3 ms·

I see the same discussion in healthcare. Life expectancy in many western countries grew by 20-30 years since the second world war, which is a radically improved

I see the same discussion in healthcare. Life expectancy in many western countries grew by 20-30 years since the second world war, which is a radically improved outcome which proxies health throughout life, yet we are shocked this outcome is much more expensive than before. There’s been more than 300% increase in the last thirty years. How much better off are we health wise than 1990? 1945, sure, but 1990?

Gibbon1 7y ago
What you are arguing against is a classic smoke and mirrors job where two unrelated things are linked together. If you look outside the US you see similar huge gains in life expectancy. Which are 95% due to basic public health measures. Seriously: Life expectancy Cuba: 79.18 years. Life expectancy US: 79.11
- IkmoIkmo 7y ago
  I don't live in, or look at exclusively at the US. In western europe for example there've been massive increases in healthcare costs, too. These are socialised, citizens don't pay them through their insurance package, but they're paid by society (citizens) through taxes for sure. And these have created large gains. Cuba is a poor example because it prioritises health over everything else. That's not a value judgement, rather that it's just an outlier. If you mandate in a dictatorial government that people should be doctors and work for a humble salary, then of course you'll see good healthcare outcomes for little money.
  - vinay427 7y ago
    > These are socialised, citizens don't pay them through their insurance package, but they're paid by society (citizens) through taxes for sure. This isn't true for much of western Europe which doesn't have a single-payer model. Subsidies and regulations are more abundant than in the US, certainly, but for example everyone where I live in western Europe has to pay out of pocket for insurance premiums and deal with deductibles, etc.
- yostrovs 7y ago
  Only those that never lived under communism would believe those numbers. Same as the information on the coronavirus from China. https://www.econlib.org/about-that-cuban-life-expectancy/ https://www.econlib.org/about-that-cuban-life-expectancy/
  - Gibbon1 7y ago
    You can make a similar argument that Cuba and China's literacy rate is very low because they're communists.
    - yostrovs 7y ago
      You can argue anything you want. I just don't believe the numbers reported. Not for healthcare in Cuba, not the virus in China. And literacy rates in communist countries were made high so kids will be indoctrinated into Lenin as quickly and thoroughly as possible. That's the only reason.
  - arcticbull 7y ago
    Sure if you just pretend, anything's possible! Your article begins with: "Wealth and health are correlated because greater wealth can buy better health care." Wealth is not the only way to obtain good health outcomes, Cuba has a ton of doctors and they don't get paid massive, overwhelming salaries. Just because they don't get paid outsized amounts doesn't mean they're bad at their jobs. Based on all the OECD charts, there's very much a point of diminishing returns re: spending on healthcare and outcomes -- and very much so re: life expectancy. [1] It's pretty clear that spending 8X as much money didn't make people live 8X longer. [1] https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus https://ourworldindata.org/the-link-between-life-expectancy-...
    - yostrovs 7y ago
      I lived in the most prosperous communist country and I know for a fact that the numbers reported are lies. You are free to believe whatever you want since you haven't established the need for skepticism in this sphere. But when lied to often enough, folks like me KNOW were being lied to. Cuban healthcare is that perfect lie the ignorant fall for.
IkmoIkmo 7y ago
Agreed, the change is much less significant. Yet I was surprised that healthcare outcomes continued to improve during this time. Life expectancy has grown by almost 4 years since the 1990s, that's absolutely not insignificant. And there's good reason to believe that healthcare interventions have strongly improved, but that baseline health is much worse. Even stable healthcare outcomes would, if this is true, be evidence for interventions having improved. If you look at obesity levels for example (just google the charts), they're absolutely ridiculous and create a much larger burden (and cost) on healthcare interventions for the same outcome (e.g. life expectancy). The corollary is of course also true, which is that healthcare has improved due to many interventions not typically financed through healthcare costs / insurance. e.g. public health campaigns to stop smoking.
deleted 7y ago
[deleted]

Gibbon1 7y ago

What you are arguing against is a classic smoke and mirrors job where two unrelated things are linked together. If you look outside the US you see similar huge gains in life expectancy. Which are 95% due to basic public health measures. Seriously: Life expectancy Cuba: 79.18 years. Life expectancy US: 79.11

IkmoIkmo 7y ago
I don't live in, or look at exclusively at the US. In western europe for example there've been massive increases in healthcare costs, too. These are socialised, citizens don't pay them through their insurance package, but they're paid by society (citizens) through taxes for sure. And these have created large gains. Cuba is a poor example because it prioritises health over everything else. That's not a value judgement, rather that it's just an outlier. If you mandate in a dictatorial government that people should be doctors and work for a humble salary, then of course you'll see good healthcare outcomes for little money.
- vinay427 7y ago
  > These are socialised, citizens don't pay them through their insurance package, but they're paid by society (citizens) through taxes for sure. This isn't true for much of western Europe which doesn't have a single-payer model. Subsidies and regulations are more abundant than in the US, certainly, but for example everyone where I live in western Europe has to pay out of pocket for insurance premiums and deal with deductibles, etc.
yostrovs 7y ago
Only those that never lived under communism would believe those numbers. Same as the information on the coronavirus from China. https://www.econlib.org/about-that-cuban-life-expectancy/ https://www.econlib.org/about-that-cuban-life-expectancy/
- Gibbon1 7y ago
  You can make a similar argument that Cuba and China's literacy rate is very low because they're communists.
  - yostrovs 7y ago
    You can argue anything you want. I just don't believe the numbers reported. Not for healthcare in Cuba, not the virus in China. And literacy rates in communist countries were made high so kids will be indoctrinated into Lenin as quickly and thoroughly as possible. That's the only reason.
- arcticbull 7y ago
  Sure if you just pretend, anything's possible! Your article begins with: "Wealth and health are correlated because greater wealth can buy better health care." Wealth is not the only way to obtain good health outcomes, Cuba has a ton of doctors and they don't get paid massive, overwhelming salaries. Just because they don't get paid outsized amounts doesn't mean they're bad at their jobs. Based on all the OECD charts, there's very much a point of diminishing returns re: spending on healthcare and outcomes -- and very much so re: life expectancy. [1] It's pretty clear that spending 8X as much money didn't make people live 8X longer. [1] https://ourworldindata.org/the-link-between-life-expectancy-and-health-spending-us-focus https://ourworldindata.org/the-link-between-life-expectancy-...
  - yostrovs 7y ago
    I lived in the most prosperous communist country and I know for a fact that the numbers reported are lies. You are free to believe whatever you want since you haven't established the need for skepticism in this sphere. But when lied to often enough, folks like me KNOW were being lied to. Cuban healthcare is that perfect lie the ignorant fall for.

IkmoIkmo 7y ago

Agreed, the change is much less significant. Yet I was surprised that healthcare outcomes continued to improve during this time. Life expectancy has grown by almost 4 years since the 1990s, that's absolutely not insignificant. And there's good reason to believe that healthcare interventions have strongly improved, but that baseline health is much worse. Even stable healthcare outcomes would, if this is true, be evidence for interventions having improved. If you look at obesity levels for example (just google the charts), they're absolutely ridiculous and create a much larger burden (and cost) on healthcare interventions for the same outcome (e.g. life expectancy). The corollary is of course also true, which is that healthcare has improved due to many interventions not typically financed through healthcare costs / insurance. e.g. public health campaigns to stop smoking.

deleted 7y ago

[deleted]