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    Life Expectancy and Health Care Spending



    http://www.stat.columbia.edu/~cook/m...thscatter2.png

    I came across this very interesting graph showing the relationship between life expectancy and spending on health care by the countries. The U.S.A. is far off the scale on the right. By the way, I don't want to make this a political thread and therefore posted it in the SMT forum rather than the Politics Forum.

    #2
    Interesting. So basically, all this money is going into our health care system, and we're not getting our moneys worth...

    Btw, where's Norway's bubble? Either it's expanded off the chart, or it's very mini haha. Neither of those would make sense.
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      #3
      I did notice Norway didn't get their circle.

      While this is interesting, but honestly not surprising - I don't think one can assume that we aren't getting our money's worth necessarily.

      First of all, this chart only shows length of life - not quality of life. For ex. you can live a long time with a wrecked hip, but live in pain and not able to walk. If you spend several years on a waiting list for a hip replacement... you live just as long, but not as well.

      Also, I think many americans have far worse diets, less exercise, and more obesity than much of Europe. Most of those european etc. countries have only 2 years more average life expectancy than the US.

      The difference from the US to the very top of the scale is only 4 years. And I suspect in Japan, at the very top, people eat a lot healther.

      I also wonder, if US were separated by social class, people with or without insurance etc. what the chart would show. My guess is that some groups would head to the top of the chart, and others would drop. Which, of course, would be evidence that everyone needs to be covered, somehow.

      I think that with the US only 4 years from the top, considering the diet and sedentary lifestyle here, this chart probably shows that the US medical care is pretty good.

      Comment


        #4
        I think theres something important thats being missed, all the countries at the top of the life expectancy list have a universal health system.

        Comment


          #5
          I pretty much commented upon that, saying you'd probably see differences in the US if you separated it by those who had insurance, and those who did not - probably also social class. Also referring to the quality of life, just not the duration.

          But who pays for the healthcare is only one factor - there are so many others. Diet, smoking, obesity, exercise.

          What I find most striking though, is that the differences are very small in years. For example, between the US and the UK there is only about 1 year. So despite their universal healthcare, and much less sedentary lifestyle, the US and UK are almost the same in longevity.

          Being at the top of a list, or the bottom, becomes somewhat irrelevant if the difference between the top and bottom are small.

          And again, quality of life counts as well as quantity (duration).

          So while this chart is somewhat interesting, I don't think it begins to address the entire picture (nor was it intended to, that's no criticism of the chart).

          Comment


            #6
            Quality of care (though it needs to improve) is not the primary issue in USA health care delivery. Affordability and availability is the problem. No matter how you slice and dice the numbers, the US is paying too much for too little under the current system. The economics of our current system are taking our country off a cliff and the speed is increasing.

            As to quality of life... the US longevity numbers would be much lower if we didn't spend a fortune keeping people alive on dialysis, respirators, and other means of extending the lives of very sick people for extended periods of time. Four years is a very significant number in this context.
            Originally posted by TAM63 View Post
            I did notice Norway didn't get their circle.

            While this is interesting, but honestly not surprising - I don't think one can assume that we aren't getting our money's worth necessarily.

            First of all, this chart only shows length of life - not quality of life. For ex. you can live a long time with a wrecked hip, but live in pain and not able to walk. If you spend several years on a waiting list for a hip replacement... you live just as long, but not as well.

            Also, I think many americans have far worse diets, less exercise, and more obesity than much of Europe. Most of those european etc. countries have only 2 years more average life expectancy than the US.

            The difference from the US to the very top of the scale is only 4 years. And I suspect in Japan, at the very top, people eat a lot healther.

            I also wonder, if US were separated by social class, people with or without insurance etc. what the chart would show. My guess is that some groups would head to the top of the chart, and others would drop. Which, of course, would be evidence that everyone needs to be covered, somehow.

            I think that with the US only 4 years from the top, considering the diet and sedentary lifestyle here, this chart probably shows that the US medical care is pretty good.
            Last edited by Foolish Old; 15 Jan 2010, 9:34 AM.
            Foolish

            "We have met the enemy and he is us."-POGO.

            "I have great faith in fools; self-confidence my friends call it."~Edgar Allan Poe

            "Dream big, you might never wake up!"- Snoop Dogg

            Comment


              #7
              I've never argued on the availability issue.

              I personally don't think that the number of people on respirators is enough to significantly affect these statistics. As far as keeping sick people on dialysis alive - well, I certainly hope you are not arguing against that. Again, I doubt that the numbers are significantly affected.

              My personal belief is that lifestyle and the availability of medical care is causing the difference in years - and I still think that the difference in years (really 1 to 2 or3 in most cases) is not that significant. I suspect it's probalby entirely accounted for by the lifestyle and availability of care. If the best care here was available to everyone, and lifestyle factored in, I suspect the US would do very well indeed on such charts as far as longevity.

              Cost, yeah, it does cost a lot.

              Comment


                #8
                If wishes were horses, beggars would ride. You can argue adjustments to the US statistic all day. The system is what the system is - broken and unsustainable.

                No, I am not arguing against care of very sick people, but you made the point about "quality of life, just not the duration". I made the point that if you removed the years of life diminished by serious illness, the US longevity statistic would compare even less favorably to other nations.

                I continue to disagree with your statement that the difference in longevity between nations is insignificant, especially as a measure of value.
                Originally posted by TAM63 View Post
                I've never argued on the availability issue.

                I personally don't think that the number of people on respirators is enough to significantly affect these statistics. As far as keeping sick people on dialysis alive - well, I certainly hope you are not arguing against that. Again, I doubt that the numbers are significantly affected.

                My personal belief is that lifestyle and the availability of medical care is causing the difference in years - and I still think that the difference in years (really 1 to 2 or3 in most cases) is not that significant. I suspect it's probalby entirely accounted for by the lifestyle and availability of care. If the best care here was available to everyone, and lifestyle factored in, I suspect the US would do very well indeed on such charts as far as longevity.

                Cost, yeah, it does cost a lot.
                Foolish

                "We have met the enemy and he is us."-POGO.

                "I have great faith in fools; self-confidence my friends call it."~Edgar Allan Poe

                "Dream big, you might never wake up!"- Snoop Dogg

                Comment


                  #9
                  Considering also that in some countries euthanasia is allowed and in others discreetly unofficially practised, this also must have a significant effect.

                  Comment


                    #10
                    I don't know the date for this chart, but the cost is through the roof here in Norway, not to talk about the US but the same there. The elderly wave will not kick in before 2012, then imagine. Currently over here we have huge total reforms ongoing with the aim to introduce some of these reforms later this year. The cost will increase as the population gets older, also due to new expensive techniques to threat more and more conditions. Typical lifestyle illnesses will also play a role in Europe, EU has for example set focus on diabetes type 2 which is exploding. Still the cost must be controlled and the cost must be taken care of because like it now is for some counties this can't continue, it could down the road damage the total economy. One has to streamline the total system, remove bottlenecks and improve the system where it fails. Not long ago in Oslo there was this story one hospital had to use cab's to send x-rays to some other specialists to have it examined, in 2009? Imagine? Clearly there are room for improvements, and that must be taken care of. Maybe the reason Norway don't have any bubble is that some thinks that Norway should pay for all

                    Comment


                      #11
                      Originally posted by Foolish Old View Post
                      If wishes were horses, beggars would ride. You can argue adjustments to the US statistic all day. The system is what the system is - broken and unsustainable.

                      No, I am not arguing against care of very sick people, but you made the point about "quality of life, just not the duration". I made the point that if you removed the years of life diminished by serious illness, the US longevity statistic would compare even less favorably to other nations.

                      I continue to disagree with your statement that the difference in longevity between nations is insignificant, especially as a measure of value.
                      I think we'll probably just have to disagree on some points

                      I'm sure there's stats all over, "proving" all sorts of things.

                      My main point though, is that what may be different in the US from the other nations, is that there's a group of people who get imo excellent health care. And a group that does not. In the other nations, it's perhaps more even.

                      If the US moved everyone into the first group, I truly believe we'd increase longevity. Hopefully that will one day occur.

                      As far as years spent in poor health - this study doesn't address that - there could be lots of people spending years in poor health in the other countries as well.

                      And I truly believe that the lifestyle choices in the US are a huge contributer.

                      As far as costs being unsustainable, true enough - but we are not the only country with that problem.

                      Comment


                        #12
                        Originally posted by ian View Post
                        Considering also that in some countries euthanasia is allowed and in others discreetly unofficially practised, this also must have a significant effect.
                        I understand what you're saying - but do you really think the numbers are high enough to make a difference in this overall statistic? You think there are that many?

                        Not saying you're wrong, but the idea really raises my eyebrows I guess.

                        Comment


                          #13
                          Originally posted by TAM63 View Post
                          I understand what you're saying - but do you really think the numbers are high enough to make a difference in this overall statistic? You think there are that many?

                          Not saying you're wrong, but the idea really raises my eyebrows I guess.
                          Universal health care systems dont have unlimited resources so medical professionals are faced constantly with the decisions of where and who to allocate the resources they do have, this is the bitter truth about socialised health.

                          Comment


                            #14
                            Originally posted by TAM63 View Post
                            I think we'll probably just have to disagree on some points

                            You are always welcome to change your view to a more evidence based conclusion.

                            I'm sure there's stats all over, "proving" all sorts of things.

                            But only the most tortured of statistics argue that we have a health care system that delivers good value.

                            My main point though, is that what may be different in the US from the other nations, is that there's a group of people who get imo excellent health care. And a group that does not. In the other nations, it's perhaps more even.

                            Yes, that is a good feature of their systems that gives them a higher longevity statistic. I imagine that on average the rich in other countries are also among the most long-lived of their citizens.

                            If the US moved everyone into the first group, I truly believe we'd increase longevity. Hopefully that will one day occur.

                            Yes, and if we housed the homeless, the statistic for homelessness would go down. But again, it is what it is.

                            As far as years spent in poor health - this study doesn't address that - there could be lots of people spending years in poor health in the other countries as well.

                            Then you agree that if you raise QoL as a problem in other countries, that we must consider that we have patients in the US with the same concerns?

                            And I truly believe that the lifestyle choices in the US are a huge contributer.

                            As far as costs being unsustainable, true enough - but we are not the only country with that problem.

                            The notable difference is that other countries are providing health care to ALL citizens - and at a much lower percentage of GDP.
                            .....
                            Foolish

                            "We have met the enemy and he is us."-POGO.

                            "I have great faith in fools; self-confidence my friends call it."~Edgar Allan Poe

                            "Dream big, you might never wake up!"- Snoop Dogg

                            Comment


                              #15
                              Originally posted by TAM63 View Post
                              My personal belief is that lifestyle and the availability of medical care is causing the difference in years - and I still think that the difference in years (really 1 to 2 or3 in most cases) is not that significant. I suspect it's probalby entirely accounted for by the lifestyle and availability of care. If the best care here was available to everyone, and lifestyle factored in, I suspect the US would do very well indeed on such charts as far as longevity.

                              Cost, yeah, it does cost a lot.
                              The difference in years may be only 1-3 in most cases, which may seem insignificant, but when the difference is TWICE the money spent, then it does become significant.

                              For example, while the UK spends under 3000 per L.E. of <79 and the U.S. spends more than 7000 per L.E. of >78, the difference in Life Expectancy is less than 1 year, but the U.S. spends MORE than double in Healthcare than the U.K.. Spending more than twice the monies for such insignificant gain, is very significant.

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