Industrialized Health: Follow-Up

Due to several comments received after this post showing the U$D amounts spent by various governments on healthcare per capita for their citizenry, a follow-up. Below are selected health indicators found on the World Health Organization’s website. These indicators are topline figures for general comparisons between countries. As a tribute to Raymond van het Groenewoud, Belgium has been added to the mix of data:

Source, WHO

Please spot the huge differences.

Child mortality rates? Compare each country in conjunction with the fertility rate figure, more/less children being born may play a role. If you feel that is a wrong analysis, please explain why countries with lower fertility rates have an equal or higher number of deaths as do countries with higher fertility rates, as well as vice versa.

Life expectancy? Again where is the huge difference? 2 to 4 years, wow. Given media accounts of the number of Americans “uninsured” and how terrible life is in the US one would expect life expectancy to be in the 60’s. There are many trade-offs in life. I for one would happily trade-off 2 years at the end of my life for the ability to provide for my family, upward economic mobility, or even the hopes of these things versus spending large stretches of my life (10+ years) dealing with economic stagnation/decline and the strain of double-digit unemployment, year after year after year after year... (you know who you are)

The above are general stats. No rational person can point to the “horrid” nature of American medical care when looking at these health indicators.

What about specific country information. The WHO also has a Mortality Database. Not the most pleasant of topics, but most reading this blog are indeed adults. Per 100,000 people of a particular country, what is the rate of death for:

Source, WHO (latest reporting year)

America’s market-based healthcare system leaves citizens dead and dying from all causes. Perfect government-run healthcare systems seem to leave citizens dead and dying too, only at a higher rate from all causes.

Problems with cost in America's health insurance system, absolutely. Problems with care in America’s healthcare system, think again.

Perhaps Raymond should donate the royalties from his anti-American screed to organizations improving the quality of life in Belgium. When it comes to life-ending diseases the “general decay” seems to be a little more closer to home for our Belgian troubadour of hate.

different way of counting

The US counts all children born alive in its infant mortality rates, while many/most other countries only count "viable" live births. If a child is born with defective lung condition and only lives 10 seconds outside the womb, it will be countend in the US mortality rate, but not in many of the European rates.

I don't know if WHO normalized this data or not, but it needs to be stated.

Since the WHO lists the

Since the WHO lists the suicide rate in Egypt as ZERO, I daresay they do not do much interpretation of the numbers.

You do have to make sure, when comparing such statistics between countries, that the two are counting the same way. With infant mortality, as has been pointed out, they DO NOT count the same way on the different sides of the Atlantic.

When you correct for the very premature births in the USA, in other words, count them as miscarriages as they do in Europe, the mortality difference evaporates.

First of all, the child

First of all, the child deaths are per/1000, so the absolute fertility rate shouldn't matter. And while the child mortality rate in the US isn't horrible, it is also obvious that it IS higher than in the other countries mentioned.

Secondly, your claims about mortality are skewed by the fact that the US has a much younger population than European countries do. Remember that the "per/100,000" is for population, not deaths. Notice that Canada, which also has a young population (for the same reasons the US does) has a much lower mortality rate than the US.

George, you seem to be arguing against the fact that US heathcare isn't horrible... but that's just a strawman! Nobody denies that the US has fabulous healthcare facilities, perhaps the best in the world. But if you're looking at how the people in a country are doing overall, it's clear that other countries are doing a better job and still paying less in the process. Look at your previous article, where you show that Americans are paying, both personally AND THROUGH TAXES far more than Europeans do.

Ask anyone if they would accept doubling their healthcare costs to receive a 5% cut in their lifespan and they would wonder if you were crazy. But that is the what you are asking someone in Europe what they think of the US system.

I'm not claiming that the European style of national healthcare is perfect, there are obviously many many problems. But the US system is broken too, just in different (and more expensive) ways.

The promise of a market-based healthcare system is that it is supposed to be cheaper and better than a nationalized one. And it may well be, just don't look to the United States as an example of it.

Set aside the fertility

Set aside the fertility rates when looking at things like infant mortality and lifespan. Make sure the countries in question are using the same technique when counting an infant mortality in the first place. Like is one country counting a very premature birth as a live birth (because it's alive) even though it will be dead in a day or so because it's very premature? Is the other country taking that same baby and calling it a spontaneous abortion (miscarriage)?

For all-cause mortality, bear in mind that a lot of that is genetic, and marches right through countries. What I mean is, Japanese live long lives, whether they are in Japan, the USA, or Europe. Blacks have shorter statistical life spans, smaller babies, just a couple examples, whether they are in Africa, Europe, or the USA, and even when corrected for socioeconomic status.

These broader lifespan issues reflect genetics, and reflect socioeconomic and public health issues, really not affected by medicine and medical care.

Where your statistics are important is it reflects the conditions where medicine really makes a difference.....treating specific diseases. Cancer. Heart Disease. There are plenty of countries with longer lifespans than the USA. But when someone has a specific disease and is looking for the "best" treatment, the USA wins. Just because the Japanese live longer statistically, it does not follow that when one has cancer and is looking for state-of-the-art treatment, you go to Tokyo for treatment.

This being said with all due respect to the Japanese, Europeans, etc., I am not foolish enough to think that the USA has a monopoly on good physicians and medical care.

Read this reference:
Lives at Risk: Single-Payer National Health Insurance Around the World (Paperback)
by John C. Goodman, Gerald L. Musgrave, Devon M. Herrick
List Price: $22.95

# Paperback: 261 pages
# Publisher: Rowman & Littlefield Publishers (July, 2004)
# Language: English
# ISBN: 0742541525

You can find a lot of the information, though a little older, on this Web site:

Missing information / Impossible to cover everything


Let's try to include everything in the equasion. Do we have 1500 pages?

Many of the health problems in the States are more related to lifestyle than the quality or availabiity of healthcare. The Japanese live longer because they live healthier. Figures on the newer generation of Japanese show they are becoming much more vulnerable to health risks because the quality of their diet and lifestyle are deteriorating.

The air in Canada is less polluted than in the population centers of the U.S. and McDonald's is not well known for building restaurants where their are 2.5 people per square mile, so they also have less risks.

Based on health care alone, the U.S. gets a bad rap because the statistics don't explain why. The U.S. does not have a healthcare problem, it has a lifestyle problem. If Americans lived as healthy as traditional Japanese or Norwegians, they'd have a life expectancy of 85 - 90.