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Comment by yboris | Hacker News Reader

Is life expectancy measured from 5 years old onwards, or from 1 second old?

It's frustrating to see numbers thrown around about how much life expectancy rose over the years in the past, only to discover that the average was so low because so many kids never made it past 5 years old. Why would including those deaths be in any way informative for people alive? That average tells me almost nothing about my life expectancy! :(

The article never mentions it, but the graph says "at birth" is the starting point.

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Maybe the article was updated since you read it? It goes into their methodology:

"Arias and her colleagues calculated life expectancy using a technique called a period life table. This involved the researchers imagining a group of 100,000 hypothetical infants and applying the death rates observed for the real population in 2021 for each year of those infants’ lives. The result is not the life expectancy for a cohort of actual babies born in 2021 but rather a snapshot of how life expectancy rates would apply to various age groups at a specific point in time, Arias says."

Life expectancy is a weird one, not going to lie.

All the numbers are wrong from some perspective.

You mention a good one. The fact that life expectancy was so low in the past was due to infant mortality. If you lived to like 15 (IIRC), your life expectancy got much longer. Like 60s to 70s (once again, IIRC).

And that even holds today. The longer you live, the longer you can expect to live. If you're 70, you have a life expectancy of 14 (male) to 17 (female) years. If you're 80, you have a life expectancy of 7 (m) to 9 (f) years. If you're 90, you have a life expectancy of about 4 years.

And all of that seems kind of weird on the face. If I'm 70, I can expect to live 14 years on average. Which takes me to 84, which is greater than 80. But if I'm 80, I can expect to live to 87, which is greater than 84.

But it's the nature of averages. When I'm 70, I'm being average with other 70 year olds. Some of them die at 71, some at 93. Every year, more and more people drop off. If you make it to 80, all those who didn't make are no longer relevant.

Well that is a problem with all stats reporting. Infant Mortality is another one "journalists" love to beat the US health system over, never highlighting how the different stats are reported by different nations, or other factors that make the US infant Mortality rate naturally higher due to our reporting standards, and standard procedures.

Life Expectancy is not really a good guide for anything, it is just a number various political groups can use to influence public policy to their agenda

I mean, there is still a large portion of the US who simply don't get any form of preventative cure, doctors becoming extremely overworked and stressed from the impossible amount of diagnostic and billing paperwork, and rural hospitals regularly closing. I've found there are few defenders of the US healthcare status quo who aren't insurance reps or ideologs who have never had a lapse in coverage

You are correct that there is not much debate over the short comings of the US system, the debate is over what is the cause of those short coming, and what is the resolution.

I, and many others, believe government regulations is the cause including everything from the tax code that irrevocably links insurance to employment, to regulations that transform "insurance" to prepaid health plans, to medicare massively under paying providers, and about 10000 other things...

The "other side" believes government is the holy grail and will magically fix everything if we just make everything single payer medicaid for all...

The main argument I've heard is that healthcare is simply something in which an individual carriers no bargainning power. Death versus payment is a system which is ideal for capitalism to thrive because you can basically charge as much as an individual can bare. In such a system, any non-guaranteed solution will be flawed because the desires of the market (low cost/high profits) will never align with the desires of patients (affordable care/access to large amount of care).

The only way to break that paradigm is to guarantee access to care through some non revokable mechanism, which typically needs an entity like a state to provide (but could be run through a sufficiently large enough non-profit)

>>Death versus payment is a system which is ideal for capitalism to thrive

Which is a false dilemma, red herring and a strawman all in one.

The vast majority of health services / decisions are not life or death, far far from it. We can see that in area's where insurance is does not normally cover or is very limited. Dental Services, Vision, Cosmetic Surgery, etc etc

Even in "traditional" health care, the "urgent care" market is pretty competitive with providers having standardized price lists I can look up online and see which provider I want to go to.

For example about a year ago I had a trip and fall, my shoulder was in pain and I have a High Deductible insurance so everything would be out of pocket. I looked at the various providers near me, got their standard prices and went to one that provided the best value to me.

Market forces absolutely can be applied to 90% of medical care. For true Life and Death emergencies, a huge part of those will be covered under other insurances anyway like Home Owners, Car, etc. for the remainder will maybe that is a place for government regulations but that does not justify a full take over by the government

I'm pretty sure this was what Obama attempted (basically universal coverage for life threatening scenarios) and it was pretty much killed on the vine.

There are many individuals who are pretty healthy and for whom high deductible plans are sufficient, but that does not apply to those with chronic health issues (and ironically, those with chronic health issues often have trouble maintaining employment, which is honestly pretty funny in a macabre way of maximizing suffering). I think the issue is that the clarity of what is minor and what is life and death is unknown until diagnosis has occurred. Additionally we still have a situation where if you have a pain in your arm and are uncovered you're in a pretty rough spot. I guess faking a car accident to get your care on someone's car insurance is a solution... but I'm not really sure that scales to an entire nation

>Additionally we still have a situation where if you have a pain in your arm and are uncovered you're in a pretty rough spot.

Correct, and I believe that market forces will reduce the costs there by making health choices economical. Walmart tried to get into the market of providing basic health care clinic at their stores. They dropped the program because the regulation were so over bearing even they could not make it profitable. The root of the high costs is government...

However at the heart of this is the underlying debate of if healthcare is a right. People that believe it is reject the idea of profiting off healthcare so anything that would allow for profits is viewed as wrong. Ironically many of these same people have no problems with mandating everyone get a COVID Vaccine that is making Pfizer, Moderna, and other billions in profit

I only support the concept of negative rights, so you in that context you should have the right to seek healthcare from the provider of your choice free from government regulations, but I do not believe the government or anyone has the duty to provide you with care. Under that system of rights the best method to provide healthcare for the most people and the lowest possible price and highest quality is a market.

>I only support the concept of negative rights, so you in that context you should have the right to seek healthcare from the provider of your choice free from government regulations, but I do not believe the government or anyone has the duty to provide you with care.

That makes sense with your positions, and I don't view long debates on fundamental positions to be productive on the Internet, ask not what your country can do for you and all that. I do hope life is always good to you and you'll never be in a position where you'd be left without access to care for an extended period; that gnawing fear of going bankrupt from your own body does terrible things to people.

It might be harder to compare against countries or consider as some sort of predictor - but as a measure presuming we the methods are similar over time - the trend should be valuable. Regardless of starting point, if the measure in the US, for life-expectancy or infant mortality change, and it wasn't a measurment change, then there is something worth understanding going on in the complex system of lifestyle and healthcare in the country.

"Life expectancy" is short hand for life expectancy at birth, but other life expectancies such as life expectancy at age 65 are also measured. For instance, https://data.oecd.org/healthstat/life-expectancy-at-65.htm

The conditional distribution of time-to-death is how I interpret it after conversation with my actuary fellow friend. "Conditional on being in this well-defined population, how long until I die in expectation?"

The people who write these papers and their reviewers don't take such elementary facts into account.

The actual answer is that US infant mortality has stayed almost constant during those 26 years, and was so low to start with that even reducing it to zero wouldn't have made much change in overall mortality.

https://www.statista.com/statistics/1041693/united-states-al...

The linked article also goes into more details.

I personally don’t see the average as useful anyway. It’s a stat meant for headlines and a surface level benchmark as it’s easy to consume. More interesting would be to see the mix perhaps by decade of age at death. It also needs to normalize for number of people alive in each cohort.

Or measure it from conception, and it’s been falling like a rock for awhile now.

Depending on what you mean by "for a while now". It appears that abortions in the US peaked over thirty years ago and have been falling since.

Interesting. I was just shooting from the hip, but it looks like you’re right. (And still right even if we look at the abortion rate or abortion ratio, instead of just the absolute number.)

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