3 ms·
You know you're in trouble with all these kinds of analyses when they try to square up cost of care with life expectancy. The principal components in life expe
by tptacek 5mo ago
You know you're in trouble with all these kinds of analyses when they try to square up cost of care with life expectancy.
The principal components in life expectancy difference between the US and the other OECDs are car accidents, homicides, and CVD. Obviously, accidents and homicides aren't a function of the health care system; they're a function of the atypical dependence the US has on cars and its wildly atypical availability of firearms. Though: it is worth noting that the OECD definition of "preventable deaths" includes vehicular accidents!
But even the CVD statistics are misleading in a comparison like this. CVD outcomes are heavily regionalized in the US. The New England states have CVD outcomes comparable to western Europe. But go to Mississippi and Alabama and we look like a developing country. There's a lot of stuff going into that difference, but the key thing here is that the structural design of the health system is the same in both regions.
There's a lot not to like about the US system of employer-paid health insurance. But these kinds of critiques are frustrating and a little unserious, and it annoys me that this article assumes its readers won't dig into the crosstabs and will just take the comparison on faith. That's disrespectful to readers.
- t0mpr1c3 5mo agoIf you look just at differences in treatment, ignoring preventable deaths, the disparity in mortality between the USA and other rich countries is just as evident. This is a long-standing fact. It's difficult to interpret without concluding that something is badly wrong with US healthcare provision. Plenty of people out there trying, though
- tptacek 5mo agoI don't think this is true. Check out: Causes of America’s Lagging Life Expectancy: An International Comparative Perspective (Jessica Ho); there's an amazing chart in the middle that breaks causes down between countries. This squares with a general observation about US healthcare, which is that it is expensive and overprovisioned and generally achieves marginally better outcomes for a variety of common serious conditions, which is also what you'd expect if you've had extended contact with the system.
- t0mpr1c3 5mo agoThat sounds about right, if you ignore disparity of access to treatment, and look narrowly at the quality of the treatment itself. 25 million Americans do not have health insurance. Looking just at treatable mortality (so not preventable deaths from cars and guns) the international ranking of mortality statistics changes only slightly. USA remains below the OECD average, behind comparably rich nations, down among middle income nations like Peru. https://www.oecd.org/en/publications/health-at-a-glance-2023_7a7afb35-en/full-report/avoidable-mortality-preventable-and-treatable_e7407977.html#title-ab071a3f22 https://www.oecd.org/en/publications/health-at-a-glance-2023...
- tptacek 5mo agoI don't know what you're showing me here. This is a table ranking all causes of avoidable death, which includes things like gunshot wounds.
- t0mpr1c3 5mo agoEnough sealioning. There are two charts. One is avoidable deaths. The other is treatable deaths. It doesn't matter which definition you use, USA is near the bottom of the table.
- tptacek 5mo agoIf you'd like to disengage, simply disengage. Incivility hurts your argument. Obviously, the US leads on avoidable deaths! We have huge numbers of car accidents, homicides, and drug overdoses. We also have huge amounts of CVD, but as I explained above, that's a regional phenomenon and the health care systems are the same in both kinds of regions. You keep coming back with data that begs the question.
- t0mpr1c3 5mo agoIt doesn't. You just don't understand the terminology.