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Comment by refurb | Hacker News Reader

US care is highly aligned with international guidelines. Saying "it's junk volume" just tells me you're not that close to the data.

Life expectancy doesn't measure quality of healthcare, there are far too many confounding variables like genetics, diet, accidental deaths, etc. No serious study of healthcare quality relies on it.

Look at 5-year cancer survival rates. The US is better (significantly better) in many of them than other countries. A big part of that is access to the latest technology.

https://www.thelancet.com/journals/lanonc/article/PIIS1470-2...

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Now do maternal death rate. Like I said, a good place to have cancer but they aren't good at stuff that matters.

The US leans aggressive on tests and heroic end of life care. I doubt you really disagree (except maybe on whether you think it's the right call). That is where the money is, since the insurance company can be forced to pay. It's kind of good for the rest of the world though if the US wants to pay (in both money and other issues) to be early adoptors.

Read "When doctors die", the US is the total opposite - everything goes to the big ticket aggressive (and yes, modern and cutting edge) treatment where it's hitting diminishing returns. https://pmc.ncbi.nlm.nih.gov/articles/PMC6179868/

> Now do maternal death rate

Sure!

https://archive.is/rMVJ0

Turns out the CDC changed the way it counts maternal deaths, while other countries didn't, so you're comparing different measures.

The old US measure was deaths that occurred during birth or shortly thereafter, now it's within six months and they added a check box only asking if the woman had been pregnant in the last year.

Not "this woman died because of poor maternal care", but rather "this woman who died had been pregnant in the last year".

This change immediately doubled the number. The data was wildly overestimating maternal deaths and in fact the CDC and many states are revising data collection to improve the number.

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