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> If you have the means to afford it, the US healthcare system is one of if not the best in the world. This is untrue according to all metrics I have seen (suc

by hedora 3y ago

> If you have the means to afford it, the US healthcare system is one of if not the best in the world. This is untrue according to all metrics I have seen (such as life expectancy). Do you have any evidence to back this statement up?

shuckles 3y ago
The drivers of poor US life expectancy is mostly guns and cars. Cars are the #1 killer of Americans between 5 and 45 (approximately). That doesn’t have much to do with the medical system.
- andsoitis 3y ago
  Leading causes of death in the US: https://www.healthline.com/health/leading-causes-of-death https://www.healthline.com/health/leading-causes-of-death 10 of the leading 12 causes of death are diseases, with the first non-disease cause coming in at #4.
  - shuckles 3y ago
    Someone dying a few years earlier than otherwise has a smaller impact on _life expectancy_ than someone dying young. Furthermore, the #1 cause is correlated with lifestyle factors which medical treatment has little control over. You can see the breakdown of life expectancy reducing factors here, none of which are attributable to "limited specialized treatment": https://ourworldindata.org/us-life-expectancy-low https://ourworldindata.org/us-life-expectancy-low
  - nradov 3y ago
    You missed the point. Cancer and heart disease primary kill people when they're already old. Treatment of those diseases, while important and necessary, doesn't impact average life expectancy much either way. Whereas fentanyl overdoses are now the leading cause of death for adults 18 - 45. That has a huge impact on average life expectancy because those people would have otherwise lived many more years. https://www.gbhoh.com/fentanyl-becomes-leading-cause-of-death-for-ages-18-45/ https://www.gbhoh.com/fentanyl-becomes-leading-cause-of-deat...
    - andsoitis 3y ago
      OK, here are the leading causes of dying at various age groups: https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2018-508.pdf https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_dea... and unintentional injuries comprising: https://www.cdc.gov/injury/wisqars/leadingcauses.html https://www.cdc.gov/injury/wisqars/leadingcauses.html I still fail to see cars and guns being the leading cause of death. Do you see something I don't?
      - nradov 3y ago
        Your information is outdated. The rate of accidental death among younger adults due to opioid poisonings has increased significantly in just the last few years. https://peterattiamd.com/anthonyhipolito/ https://peterattiamd.com/anthonyhipolito/ https://www.statesman.com/story/news/politics/politifact/2022/10/02/fact-check-fentanyl-leading-cause-of-death-among-adults/65417990007/ https://www.statesman.com/story/news/politics/politifact/202...
        andsoitis 3y ago
        > death among younger adults due to opioid poisonings The point under debate is guns and car accidents being asserted as the leading cause of death. I continue to assert it is not true.
        shuckles 3y ago
        My primary assertion was that life expectancy does not inform you about the quality of the US medical system. I focused on guns and cars, but adding opioids (and even lifestyle issues like obesity) doesn’t change my argument or the conclusion.
nradov 3y ago
It depends on which metric you look at. The USA is at or near the top in 5-year survival rates for most types of cancer. We also have unrivalled trauma care. In other metrics we're well many behind other developed countries. Many of our worse outcomes though have nothing to do with the healthcare system. The decrease in life expectancy is being driven by factors like obesity, substance abuse, sedentary lifestyles, vehicle crashes, suicide, and violence.
- adgjlsfhk1 3y ago
  survival rates are a pretty bad metric because you can easily change them by changing the amount of screening without making people live longer or healthier. when you compare cancer mortality rates, the US is not doing well.
  - nradov 3y ago
    Nope. Certain types of cancer screening are helpful in making people live longer and healthier. It is much easier to treat cancer when it is caught early.
    - adgjlsfhk1 3y ago
      Absolutely, but 5 survival rates are still a really bad metric because they make things look better even for uncurable cancer (or cancer that was curable but treatment was given up on because of price). Also, if a 90 year old gets a slow growing cancer that doesn't require treatment (cause they'll be dead before it's a problem), screening for it will increase survival rates even though you didn't actually treat anything.

by hedora 3y ago

shuckles 3y ago

The drivers of poor US life expectancy is mostly guns and cars. Cars are the #1 killer of Americans between 5 and 45 (approximately). That doesn’t have much to do with the medical system.

andsoitis 3y ago
Leading causes of death in the US: https://www.healthline.com/health/leading-causes-of-death https://www.healthline.com/health/leading-causes-of-death 10 of the leading 12 causes of death are diseases, with the first non-disease cause coming in at #4.
- shuckles 3y ago
  Someone dying a few years earlier than otherwise has a smaller impact on _life expectancy_ than someone dying young. Furthermore, the #1 cause is correlated with lifestyle factors which medical treatment has little control over. You can see the breakdown of life expectancy reducing factors here, none of which are attributable to "limited specialized treatment": https://ourworldindata.org/us-life-expectancy-low https://ourworldindata.org/us-life-expectancy-low
- nradov 3y ago
  You missed the point. Cancer and heart disease primary kill people when they're already old. Treatment of those diseases, while important and necessary, doesn't impact average life expectancy much either way. Whereas fentanyl overdoses are now the leading cause of death for adults 18 - 45. That has a huge impact on average life expectancy because those people would have otherwise lived many more years. https://www.gbhoh.com/fentanyl-becomes-leading-cause-of-death-for-ages-18-45/ https://www.gbhoh.com/fentanyl-becomes-leading-cause-of-deat...
  - andsoitis 3y ago
    OK, here are the leading causes of dying at various age groups: https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_death_by_age_group_2018-508.pdf https://www.cdc.gov/injury/wisqars/pdf/leading_causes_of_dea... and unintentional injuries comprising: https://www.cdc.gov/injury/wisqars/leadingcauses.html https://www.cdc.gov/injury/wisqars/leadingcauses.html I still fail to see cars and guns being the leading cause of death. Do you see something I don't?
    - nradov 3y ago
      Your information is outdated. The rate of accidental death among younger adults due to opioid poisonings has increased significantly in just the last few years. https://peterattiamd.com/anthonyhipolito/ https://peterattiamd.com/anthonyhipolito/ https://www.statesman.com/story/news/politics/politifact/2022/10/02/fact-check-fentanyl-leading-cause-of-death-among-adults/65417990007/ https://www.statesman.com/story/news/politics/politifact/202...
      - andsoitis 3y ago
        > death among younger adults due to opioid poisonings The point under debate is guns and car accidents being asserted as the leading cause of death. I continue to assert it is not true.
        shuckles 3y ago
        My primary assertion was that life expectancy does not inform you about the quality of the US medical system. I focused on guns and cars, but adding opioids (and even lifestyle issues like obesity) doesn’t change my argument or the conclusion.

nradov 3y ago

It depends on which metric you look at. The USA is at or near the top in 5-year survival rates for most types of cancer. We also have unrivalled trauma care. In other metrics we're well many behind other developed countries. Many of our worse outcomes though have nothing to do with the healthcare system. The decrease in life expectancy is being driven by factors like obesity, substance abuse, sedentary lifestyles, vehicle crashes, suicide, and violence.

adgjlsfhk1 3y ago
survival rates are a pretty bad metric because you can easily change them by changing the amount of screening without making people live longer or healthier. when you compare cancer mortality rates, the US is not doing well.
- nradov 3y ago
  Nope. Certain types of cancer screening are helpful in making people live longer and healthier. It is much easier to treat cancer when it is caught early.
  - adgjlsfhk1 3y ago
    Absolutely, but 5 survival rates are still a really bad metric because they make things look better even for uncurable cancer (or cancer that was curable but treatment was given up on because of price). Also, if a 90 year old gets a slow growing cancer that doesn't require treatment (cause they'll be dead before it's a problem), screening for it will increase survival rates even though you didn't actually treat anything.