 401k are invested? Where do you think main street people work?
      - tezzer 7y ago
        Only a third of Americans -have- a 401k, and only 13% have pensions.
      - maximente 7y ago
        most equity is held by the richest americans, while others primarily depend on wages which haven't risen in decades, basically. also most people aren't employed by large business. https://www.pewresearch.org/fact-tank/2018/08/07/for-most-us-workers-real-wages-have-barely-budged-for-decades/ https://www.pewresearch.org/fact-tank/2018/08/07/for-most-us... https://www.huffpost.com/entry/five-big-myths-about-amer_b_866118 https://www.huffpost.com/entry/five-big-myths-about-amer_b_8...
myth_buster 7y ago
[Nit] Show me 4 embedded ads but not a single chart when talking about trends. Also 2018.
- cagenut 7y ago
  one of the side affects of google's search monopoly is the entire news/info media has been frozen in a textual model. facebook "helped" a little bit by requiring at least one good image to get shared, but that was in like 2012. we get the content we get because of the algorithms, not because its a good way to present information.
- dang 7y ago
  > Also 2018. Good catch. Added above.
- disabled 7y ago
  This is a good starting point. This is all open access, and funded through the Bill and Melinda Gates Foundation. This is done at the University of Washington Medical School, which is basically "as good as it gets" for a public medical school in the US. UW also has solid allied health departments. Their statistics department (even outside of the realm of health) is solid too: http://www.healthdata.org/us-health/publications http://www.healthdata.org/us-health/publications
jimbob45 7y ago
“Higher suicide rates in rural areas are due to nearly 60 percent of rural homes having a gun versus less than half of homes in urban areas,” psychiatrist and behavioral scientist Keith Humphreys of Stanford University says. “Having easily available lethal means is a big risk factor for suicide.” Pretty bold claim there. Seems like you could run a pretty big study just based off that one hypothesis.
- mikeyouse 7y ago
  It's not especially controversial. Many people who attempt suicide regret trying and go on to live fairly normal lives but most people who attempt suicide with a firearm are successful. It's long been a causal factor in the male/female discrepancy in rates as well as the rural/urban divide. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984734/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984734/ https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/ https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/
- smt88 7y ago
  It's not a bold claim anymore. It's well-established public health knowledge that people with faster and less failure-prone suicide methods are more likely to take their lives. For example, women attempt suicide at a higher rate, but die less often because they use less-lethal methods (like pills). Further, making it impossible to spontaneously jump off bridges lowers suicide rates. Study about guns here: https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/ https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/
- trymas 7y ago
  Wasn't this fact tested/proved numerous times? Quick search lists plenty of articles on this topic.
- tntn 7y ago
  "Urban–Rural Differences in Suicide in the State of Maryland: The Role of Firearms" https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2017.303865 https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2017.... > Conclusions. Male firearm use drives the increased rate of suicide in rural areas
cletus 7y ago
The article says the drop is due to people in their 20s and 30s are dying but why? The article states there is a big increase in overdose deaths but in percentage terms. Is this significant? Are deaths from fentanyl up from 1,000 to 2,000 or 100,000 to 200,000? I also didn't find the word "obesity" anywhere in this article and I have to wonder how much this is a factor too. As much as people might take this as "see how much life is better in [country X]", you still see people desperate to come here. Even in the EU, legal and illegal immigrants are much more likely to be headed to the UK and Germany. I'm Australian but I've now lived in the US coming up on 9 years. The reason? As a software engineer, you can squeeze what would be a lifetime of savings in Australia into 10 years or less and that's hard to ignore. The US is a pretty terrible place to live if you're poor however. And that goes far beyond life expectancy (but it of course plays into it).
- foxyv 7y ago
  A lot of young adults are graduating and finding zero hope of getting a full time job with benefits. Also they have large amounts of non-dischargeable student loans. In addition if they have any health problems they are no longer on parent's insurance and suffering disproportionately. I'm not surprised to see issues with drug use and suicide bringing down life expectancies. I also don't expect the trend to get much better in the next few years.
  - beenBoutIT 7y ago
    The student loans and collections effectively give up when a borrower moves to Europe or leaves the country.
  - rayiner 7y ago
    The median student loan payment is $220 per month, for the minority of young people who even have student loans. (Only a third of millennials have any student loans, and the median amount is less than $25,000.) People are killing them selves over a car payments worth of debt? Or are you trying to shoe horn these mortality statistics into a pre-constructed narrative?
mrosett 7y ago
I'm open the idea of various forms of drug legalization, but someone pointed out that the opioid epidemic (which is behind the decline in life expectancy) is arguably an experiment with legalizing heroin. The analogy isn't perfect, but that gave me pause.
- danans 7y ago
  Decriminalization (which is subtly different than legalization) of drugs isn't in conflict with preventing addiction and abuse by treating these as health problems, which is what they actually are. The opioid epidemic was in significant part pushed forward by the unscrupulous marketing of prescription opioid manufacturers, and further catalyzed by the declining socioeconomic conditions in the areas most affected by the epidemic.
  - vonmoltke 7y ago
    > Decriminalization (which is subtly different than legalization) of drugs isn't in conflict with preventing addiction and abuse by treating these as health problems, which is what they actually are. It is when you hold the belief that addiction is a moral failing. Most parts of the US seem to be digging out from under that misconception, though. Finishing it off for good could be the one good thing to come out of the opioid epidemic.
    - atlasunshrugged 7y ago
      Yes, if there's any benefit to the current opioid crisis, it's that American perceptions of addiction are changing as they see that anyone, not just poor/minorities can be affected by addiction and that it's absolutely not a moral failing
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bluedino 7y ago
I was expecting the cause to be obesity - just imagine how much healthcare costs would go down if the 40% of Americans who are obese, weren’t. I’d imagine life expectancy would go up a bit too.
- deleted 7y ago
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- abstractbarista 7y ago
  Free or reduced cost stuff is all the rage these days. Yet we refuse to look in the mirror, where at least a partial explanation for the costs may be found. Quite unfortunate.
  - atlasunshrugged 7y ago
    There are some other interesting tweaks that can be done as well, sin taxes on things like sugar, tobacco, and booze are all likely to have major impacts on increasing the overall life expectancy
- jodrellblank 7y ago
  In this week's UK news: https://www.bbc.com/news/health-48826850 https://www.bbc.com/news/health-48826850 "Cancer Research UK says bowel, kidney, ovarian and liver cancers are more likely to have been caused by being overweight than by smoking tobacco. It says millions are at risk of cancer because of their weight and that obese people outnumber smokers two to one. But its new billboard campaign highlighting the obesity-cancer risk has been criticised for fat-shaming." [..] "NHS England chief executive Simon Stevens said: "The NHS can't win the 'battle against the bulge' on its own. "Families, food businesses and government all need to play their part if we're to avoid copying America's damaging and costly example.""
YeahSureWhyNot 7y ago
thanks Obama, what a great healthcare reform it was
Someone1234 7y ago
I moved from the EU to the US... Toddler had a seizure (first and last ever). Called 911. $1300 for a 1.5 mile (per Google Maps) ambulance ride to the hospital plus a $300 bill just towards "medical care" for the ride (none actually given). Then $800 for the ER, and a seperate $400 bill for the doctor (who sent us home after telling us to come back if more occurred but otherwise give child's tylenol and go see the child's pediatrician on Monday). Did I mention that both the ambulance company and the hospital have a local monopoly? There's no price competition, no choice to be made, nor could there be in a medical emergency. The problem with all of these is: If it happened again, I'm genuinely going to think "is this an emergency enough to justify a $2K medical bill?" That shouldn't be how medical treatment is decided. The whole "capitalism will solve it" thing just isn't working. I cannot shop around for medical care, I cannot see prices, and insurance is $1300/month for essentially no benefit (except to turn prices from bonkers to incredibly high).
- elamje 7y ago
  I agree that is outrageous. The problem is that people think it is capitalism. When there is no price transparency, there is no capitalism, period. Hopefully the US is on the way to government healthcare, but for now it would be great to just achieve price transparency so people can shop around. Without price there is no competition. Without competition there is no capitalism.
  - metalchianti 7y ago
    Our current system is completely fueled by legalized price gouging. It's insane how much the medical industry is allowed to exploit these regulations.
  - qwsxyh 7y ago
    No true capitalism.
    - orwin 7y ago
      is this a reference to : https://en.wikipedia.org/wiki/No_true_Scotsman https://en.wikipedia.org/wiki/No_true_Scotsman ?
mr_tristan 7y ago
Has there been comparison of urban to rural areas with this? Are young people in rural areas dying faster than urban areas? I found this from 2017: https://www.cdc.gov/media/releases/2017/p1019-rural-overdose-deaths.html https://www.cdc.gov/media/releases/2017/p1019-rural-overdose... My sense is that rural areas are harder to change, and probably far more prone to monopolies from service providers. The combination of higher costs of monopoly with higher rates of drug use might lead to more deaths. Or, in another way, in the US, is being poor in a rural area better/worse/similar to being homeless in an urban one?
- Frost1x 7y ago
  Unless I'm missing a parent reference you're referring to, the article explicitly mentioned this: >In terms of deaths from suicide, Bernstein writes that there is a huge disparity between urban and rural Americans. The suicide rate amongst urban residents is 11.1 per 100,000 people, as opposed to rural residents’ 20 per 100,000.
  - mr_tristan 7y ago
    I'm just wondering if there's ways to link the timelines of the main article (last 3 years) and the rural vs urban comparison (which was from 2017, but cites data much earlier)
deleted 7y ago
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mrhappyunhappy 7y ago
Lack of a stable career, terrible health insurance, high premiums, lack of community involvement, isolation from people, increased screen time and media consumption, hopelessness from always on sensational news, hopelessness in the face of global catastrophe to be coming near you due to ever worsening climate problem, student debt, not being able to afford a home, lack of healthy food options, diet and exercise misinformation, overprescribed medication, always on notifications never allowing you to relax, binge watching Netflix no time for brain to relax, shortened sleep cycles disrupting circadian rhythm. I wonder what could possibly make people feel like shit and wanting to end it all...
tanin 7y ago
Might be off-topic, but in general, US is very harsh on poor people. Apart from healthcare, Two more things that are harsh on people that don't have money (like students) are: 1. You need a car, which costs thousands of dollars (depending on how much reliability you need). Then, if your car breaks down and you're poor, you're really fucked. 2. Eating out is a big expense (e.g. tip makes it worse). It's ridiculous that eating out every day in a month could cost as much as a round-trip flight to Thailand. You could also buy a macbook with that money. Back, in Thailand, when I was a college student, my allowance was $15 USD a week, and I ate out pretty much every meal. Most of semi-poor/average-income people in Thailand eat out. Granted, the food safety standard is way worse. But I'd still prefer that than spending time doing the cooking myself.
- s_y_n_t_a_x 7y ago
  If you live in a city, a car is much less needed, anywhere else, you're correct, it's a big expense. When I was poor my car always caused me money troubles. Insurance, tags, gas, breakdowns. If any of that goes out you pay more in fines. Eating out is a luxury. It's much much cheaper to buy groceries. Groceries are cheaper in the US than any country I've been to, including Thailand. I didn't try to eat natively though (bought cheese/beef/milk imported from Australia) When we eat out it's usually fast food or pick-up, we don't like eating in public. It's between $15-30 for both of us. Thailand it was cut in half, but we used Grab to deliver it to us. Japan we spend upwards of $50 for half the portions. You're comparing being poor in US vs Thailand. I'm sure you know the standard of poor is very different. Being poor in the US would be middleclass living at least in Thailand. tl;dr I disagree, being poor in America is a much more pleasant experience than being poor in many other countries.
  - andbberger 7y ago
    Who are you to decide that?
    - s_y_n_t_a_x 7y ago
      People can decide whatever they want, but if they're wasting money on eating out when they don't have much money, I don't feel bad for them. I thought it was a common sentiment that eating out is something you do as a special occasion. I'm not here to tell people how to live their lives, but I've been on both sides of the poverty line. Eating in is a great way to save money. The exception is certain fast food places that are close to the same expense (value menu at McDonalds or Taco Bell) I'm beginning to think I'm an outlier here though. I don't really like food. I just want to not be hungry. I could eat the same thing for weeks. I usually skip lunch, I eat cheese and jerky every morning for breakfast, and one big homecooked meal for dinner.
mighty_bander 7y ago
Glad to live in Canada. As of 2016, life expectancy was nearly four years ahead of the US, and trending in the right direction.
- refurb 7y ago
  Huh? "Life expectancy in Canada has stopped increasing for the first time in more than four decades, due largely to soaring overdose deaths in the Western provinces."[1] [1]https://www.theglobeandmail.com/canada/british-columbia/article-overdose-crises-lowering-life-expectancy-statistics-canada/ https://www.theglobeandmail.com/canada/british-columbia/arti...
  - mighty_bander 7y ago
    My bad, there's a drop two years after the source I looked at. Seems like the problem is international. So I guess the question is: what can we do about it?
11thEarlOfMar 7y ago
Meanwhile, I was informed yesterday that my health insurance premium is going up by 12%.
beenBoutIT 7y ago
Even in a country where people were well educated, the average life expectancy rising beyond some point wouldn't be a good thing. No idea where that optimum average life expectancy is, but it's entirely possible that we exceeded it and the drop noted here is actually a positive thing.
- jedharris 7y ago
  What is your rationale for capping average life expectancy? I hope not some reasoning based on costs due to old age since that is not a logical consequence. Advances leading to increased life expectancy could also lead to healthier / more productive old age.
  - beenBoutIT 7y ago
    Not capping life expectancy artificially and not artificially working to extend it for everyone. The world got along fine from 1800-1900 with the world average life expectancy existing at less than 50, but there's no guarantee of the same being true at a global average of 100. IRL everyone alive now exists in a tenuous situation where one of the key constraints is Earth's finite resources. Everyone can't have everything everywhere at the same time while living to 100 unless the population stays artificially low. *https://ourworldindata.org/life-expectancy https://ourworldindata.org/life-expectancy
conanbatt 7y ago
The writing is on the wall: the US has to fix is healthcare system.
drinane 7y ago
Anecdotal Comments < Hard Evidence. US is indeed in relative decline.
jwilbs 7y ago
Two weeks, I had open heart surgery in my mid-20s in the US. My main takeaway is this: those of us who work in tech or companies with decent health insurance are extremely fortunate. In total (knock on wood that this doesn’t go up), I spent around $10k out of pocket. This included more than surgery itself: - multiple ER visits because of my deteriorating valve - a LOT of dentist work (cleanings, fillings, wisdom teeth removal); these things increase your risk of stroke/heart attack after heart surgery. - multiple visits with cardiologist and surgeon consultations - pre-operation - six days in the hospital recovering To be honest, that’s a lot less than I expected to pay. However, I can’t help but think of people in less fortunate positions that would 1) get fucked by the bills if they had no insurance or 2) still go into debt despite having insurance. When you really think about it, all options are ridiculous for an operation that is literally do-or-die. I’d also like to add a note on specialized vs ‘routine’ care here in the US. Or my experience with it, anyway. All specialized treatment I received (dentist, heart surgery, cardiologist) was outstanding. Routine cafe was awful, and ER visits were nothing short of ridiculous. I went in with chest pain/shortness of breath (that I now know was very serious). I waited for 6 hours. They gave me some blood work and an ekg and sent me on my way. I went again the next week, because my symptoms were getting progressively worse. Once again, I waited about 6 hours in the waiting room before getting an ekg and some blood work. Both visits were a complete waste of time. Luckily, I saw a cardiologist shortly after who gave me an echocardiogram and identified the valve issue. This (the shortness of breath, dentist visits, surgery) was all done within the last two months. Were I in a less fortunate financial position, I probably would have hesitated to even go to the cardiologist. Especially after having thrown money at the ER for nothing. It’s unfortunate how our healthcare system mirrors some sort of class-based hierarchy: If you can afford it, great! Else, get fucked.
- rrss 7y ago
  Did the ER send you on your way with a recommendation to see your PCP or a cardiologist?
  - jwilbs 7y ago
    Nope! Just told me to reach out to a cardiologist if things didn’t get better, and suggested it’s probably anxiety. I suppose I can’t blame them given my age, but it makes me wonder how many cardiac deaths (#1 source of deaths in the US [1]) are preventable. [1] https://www.healthline.com/health/leading-causes-of-death#cancer https://www.healthline.com/health/leading-causes-of-death#ca...
examancer 7y ago
We continue paying more for demonstrably worse care and outcomes than our global peers. Single payer needs to happen, now. Medicare for All.
- refurb 7y ago
  You do realize that Medicare Part D is entirely run by private companies and thus is no "single payer".
  - vonmoltke 7y ago
    That's true, but it only covers prescription drugs. The rest of the system is single-payer. Not that we need single-payer, just more controls on costs and benefits. Germany and Switzerland do fine without single-payer.
    - refurb 7y ago
      Medicare Advantage includes Parts A,B,D and are run by private insurers as well. It just irks me when people call for "Medicare for all", but clearly don't understand what Medicare actually is.
      - robbintt 7y ago
        Not accurate. Part A and B are paid directly to medicare.
        refurb 7y ago
        Part C plans offer Part A and B through private insurers.
    - deleted 7y ago
      [deleted]
  - sdinsn 7y ago
    You do realize that Medicare Part D is an optional program that is separate from the rest of Medicare?
whiddershins 7y ago
Quick googling shows suicide deaths increasing 24% over 15 years, to 45,000 in 2014. I heard an interview on Sam Harris’ podcast where the contention was teenage suicide rates are dramatically increasing. Overdose deaths are at around 70,000 for 2017. Overdose deaths and suicide are very connected, insofar as they can be traced to a feeling of hopelessness or meaninglessness. Alcoholics are at a very high risk for suicide, for example. There may be many other related causes of death: homicides, car crashes, and other destructive behaviors can still be viewed through a lens of lack of self worth or hope. I think it is a huge mistake to treat it as a priori that economic factors drive this situation. You can argue that even though we are all materially much more well off than 100 years ago, the awareness of relative status still has a profound psychological impact. But I think looking at possible non-economic factors relating to psychological, philosophical, and spiritual health might provide alternate hypothesis that could help. I think policy makers and pundits avoid that because it seems much harder to address those issues via policy. To me, though, the data implies a widespread crisis in sense of meaning.
- khuey 7y ago
  US population is up 15% over those same 15 years. The increase in suicides is a lot less dramatic when normalized per-capita.
chabes 7y ago
Interesting quotes from the article: > Speaking with NPR, disease prevention expert William Dietz of George Washington University stressed the links between overdoses and suicides. Both may occur amongst people “less connected to each other in communities” and are tied to a “sense of hopelessness, which in turn could lead to an increase in rates of suicide and certainly addictive behaviors.” > McHugh echoes Dietz, concluding, “There's a tremendous amount of overlap between the two that isn't talked about nearly enough.”
ilyaeck 7y ago
Folks, the equation is quite simple: the US is a high-risk, high (financial) reward society. Unlike the EU, it's optimized for the upside: you have many opportunities to create wealth for yourself (and sometimes for others). The EU, conversely, is optimized for the downside: you may not have too many opportunities to climb high, but even if you are the bottom, life can still be relatively comfortable. So, for the averaghe person, the European system is likely (almost definitely) better. For risk-craving entrepreneurs, the US is better (although some other places may have even more and bigger high-risk opportunities nowadays). For you? You decide!
- nraynaud 7y ago
  How do you decide which country you get born in exactly?
  - AlexTWithBeard 7y ago
    You don't, but if the countries are different, you can at least relocate to your liking. If all countries are the same then you're out of luck.
    - nraynaud 7y ago
      poor people can't relocate.
- bodono 7y ago
  True, but life expectancy is declining here in the UK as well.
- cultus 7y ago
  That's not actually true at all. The US has lower social mobility than most wealthy European countries. Thus, there are actually fewer opportunities for most people to create wealth for themselves compared to countries with more equality. It's hard to start a business, if, like the vast majority of people, you don't have a bunch of excess money sitting around. https://www.forbes.com/sites/aparnamathur/2018/07/16/the-u-s-does-poorly-on-yet-another-metric-of-economic-mobility/#1dab24b66a7b https://www.forbes.com/sites/aparnamathur/2018/07/16/the-u-s... https://www.economist.com/graphic-detail/2018/02/14/americans-overestimate-social-mobility-in-their-country https://www.economist.com/graphic-detail/2018/02/14/american...
gingabriska 7y ago
I see some people talking about Germany and France offering far better and cheaper healthcare. But can you afford to look only at Germany and France? They operate in a broader framework of EU. If you are going to compare services/living standards then must also directly compare Romania or Bulgaria to the US because Germany and France are able to provide cheap healthcare because their healthcare staff are willing to accept lower prices and how does it work? By importing labor from cheaper European countries. Presently, many doctors and nurses from Romania work in Germany without them good luck being able to maintain "cheap" healthcare. If you cut off Germany and France from rest of the EU, the healthcare cost will likely shoot up far more than what it costs in US now. There is downward pressure on wages in whole EU and this is why Europeans come to states for better employment opportunities, and better pay which can and does buy you better living standards if you are willing to spend the money you make but it seems not many want to do that, they want free healthcare in addition to taking large proportion of their wages home.
- pcardoso 7y ago
  I am from Portugal, a country that has many people working in richer EU countries, but I don't think this is true. Romanian or Portuguese nurses and doctors working in France or Germany or any other country will have the same wages as a french nurse or doctor. Or most of the time at least. My wife is a nurse and we did some research on this a few years ago.
  - nraynaud 7y ago
    and there is the converse too, where people go to eastern countries to get surgeries.
  - atlasunshrugged 7y ago
    I don't know specifically wages but often there are re-certifications needed even within the EU (currently a friend's wife who is an M.D. is trying to switch from Estonia to the UK and has to jump through several administrative hoops and get certifications in English and a few other things)
  - 7y ago
disabled 7y ago
If you live in the US and plan on staying alive in the long run, then you better spend a lot of time consulting HealthData.org--and analyzing the data there--to fit your particular situation. The third leading cause of death--or at least what is believed to be the third leading cause of death--is preventable medical errors: https://www.npr.org/sections/health-shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors https://www.npr.org/sections/health-shots/2016/05/03/4766361... Let's not even get in to how much health care actually costs in the US. But, if you want a completely solid read on that matter, get the book CASINO HEALTHCARE via Amazon. You will not be disappointed. That being said, both me and my fraternal twin brother turned 30 a month ago. Unlike for most people, turning 30, together with my brother, was a very special milestone that I never expected to reach in life. I have 2 rare autoimmune neurological diseases, that affect my peripheral nervous system (with one of them being very rare, with only case reports and cohorts published in the medical literature...and it was discovered relatively recently in the medical world...in the past 20 years via NIH research grants to physician-scientists) plus type 1 diabetes. It is all connected, but that is another story for another time. The US health care system is unequipped to properly deal with people who have rare diseases. 6-7% of the general population has a rare disease, so having one, diagnosed or not, is actually common, and is even more common than the prevalence of ADHD in adults! This too is another story for another time, but I ended up self diagnosing the very rare one correctly, even though in my case the whole situation is beyond confounding, even compared to others with the same very rare condition that I have. The issue is that for people with rare disease, the situation can be desperate, dismal, and even hopeless. In the case of rare disease, the social support structures in place within a society are literally just as important as the medical aspects of care. We really do need highly specific plans and approaches for, rare diseases in general, for dealing with our unique situations. Compared the the United States, the European Union excels at this, and is the only world superpower that has a practical, pragmatic, and winning approach on the matter. For access to orphan drugs, Germany is the clear winner worldwide. For societal supports, Norway (which is not part of the EU but it is kind of part of the EU for the purposes here) is phenomenal and no other country compares, worldwide. Their government has extremely well developed programs, offices, and "medical homes" (go to contacts that are teams that coordinate all care) for rare disease patients, and for them only. Remember, our situations are unique and different compared to other more common chronic illnesses, whether you want to believe this or not. In fact, probably the biggest threat to my well being as somebody with rare disease: a government that does not reform, regulation wise, with the rapidly changing pace of technology. (And yes, all technology in general needs to be regulated, to varying degrees, whether you want to agree or not.) Sorry to go off on a tangent. If I told the whole story, which would take quite awhile, you would be shocked, amazed, stunned, and impressed, all at the same time. I have cheated death many times, and I really shouldn't be alive. Both my doctors and I very much are aware of that. I certainly do not know why I am here, however I have purpose and I have meaning in my life. I would love to go into more specifics, but I cannot without effectively writing a novel here. The point is, on my 30th birthday, I came to the realization that I basically have to go to the EU (I am a dual US|EU citizen) to not only stay alive in the long term, but to potentially avoid having to suffer profoundly for the rest of my life. I cannot go in to the specifics here, though. But, trust me, the US health care system is not equipped to deal with rare disease properly, at all. So, instead of celebrating the remarkable accomplishment of my 30th birthday with my best friend (I really shouldn't be alive), I was realizing that I had to leave the US for good, to stay alive. I cannot go in to specifics here, but this is not an exaggeration at all. It was profoundly sad for me, because I have to leave my family, who mostly live int he US, and basically start a new life.

280 points by EL_Loco 7y ago

tntn 7y ago

HN title is not good. Original title is "U.S. Life Expectancy Drops for Third Year in a Row, Reflecting Rising Drug Overdoses, Suicides." The comparison is between the last three years and 1915-1918, but the Spanish flu was just getting going in 1918. EDIT: folks just arriving, the HN title has changed since I commented. It previously said "worst trend since Spanish flu," or something.

ilikehurdles 7y ago
The title is fine, and reflects the factual subtitle immediately below the headline. There is no requirement to post the article headline as-is on HN.
- tntn 7y ago
  But it doesn't reflect the factual subtitle. The title here says 1918, but the true trend is 1915-1918, which had a bit of a war as well. > There is no requirement to post the article headline as-is on HN. There is. From the guidelines: > Otherwise [i.e. not excessive clickbait] please use the original title, unless it is misleading or linkbait; don't editorialize.
  - ilikehurdles 7y ago
    Apologies, you're correct. I think focusing on the year or years will bury the lede in any case.
    - trentlott 7y ago
      It is commonly known as "the 1918 Spanish influenza pandemic" It's a title, not a series of facts
spanxx 7y ago
> Spanish flu of 1918 It was not Spanish. It's origins come from the battlefields of WWI.
- RmDen 7y ago
  Everyone knows it as the Spanish flu.. it's called like that because the Spanish newspapers didn't censor these deaths like the other countries that were busy with World War I
- derefr 7y ago
  Hawaiian pizza does not come from Hawaii, and yet that is still its proper name (in English, at least.)
- tntn 7y ago
  Next you're probably going to tell me about French fries, right?
  - simonh 7y ago
    Freedom Fries
deleted 7y ago
[deleted]
dang 7y ago
The submitted title was "Drop in US life expectancy trend not seen since 1918 influenza epidemic". A moderator changed it because it broke the site guideline: "Please use the original title, unless it is misleading or linkbait; don't editorialize." https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html Submitters: Cherry-picking a detail from an article is editorializing, so please don't do that. If you want to say what you think is important about the topic, please do so in a comment, where your view is on a level playing field with everyone else's. https://hn.algolia.com/?sort=byDate&dateRange=all&type=comment&storyText=false&prefix&page=0&query=by:dang%20title%20level%20playing%20field https://hn.algolia.com/?sort=byDate&dateRange=all&type=comme...

ilikehurdles 7y ago

Leaving your 20s and 30s with a career you enjoy, basic benefits such as health insurance, retirement funding, and paid time off, and the ability to afford a reasonably sized home without falling into tremendous amounts of debt seems less and less likely each year. I have a lot of family who have moved from the EU to the US and back to the EU, I have also lived there myself, and I'm intimately familiar with their day-to-day. If the average American knew what the benefits and lifestyle are like for a middle-class German family, all those totally disconnected accolades about job and GDP growth that our oligarchs like to shower upon us would do nothing to prevent work strikes and riots in the streets.

dv_dt 7y ago
That reminds me of this twitter thread about our healthcare system. There are absolutely heartbreaking stories on there. The one that really sticks in my mind is the parents who were paying off and earlier ER trip and were literally waiting in the parking lot of the ER again with a fevered child, waiting to see if seizures started or the fever broke. https://twitter.com/AllOnMedicare/status/1124042436345569286 https://twitter.com/AllOnMedicare/status/1124042436345569286
wickerman 7y ago
As a south american living in the EU, I grew up hearing people saying "ah, in the US..." and while probably they were thinking back to a time when the US wasn't as terrible as it is now, it's a bit irritating for me to hear that kind of stuff considering that I graduated in the top university of my country with a masters in engineering and had to pay nothing because university is free and for everyone. I've met so many american expats in Europe who basically fled their student debt by emigrating. And that's just one thing, the fact that healthcare isn't free, people avoid calling for ambulances because they cost money, and people are jailed because the prision system has become a very profitable business.
- supergauntlet 7y ago
  Every day I see headlines like this and I think "surely soon enough it will get bad enough that people will support universal healthcare" or really any "socialist" policy. Every day I am mistaken. If people actually did the research they'd see that these policies are just good common sense for them, but too many of our voters are lied to by the media they consume, so I worry things will never change.

EastLondonCoder 7y ago

I think this has to do with the Great Recession. Prolonged economic insecurity is associated with a poor mental health. And that is in turn associated with self medication with things like alcohol and opioids. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741013/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4741013/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151244/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151244/

zaroth 7y ago
That would be a quite a laggy effect at this point. The US has been having it’s longest continuous period of economic growth ever.
- danans 7y ago
  Growth on Wall Street isn't growth on main street, and huge corporate and big investor profits (and associated cash hordes) haven't meant economic recovery in the places and communities hardest hit by the opioid epidemic.
  - refurb 7y ago
    Growth on Wall Street isn't growth on main street Of course it is. Where do you think main streets pensions and 401k are invested? Where do you think main street people work?
    - tezzer 7y ago
      Only a third of Americans -have- a 401k, and only 13% have pensions.
    - maximente 7y ago
      most equity is held by the richest americans, while others primarily depend on wages which haven't risen in decades, basically. also most people aren't employed by large business. https://www.pewresearch.org/fact-tank/2018/08/07/for-most-us-workers-real-wages-have-barely-budged-for-decades/ https://www.pewresearch.org/fact-tank/2018/08/07/for-most-us... https://www.huffpost.com/entry/five-big-myths-about-amer_b_866118 https://www.huffpost.com/entry/five-big-myths-about-amer_b_8...

myth_buster 7y ago

[Nit] Show me 4 embedded ads but not a single chart when talking about trends. Also 2018.

cagenut 7y ago
one of the side affects of google's search monopoly is the entire news/info media has been frozen in a textual model. facebook "helped" a little bit by requiring at least one good image to get shared, but that was in like 2012. we get the content we get because of the algorithms, not because its a good way to present information.
dang 7y ago
> Also 2018. Good catch. Added above.
disabled 7y ago
This is a good starting point. This is all open access, and funded through the Bill and Melinda Gates Foundation. This is done at the University of Washington Medical School, which is basically "as good as it gets" for a public medical school in the US. UW also has solid allied health departments. Their statistics department (even outside of the realm of health) is solid too: http://www.healthdata.org/us-health/publications http://www.healthdata.org/us-health/publications

jimbob45 7y ago

“Higher suicide rates in rural areas are due to nearly 60 percent of rural homes having a gun versus less than half of homes in urban areas,” psychiatrist and behavioral scientist Keith Humphreys of Stanford University says. “Having easily available lethal means is a big risk factor for suicide.” Pretty bold claim there. Seems like you could run a pretty big study just based off that one hypothesis.

mikeyouse 7y ago
It's not especially controversial. Many people who attempt suicide regret trying and go on to live fairly normal lives but most people who attempt suicide with a firearm are successful. It's long been a causal factor in the male/female discrepancy in rates as well as the rural/urban divide. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984734/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4984734/ https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/ https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/
smt88 7y ago
It's not a bold claim anymore. It's well-established public health knowledge that people with faster and less failure-prone suicide methods are more likely to take their lives. For example, women attempt suicide at a higher rate, but die less often because they use less-lethal methods (like pills). Further, making it impossible to spontaneously jump off bridges lowers suicide rates. Study about guns here: https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/ https://www.hsph.harvard.edu/news/magazine/guns-and-suicide/
trymas 7y ago
Wasn't this fact tested/proved numerous times? Quick search lists plenty of articles on this topic.
tntn 7y ago
"Urban–Rural Differences in Suicide in the State of Maryland: The Role of Firearms" https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2017.303865 https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2017.... > Conclusions. Male firearm use drives the increased rate of suicide in rural areas

cletus 7y ago

The article says the drop is due to people in their 20s and 30s are dying but why? The article states there is a big increase in overdose deaths but in percentage terms. Is this significant? Are deaths from fentanyl up from 1,000 to 2,000 or 100,000 to 200,000? I also didn't find the word "obesity" anywhere in this article and I have to wonder how much this is a factor too. As much as people might take this as "see how much life is better in [country X]", you still see people desperate to come here. Even in the EU, legal and illegal immigrants are much more likely to be headed to the UK and Germany. I'm Australian but I've now lived in the US coming up on 9 years. The reason? As a software engineer, you can squeeze what would be a lifetime of savings in Australia into 10 years or less and that's hard to ignore. The US is a pretty terrible place to live if you're poor however. And that goes far beyond life expectancy (but it of course plays into it).

foxyv 7y ago
A lot of young adults are graduating and finding zero hope of getting a full time job with benefits. Also they have large amounts of non-dischargeable student loans. In addition if they have any health problems they are no longer on parent's insurance and suffering disproportionately. I'm not surprised to see issues with drug use and suicide bringing down life expectancies. I also don't expect the trend to get much better in the next few years.
- beenBoutIT 7y ago
  The student loans and collections effectively give up when a borrower moves to Europe or leaves the country.
- rayiner 7y ago
  The median student loan payment is $220 per month, for the minority of young people who even have student loans. (Only a third of millennials have any student loans, and the median amount is less than $25,000.) People are killing them selves over a car payments worth of debt? Or are you trying to shoe horn these mortality statistics into a pre-constructed narrative?

mrosett 7y ago

I'm open the idea of various forms of drug legalization, but someone pointed out that the opioid epidemic (which is behind the decline in life expectancy) is arguably an experiment with legalizing heroin. The analogy isn't perfect, but that gave me pause.

danans 7y ago
Decriminalization (which is subtly different than legalization) of drugs isn't in conflict with preventing addiction and abuse by treating these as health problems, which is what they actually are. The opioid epidemic was in significant part pushed forward by the unscrupulous marketing of prescription opioid manufacturers, and further catalyzed by the declining socioeconomic conditions in the areas most affected by the epidemic.
- vonmoltke 7y ago
  > Decriminalization (which is subtly different than legalization) of drugs isn't in conflict with preventing addiction and abuse by treating these as health problems, which is what they actually are. It is when you hold the belief that addiction is a moral failing. Most parts of the US seem to be digging out from under that misconception, though. Finishing it off for good could be the one good thing to come out of the opioid epidemic.
  - atlasunshrugged 7y ago
    Yes, if there's any benefit to the current opioid crisis, it's that American perceptions of addiction are changing as they see that anyone, not just poor/minorities can be affected by addiction and that it's absolutely not a moral failing
- deleted 7y ago
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bluedino 7y ago

I was expecting the cause to be obesity - just imagine how much healthcare costs would go down if the 40% of Americans who are obese, weren’t. I’d imagine life expectancy would go up a bit too.

deleted 7y ago
[deleted]
abstractbarista 7y ago
Free or reduced cost stuff is all the rage these days. Yet we refuse to look in the mirror, where at least a partial explanation for the costs may be found. Quite unfortunate.
- atlasunshrugged 7y ago
  There are some other interesting tweaks that can be done as well, sin taxes on things like sugar, tobacco, and booze are all likely to have major impacts on increasing the overall life expectancy
jodrellblank 7y ago
In this week's UK news: https://www.bbc.com/news/health-48826850 https://www.bbc.com/news/health-48826850 "Cancer Research UK says bowel, kidney, ovarian and liver cancers are more likely to have been caused by being overweight than by smoking tobacco. It says millions are at risk of cancer because of their weight and that obese people outnumber smokers two to one. But its new billboard campaign highlighting the obesity-cancer risk has been criticised for fat-shaming." [..] "NHS England chief executive Simon Stevens said: "The NHS can't win the 'battle against the bulge' on its own. "Families, food businesses and government all need to play their part if we're to avoid copying America's damaging and costly example.""

YeahSureWhyNot 7y ago

thanks Obama, what a great healthcare reform it was

Someone1234 7y ago

I moved from the EU to the US... Toddler had a seizure (first and last ever). Called 911. $1300 for a 1.5 mile (per Google Maps) ambulance ride to the hospital plus a $300 bill just towards "medical care" for the ride (none actually given). Then $800 for the ER, and a seperate $400 bill for the doctor (who sent us home after telling us to come back if more occurred but otherwise give child's tylenol and go see the child's pediatrician on Monday). Did I mention that both the ambulance company and the hospital have a local monopoly? There's no price competition, no choice to be made, nor could there be in a medical emergency. The problem with all of these is: If it happened again, I'm genuinely going to think "is this an emergency enough to justify a $2K medical bill?" That shouldn't be how medical treatment is decided. The whole "capitalism will solve it" thing just isn't working. I cannot shop around for medical care, I cannot see prices, and insurance is $1300/month for essentially no benefit (except to turn prices from bonkers to incredibly high).

elamje 7y ago
I agree that is outrageous. The problem is that people think it is capitalism. When there is no price transparency, there is no capitalism, period. Hopefully the US is on the way to government healthcare, but for now it would be great to just achieve price transparency so people can shop around. Without price there is no competition. Without competition there is no capitalism.
- metalchianti 7y ago
  Our current system is completely fueled by legalized price gouging. It's insane how much the medical industry is allowed to exploit these regulations.
- qwsxyh 7y ago
  No true capitalism.
  - orwin 7y ago
    is this a reference to : https://en.wikipedia.org/wiki/No_true_Scotsman https://en.wikipedia.org/wiki/No_true_Scotsman ?

mr_tristan 7y ago

Has there been comparison of urban to rural areas with this? Are young people in rural areas dying faster than urban areas? I found this from 2017: https://www.cdc.gov/media/releases/2017/p1019-rural-overdose-deaths.html https://www.cdc.gov/media/releases/2017/p1019-rural-overdose... My sense is that rural areas are harder to change, and probably far more prone to monopolies from service providers. The combination of higher costs of monopoly with higher rates of drug use might lead to more deaths. Or, in another way, in the US, is being poor in a rural area better/worse/similar to being homeless in an urban one?

Frost1x 7y ago
Unless I'm missing a parent reference you're referring to, the article explicitly mentioned this: >In terms of deaths from suicide, Bernstein writes that there is a huge disparity between urban and rural Americans. The suicide rate amongst urban residents is 11.1 per 100,000 people, as opposed to rural residents’ 20 per 100,000.
- mr_tristan 7y ago
  I'm just wondering if there's ways to link the timelines of the main article (last 3 years) and the rural vs urban comparison (which was from 2017, but cites data much earlier)

deleted 7y ago

[deleted]

mrhappyunhappy 7y ago

Lack of a stable career, terrible health insurance, high premiums, lack of community involvement, isolation from people, increased screen time and media consumption, hopelessness from always on sensational news, hopelessness in the face of global catastrophe to be coming near you due to ever worsening climate problem, student debt, not being able to afford a home, lack of healthy food options, diet and exercise misinformation, overprescribed medication, always on notifications never allowing you to relax, binge watching Netflix no time for brain to relax, shortened sleep cycles disrupting circadian rhythm. I wonder what could possibly make people feel like shit and wanting to end it all...

tanin 7y ago

Might be off-topic, but in general, US is very harsh on poor people. Apart from healthcare, Two more things that are harsh on people that don't have money (like students) are: 1. You need a car, which costs thousands of dollars (depending on how much reliability you need). Then, if your car breaks down and you're poor, you're really fucked. 2. Eating out is a big expense (e.g. tip makes it worse). It's ridiculous that eating out every day in a month could cost as much as a round-trip flight to Thailand. You could also buy a macbook with that money. Back, in Thailand, when I was a college student, my allowance was $15 USD a week, and I ate out pretty much every meal. Most of semi-poor/average-income people in Thailand eat out. Granted, the food safety standard is way worse. But I'd still prefer that than spending time doing the cooking myself.

s_y_n_t_a_x 7y ago
If you live in a city, a car is much less needed, anywhere else, you're correct, it's a big expense. When I was poor my car always caused me money troubles. Insurance, tags, gas, breakdowns. If any of that goes out you pay more in fines. Eating out is a luxury. It's much much cheaper to buy groceries. Groceries are cheaper in the US than any country I've been to, including Thailand. I didn't try to eat natively though (bought cheese/beef/milk imported from Australia) When we eat out it's usually fast food or pick-up, we don't like eating in public. It's between $15-30 for both of us. Thailand it was cut in half, but we used Grab to deliver it to us. Japan we spend upwards of $50 for half the portions. You're comparing being poor in US vs Thailand. I'm sure you know the standard of poor is very different. Being poor in the US would be middleclass living at least in Thailand. tl;dr I disagree, being poor in America is a much more pleasant experience than being poor in many other countries.
- andbberger 7y ago
  Who are you to decide that?
  - s_y_n_t_a_x 7y ago
    People can decide whatever they want, but if they're wasting money on eating out when they don't have much money, I don't feel bad for them. I thought it was a common sentiment that eating out is something you do as a special occasion. I'm not here to tell people how to live their lives, but I've been on both sides of the poverty line. Eating in is a great way to save money. The exception is certain fast food places that are close to the same expense (value menu at McDonalds or Taco Bell) I'm beginning to think I'm an outlier here though. I don't really like food. I just want to not be hungry. I could eat the same thing for weeks. I usually skip lunch, I eat cheese and jerky every morning for breakfast, and one big homecooked meal for dinner.

mighty_bander 7y ago

Glad to live in Canada. As of 2016, life expectancy was nearly four years ahead of the US, and trending in the right direction.

refurb 7y ago
Huh? "Life expectancy in Canada has stopped increasing for the first time in more than four decades, due largely to soaring overdose deaths in the Western provinces."[1] [1]https://www.theglobeandmail.com/canada/british-columbia/article-overdose-crises-lowering-life-expectancy-statistics-canada/ https://www.theglobeandmail.com/canada/british-columbia/arti...
- mighty_bander 7y ago
  My bad, there's a drop two years after the source I looked at. Seems like the problem is international. So I guess the question is: what can we do about it?

11thEarlOfMar 7y ago

Meanwhile, I was informed yesterday that my health insurance premium is going up by 12%.

beenBoutIT 7y ago

Even in a country where people were well educated, the average life expectancy rising beyond some point wouldn't be a good thing. No idea where that optimum average life expectancy is, but it's entirely possible that we exceeded it and the drop noted here is actually a positive thing.

jedharris 7y ago
What is your rationale for capping average life expectancy? I hope not some reasoning based on costs due to old age since that is not a logical consequence. Advances leading to increased life expectancy could also lead to healthier / more productive old age.
- beenBoutIT 7y ago
  Not capping life expectancy artificially and not artificially working to extend it for everyone. The world got along fine from 1800-1900 with the world average life expectancy existing at less than 50, but there's no guarantee of the same being true at a global average of 100. IRL everyone alive now exists in a tenuous situation where one of the key constraints is Earth's finite resources. Everyone can't have everything everywhere at the same time while living to 100 unless the population stays artificially low. *https://ourworldindata.org/life-expectancy https://ourworldindata.org/life-expectancy

conanbatt 7y ago

The writing is on the wall: the US has to fix is healthcare system.

drinane 7y ago

Anecdotal Comments < Hard Evidence. US is indeed in relative decline.

jwilbs 7y ago

Two weeks, I had open heart surgery in my mid-20s in the US. My main takeaway is this: those of us who work in tech or companies with decent health insurance are extremely fortunate. In total (knock on wood that this doesn’t go up), I spent around $10k out of pocket. This included more than surgery itself: - multiple ER visits because of my deteriorating valve - a LOT of dentist work (cleanings, fillings, wisdom teeth removal); these things increase your risk of stroke/heart attack after heart surgery. - multiple visits with cardiologist and surgeon consultations - pre-operation - six days in the hospital recovering To be honest, that’s a lot less than I expected to pay. However, I can’t help but think of people in less fortunate positions that would 1) get fucked by the bills if they had no insurance or 2) still go into debt despite having insurance. When you really think about it, all options are ridiculous for an operation that is literally do-or-die. I’d also like to add a note on specialized vs ‘routine’ care here in the US. Or my experience with it, anyway. All specialized treatment I received (dentist, heart surgery, cardiologist) was outstanding. Routine cafe was awful, and ER visits were nothing short of ridiculous. I went in with chest pain/shortness of breath (that I now know was very serious). I waited for 6 hours. They gave me some blood work and an ekg and sent me on my way. I went again the next week, because my symptoms were getting progressively worse. Once again, I waited about 6 hours in the waiting room before getting an ekg and some blood work. Both visits were a complete waste of time. Luckily, I saw a cardiologist shortly after who gave me an echocardiogram and identified the valve issue. This (the shortness of breath, dentist visits, surgery) was all done within the last two months. Were I in a less fortunate financial position, I probably would have hesitated to even go to the cardiologist. Especially after having thrown money at the ER for nothing. It’s unfortunate how our healthcare system mirrors some sort of class-based hierarchy: If you can afford it, great! Else, get fucked.

rrss 7y ago
Did the ER send you on your way with a recommendation to see your PCP or a cardiologist?
- jwilbs 7y ago
  Nope! Just told me to reach out to a cardiologist if things didn’t get better, and suggested it’s probably anxiety. I suppose I can’t blame them given my age, but it makes me wonder how many cardiac deaths (#1 source of deaths in the US [1]) are preventable. [1] https://www.healthline.com/health/leading-causes-of-death#cancer https://www.healthline.com/health/leading-causes-of-death#ca...

examancer 7y ago

We continue paying more for demonstrably worse care and outcomes than our global peers. Single payer needs to happen, now. Medicare for All.

refurb 7y ago
You do realize that Medicare Part D is entirely run by private companies and thus is no "single payer".
- vonmoltke 7y ago
  That's true, but it only covers prescription drugs. The rest of the system is single-payer. Not that we need single-payer, just more controls on costs and benefits. Germany and Switzerland do fine without single-payer.
  - refurb 7y ago
    Medicare Advantage includes Parts A,B,D and are run by private insurers as well. It just irks me when people call for "Medicare for all", but clearly don't understand what Medicare actually is.
    - robbintt 7y ago
      Not accurate. Part A and B are paid directly to medicare.
      - refurb 7y ago
        Part C plans offer Part A and B through private insurers.
  - deleted 7y ago
    [deleted]
- sdinsn 7y ago
  You do realize that Medicare Part D is an optional program that is separate from the rest of Medicare?

whiddershins 7y ago

Quick googling shows suicide deaths increasing 24% over 15 years, to 45,000 in 2014. I heard an interview on Sam Harris’ podcast where the contention was teenage suicide rates are dramatically increasing. Overdose deaths are at around 70,000 for 2017. Overdose deaths and suicide are very connected, insofar as they can be traced to a feeling of hopelessness or meaninglessness. Alcoholics are at a very high risk for suicide, for example. There may be many other related causes of death: homicides, car crashes, and other destructive behaviors can still be viewed through a lens of lack of self worth or hope. I think it is a huge mistake to treat it as a priori that economic factors drive this situation. You can argue that even though we are all materially much more well off than 100 years ago, the awareness of relative status still has a profound psychological impact. But I think looking at possible non-economic factors relating to psychological, philosophical, and spiritual health might provide alternate hypothesis that could help. I think policy makers and pundits avoid that because it seems much harder to address those issues via policy. To me, though, the data implies a widespread crisis in sense of meaning.

khuey 7y ago
US population is up 15% over those same 15 years. The increase in suicides is a lot less dramatic when normalized per-capita.

chabes 7y ago

Interesting quotes from the article: > Speaking with NPR, disease prevention expert William Dietz of George Washington University stressed the links between overdoses and suicides. Both may occur amongst people “less connected to each other in communities” and are tied to a “sense of hopelessness, which in turn could lead to an increase in rates of suicide and certainly addictive behaviors.” > McHugh echoes Dietz, concluding, “There's a tremendous amount of overlap between the two that isn't talked about nearly enough.”

ilyaeck 7y ago

Folks, the equation is quite simple: the US is a high-risk, high (financial) reward society. Unlike the EU, it's optimized for the upside: you have many opportunities to create wealth for yourself (and sometimes for others). The EU, conversely, is optimized for the downside: you may not have too many opportunities to climb high, but even if you are the bottom, life can still be relatively comfortable. So, for the averaghe person, the European system is likely (almost definitely) better. For risk-craving entrepreneurs, the US is better (although some other places may have even more and bigger high-risk opportunities nowadays). For you? You decide!

nraynaud 7y ago
How do you decide which country you get born in exactly?
- AlexTWithBeard 7y ago
  You don't, but if the countries are different, you can at least relocate to your liking. If all countries are the same then you're out of luck.
  - nraynaud 7y ago
    poor people can't relocate.
bodono 7y ago
True, but life expectancy is declining here in the UK as well.
cultus 7y ago
That's not actually true at all. The US has lower social mobility than most wealthy European countries. Thus, there are actually fewer opportunities for most people to create wealth for themselves compared to countries with more equality. It's hard to start a business, if, like the vast majority of people, you don't have a bunch of excess money sitting around. https://www.forbes.com/sites/aparnamathur/2018/07/16/the-u-s-does-poorly-on-yet-another-metric-of-economic-mobility/#1dab24b66a7b https://www.forbes.com/sites/aparnamathur/2018/07/16/the-u-s... https://www.economist.com/graphic-detail/2018/02/14/americans-overestimate-social-mobility-in-their-country https://www.economist.com/graphic-detail/2018/02/14/american...

gingabriska 7y ago

I see some people talking about Germany and France offering far better and cheaper healthcare. But can you afford to look only at Germany and France? They operate in a broader framework of EU. If you are going to compare services/living standards then must also directly compare Romania or Bulgaria to the US because Germany and France are able to provide cheap healthcare because their healthcare staff are willing to accept lower prices and how does it work? By importing labor from cheaper European countries. Presently, many doctors and nurses from Romania work in Germany without them good luck being able to maintain "cheap" healthcare. If you cut off Germany and France from rest of the EU, the healthcare cost will likely shoot up far more than what it costs in US now. There is downward pressure on wages in whole EU and this is why Europeans come to states for better employment opportunities, and better pay which can and does buy you better living standards if you are willing to spend the money you make but it seems not many want to do that, they want free healthcare in addition to taking large proportion of their wages home.

pcardoso 7y ago
I am from Portugal, a country that has many people working in richer EU countries, but I don't think this is true. Romanian or Portuguese nurses and doctors working in France or Germany or any other country will have the same wages as a french nurse or doctor. Or most of the time at least. My wife is a nurse and we did some research on this a few years ago.
- nraynaud 7y ago
  and there is the converse too, where people go to eastern countries to get surgeries.
- atlasunshrugged 7y ago
  I don't know specifically wages but often there are re-certifications needed even within the EU (currently a friend's wife who is an M.D. is trying to switch from Estonia to the UK and has to jump through several administrative hoops and get certifications in English and a few other things)
- 7y ago

disabled 7y ago

If you live in the US and plan on staying alive in the long run, then you better spend a lot of time consulting HealthData.org--and analyzing the data there--to fit your particular situation. The third leading cause of death--or at least what is believed to be the third leading cause of death--is preventable medical errors: https://www.npr.org/sections/health-shots/2016/05/03/476636183/death-certificates-undercount-toll-of-medical-errors https://www.npr.org/sections/health-shots/2016/05/03/4766361... Let's not even get in to how much health care actually costs in the US. But, if you want a completely solid read on that matter, get the book CASINO HEALTHCARE via Amazon. You will not be disappointed. That being said, both me and my fraternal twin brother turned 30 a month ago. Unlike for most people, turning 30, together with my brother, was a very special milestone that I never expected to reach in life. I have 2 rare autoimmune neurological diseases, that affect my peripheral nervous system (with one of them being very rare, with only case reports and cohorts published in the medical literature...and it was discovered relatively recently in the medical world...in the past 20 years via NIH research grants to physician-scientists) plus type 1 diabetes. It is all connected, but that is another story for another time. The US health care system is unequipped to properly deal with people who have rare diseases. 6-7% of the general population has a rare disease, so having one, diagnosed or not, is actually common, and is even more common than the prevalence of ADHD in adults! This too is another story for another time, but I ended up self diagnosing the very rare one correctly, even though in my case the whole situation is beyond confounding, even compared to others with the same very rare condition that I have. The issue is that for people with rare disease, the situation can be desperate, dismal, and even hopeless. In the case of rare disease, the social support structures in place within a society are literally just as important as the medical aspects of care. We really do need highly specific plans and approaches for, rare diseases in general, for dealing with our unique situations. Compared the the United States, the European Union excels at this, and is the only world superpower that has a practical, pragmatic, and winning approach on the matter. For access to orphan drugs, Germany is the clear winner worldwide. For societal supports, Norway (which is not part of the EU but it is kind of part of the EU for the purposes here) is phenomenal and no other country compares, worldwide. Their government has extremely well developed programs, offices, and "medical homes" (go to contacts that are teams that coordinate all care) for rare disease patients, and for them only. Remember, our situations are unique and different compared to other more common chronic illnesses, whether you want to believe this or not. In fact, probably the biggest threat to my well being as somebody with rare disease: a government that does not reform, regulation wise, with the rapidly changing pace of technology. (And yes, all technology in general needs to be regulated, to varying degrees, whether you want to agree or not.) Sorry to go off on a tangent. If I told the whole story, which would take quite awhile, you would be shocked, amazed, stunned, and impressed, all at the same time. I have cheated death many times, and I really shouldn't be alive. Both my doctors and I very much are aware of that. I certainly do not know why I am here, however I have purpose and I have meaning in my life. I would love to go into more specifics, but I cannot without effectively writing a novel here. The point is, on my 30th birthday, I came to the realization that I basically have to go to the EU (I am a dual US|EU citizen) to not only stay alive in the long term, but to potentially avoid having to suffer profoundly for the rest of my life. I cannot go in to the specifics here, though. But, trust me, the US health care system is not equipped to deal with rare disease properly, at all. So, instead of celebrating the remarkable accomplishment of my 30th birthday with my best friend (I really shouldn't be alive), I was realizing that I had to leave the US for good, to stay alive. I cannot go in to specifics here, but this is not an exaggeration at all. It was profoundly sad for me, because I have to leave my family, who mostly live int he US, and basically start a new life.