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clouddrover

The US spends more per capita on health care than other OECD countries, even ones with universal public health care:

http://kff.org/health-costs/issue-brief/snapshots-health-car...

And yet the US has lower life expectancy than those countries:

https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...

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Infant mortality is also 75% higher in the US compared to France: https://www.cia.gov/library/publications/the-world-factbook/...

Most of the difference between US and other OECD countries in infant mortality is that the US has a much lower standard for what's considered a viable birth. Basically, lots of what in France are classified as still births would be infant deaths in the US.

Using: http://chartsbin.com/view/1445 and https://en.wikipedia.org/wiki/List_of_countries_by_infant_mo...

births out of 1000 that are stillbirths:

France 3.87

UK 3.50

USA 2.95

Germany 2.43

Infant Mortality (under 5) per 1000 live births

USA 5.87

UK 4.38

France 4.30

Germany 3.70

Combining the two for a birthed (Still or not) and didn't make it to 5 rate:

USA: 8.8

France: 8.2

UK: 7.9

Germany: 6.1

Obviously the studies aren't matched, but it does suggest that the variance isn't as great as either statistic shows, and there likely is a very strong ranking.

Now refine that down to college educated nonndrug using people. I suspect it would be even more narrow.

Why would one take a subset of healthy people in a comparison?

If anything, healthcare systems ought to be ranked on the life expectancies of the bottom percentile. Making a great health care system for the not-poor, not-addicted and those without preexisting conditions isn't a hard problem.

Part of the difference in mindset might be that addiction or poverty is partly seen as self inflicted in the US whereas I would always classify both as being mostly beyond the control of the individual. Even with our socialized medicine rich people eat bettter, excercise more, stress less and thus live longer. I'm glad our healthcare system offsets the life expectancy difference down to 5-10 years between me and a poor person, and I'm happy to pay for it.

Because you are now selecting for that which is untreatable, assuming access to finance and an education of the parents are the primary factors in treatable deaths.

If that is the case the interesting comparison would be the rate for the populace excluding those people.

Here is data that suggests infant mortality ranges from 9.6 in Mississippi to 4.2 in MA. So by this metric, infant mortality is in fact LOWER for many people than in France (or many parts of Europe).

http://kff.org/other/state-indicator/infant-death-rate/?curr...

Could downvoter(s) explain?

He's literally asking us to disregard the health outcomes for a particularly vulnerable section of society. That strongly implies that these people aren't worth factoring in to our evaluation of a healthcare system, that their health simply doesn't matter.

On a purely statistical level, it makes very little sense. Does he believe that poverty and drug addiction are uniquely American phenomena? Does he believe that the healthcare system has no impact on the number of people with drug addictions or chronic poverty-related diseases?

On the other hand, if you want to compare the enormous, diverse US to tiny, homogeneous EU countries 1-1, that's somewhat disingenuous as well.

I'm pointing out that you are comparing apples to oranges.

France is closer in composition to New Hampshire than the US as a whole.

So comparing health outcomes of the US as a whole to France is wrong.

Compare health outcomes of say New Hampshire or Vermont to France....

This is the same mistake the news and popular politicians use to exploit the groupthink. "Look how bad the US is at X compared to this homogenous European country". Be it prison rate or poverty level or what have you.

>France is closer in composition to New Hampshire than the US as a whole.

Does New Hampshire have any cities where 30-40% of the population are Muslim?

http://www.pbs.org/newshour/bb/resentment-growing-christians...

To describe France as homogeneous is utterly, profoundly ignorant.

Compared to the United States, it is.

If you want actual numbers, you can start here:

https://en.wikipedia.org/wiki/List_of_countries_ranked_by_et...

It is not a huge difference, but it's there. I wouldn't consider religion the top factor to pivot on, I would consider things like native language a better model.

Here is data that suggests infant mortality ranges from 9.6 in Mississippi to 4.2 in MA. So by this metric, infant mortality is in fact LOWER for many people than in France (or many parts of Europe).

http://kff.org/other/state-indicator/infant-death-rate/?curr...

The fundamental problem to solve, though, is getting money back out of medicine. American doctors get paid ridiculous amounts more than doctors in other developed nations. If you want affordable medicine, then medical salaries are going to have to take a hit, so you can afford more staff overall.

An example of how much money is in the system: I was talking to a nurse in the US whose adult son had a series of mental illnesses. She was going to see a specialist neurologist about one of them. "Why not ask him about all of them?", asks I. Turns out that in the US, it's quite common for specialists to specialise into a single syndrome, and will happily reject similar things in their field that aren't their specialty. I was horrified - here are people that take a decade and a half of training, all to become a glorified lookup table. I used to work in a neuro lab myself, and while I could see a motor neuron specialist perhaps referring on a brain problem to someone more suitable, the idea that any of the doctors would only take patients with a single, prediagnosed syndrome... was just alien.

But in the US you can do that, and get ridiculous amounts of money for it.

And that hits the point that the US is very different in a lot of ways, and changing one of those things without changing the others is difficult.

Its harder to make health care cheaper because of the salaries, drug cost, hospital costs, etc.

A lot of those things are expensive because of education costs, housing cost, etc. And don't forget the lawyer happy culture that raises costs too.

Then once you fix that, you have to take into account the added cost of the current poor demographic, illegal immigration, etc.

Then when you fix that...etc etc etc.

Its a very complicated net of problems. Its not as simple as "LOL wave a wand and make it free".

It's made worse in that you have to kick down some people a few notches to have similar taxes (upper middle class would get taxed way more) combined with how a lot of people moved to the US because they did better $$ money with low taxes, and you'll have a lot of pissed off people.

Yes, all that needs to happen eventually, but it's very painful to actually do.

US doctors are paid more because they take risks (they have expensive education, handle expensive treatments etc)

If an MD cost zero to get, doctors would still be paid well, but not crazy well.

I will believe it a little bit more once the number of people who has the right to practice is not artificially capped.

'handle expensive treatments'? What, unlike doctors everywhere else? Apart from the education costs, what is different?

The US also takes in a lot of foreign-trained doctors, who don't have those same education costs.

The costs involved are higher (though or course of the same magnitude), but money seems ever present e.g the concept of malpractice insurance.

Foreign doctors can certainly help lower salaries for doctors but they need to be a large fraction, if they are a small fraction they'll just enjoy the high salaries of their US educated peers.

> The US spends more per capita on health care than other OECD countries, even ones with universal public health care:

Sure, but the French social security system (la secu) is completely bankrupt and survives only because France continues growing its national debt. NO matter how you look at it, all these health systems are not sustainable anywhere on Earth.

Germany introduced national health care in 1883 but I'm sure we'll see how unsustainable it is any day now.

Ok then, what about countries such as Canada or Germany? Universal healthcare, stable debt levels.

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