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Comment by tumdum_ | Hacker News Reader

It’s actually better to be average Western European than white and top 1-5% American: https://jamanetwork.com/journals/jamainternalmedicine/fullar...

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It turns out that when you make a massive profit motive to sell expensive fancy interventions, health outcomes suffer.

You see this to an even more extreme degree amongst the ultra rich and powerful, who are often using cutting edge, experimental treatments, and often reaping the downsides of being on that edge (though of course also the upsides).

To be fair, the structure of that study is pretty bizarre. Why only look at 6 specific illnesses rather than something like life expectancy?

They are looking at the outcomes of specific procedures because they are interested in the health care system quality. Looking at things like life expectancy would make it impossible to disentangle them from other factors like lifestyle or environment.

Sure, but it's only six (6) specific illnesses. There are tens of thousands of illnesses. I'm almost 100% confident you could cherry pick any six illenses to get any outcome you want.

Edit: Seems the lead author is also a vocal supporter of universal healthcare, being a senior fellow of the Center for American Progress. So yeah, probably why it's such a strange setup, and what compelled me to check since this kind of thing is super common for "activist research".

I guess the takeaway is to always take a study for what it is, rather than what it paints itself to be.

So you are saying that they cherrypicked some obscure illnesses to make Europe look good? They used data for:

- infant mortality

- maternal mortality

- colon and breast cancer survival

- heart attack mortality

- childhood acute lymphocytic leukemia (most common childhood cancer)

Those are one of the most common health issues.

Also, here is another recent paper showing how it’s better (health care wise) to be average in EU than wealthy in US: https://www.nejm.org/doi/full/10.1056/NEJMsa2408259

No, I didn't make the argument they were obscure, in fact they all are from a set of common illnesses that....also contains thousands of illnesses. Again, this is the kind of stuff you see with "activist research". Why would they only do 6 instead of hundreds or thousands? I'm sure you see my point.

There are also other oddities like using median county wealth rather than household wealth. In many wealthy counties there are still poor areas, I know more than a few. In fact if you look at the appendix, most of the households in the study are, well, average or poor. They also don't include absolute numbers or definitions for the illnesses.

All in all, it's a bad study, and clearly made to color in an agenda.

The second study looks more grounded, thanks.

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