On a recent business trip, I picked up a copy of Scientific American magazine at an airport news stand to read on the plane.
I’m not a regular reader. I was a put-off by the lead editorial in the magazine, Physician Heal The System. In it, the editors conclude:
It [the U.S.] spends far more per capita than any other industrial nation, yet all that money fails to buy the best care.
And how did they determine what the “best care” is? They at least mention more than life expectancy. But, that’s the only stat they expand on.
In terms of people’s level of disability, the care they receive for chronic conditions, and their life expectancy, the U.S. ranks below many other countries that spend much less. Compared with the average American, the average citizen of France or Israel lives three years longer, the average Australian four years, and the average Japanese five years.
But, the fact that they even included life expectancy and then gave actual figures on it alone made me think that the editors are not scientific, but rather political.
It doesn’t take much scientific thinking to figure out that life expectancy is not a good measure on which to make cross country comparisons on the quality of medical care because there is much more that influences life expectancy.
For example, Americans, drive more miles on average than citizens of other countries that happen to have taxpayer provided medical care. Driving more miles increases the chances of dying in a car accident and is not related to the quality of the medical system.
That’s just one non-medical care factor. There are others. Rates of obesity, age composition of the population, smoking habits, alcohol and drug abuse and ethnic diversity also contribute to the differences in life expectancy and also have nothing to do with the quality of medical care.
I think most people are intuitively skeptical of the life expectancy/quality of medical care link. If it were true that we could get three to five years longer lives simply by moving to these countries to take advantage of their high quality and “free” health care systems, wouldn’t more people be moving out of the U.S. to these countries? Aren’t we shortening our children’s lives by raising them in this country with high-cost, lower quality medical care?
Thomas Sowell discusses this topic in his column today and its worth a read. He writes:
But supporters of government medical care show virtually no interest in such realities [actual quality of medical care in those countries]. Their big talking point is that the life expectancy in the United States is not as long as in those other countries. End of discussion, as far as they are concerned.
They have no interest in the reality that medical care has much less effect on death rates from homicide, obesity, and narcotics addiction than it has on death rates from cancer or other conditions that doctors can do something about. Americans survive various cancers better than people anywhere else. Americans also get to see doctors much sooner for medical treatment in general.
In the same issue of Scientific American magazine, just a few pages later, writer Jessica Wapner explores why rates of HIV are so high in the southern U.S. Amazingly, she didn’t just assume medical care quality as the sole reason for this statistical disparity. She writes:
As with all these other health problems, however, addressing the HIV epidemic in the southern U.S. requires much more than just having effective and affordable medicine. It demands an understanding of why individuals in the South turn out to be particularly likely both to delay testing and to seek medical attention only in the later stages of HIV infection, when it is most difficult to treat.
Nice job Jessica. Perhaps you can teach your editors something. I would like to reword your passage as such:
As with all these other health problems, however, Addressing the life expectancy variations HIV epidemic between in the countries southern U.S. requires much more than just having effective and affordable medicine. It demands an understanding of why individuals in the U.S. South turn out to be particularly more likely both to delay testing and to seek medical attention only in the later stages of HIV infection, when it is most difficult to treat to engage in life shortening behavior.