US Life Expectancy Not Great

oecd

Mark Gongloff of the Huffington Post entitled his editorial The U.S. Health Care System is Terrible, in 1 Enraging Chart.  The chart is above and he goes on to say:

If you’re unconvinced, here is a chart that demonstrates its terribleness. It shows, using OECD data, how much money different countries spend on health care per person, charted against life expectancy in each of those countries. As you can see, there is a pretty close relationship between health-care spending and life expectancy. Except for one very, very terrible country. Can you spot it?

He sure seems emotional about it.  Here are some other points he makes:

  • This confirms what we pretty much already knew about the terribleness of U.S. health care.
  • Why is our system so terrible? Largely because it is built for profit.  Unlike many other countries, the government has no role in either providing care or setting prices, and so prices skyrocket.

Here is how the OECD (Organization for Economic Co-operation and Development) explains their results:

The OECD suggests a few explanations for the lower gains. First, it highlights “the highly fragmented nature of the US health system, with relatively few resources devoted to public health and primary care, and a large share of the population uninsured.” Second, it notes the US has a higher calorie consumption per capita and obesity rates, higher consumption of prescription and illegal drugs, higher deaths from road traffic accidents, and higher homicide rates than many nations. Finally, it suggests socio-economic conditions — in particular a more prominent rich-poor divide than other countries — could be to blame.

It’s not exactly the same explanation.  First, I agree we are fragmented but we devote a ton of money to public health (Medicaid, Medicare).   Second, they point out personal responsibility (calories, drugs, accidents, murders) issues.   Yes!!!!!  That is huge! Lastly, OECD suggest socioeconomic conditions, which could be back to the issue of healthcare not being affordable.

Do you see the difference in explanations?  Mark’s is political but neglects to cover the reasons the OECD itself gives.

This chart looks at life expectancy vs. cost.   We are comprised of mostly overweight or obese people subsisting on crappy food, who rarely exercise and sit in front of computers, TVs or iPhones all day.   Do we have a costly healthcare industry?  Absolutely.  Should that be fixed?  Absolutely.  I disagree with Mark Gongloff on how but it doesn’t matter.  Without that personal responsibility change, it would only move that point on the chart to the left but it wold not move it higher!

Mark has an agenda.   He spreads misinformation to push his agenda and then it goes viral on Facebook, etc.  But facts are important.  People see what they believe instead of believing what they see.  That gets us nowhere.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  9 comments for “US Life Expectancy Not Great

  1. Ben
    November 24, 2013 at 6:19 pm

    I don’t have a dog in this fight, and I’m no friend to socialized medicine, but it seems to me that you’re playing just as fast and loose with the facts as Mark (maybe more so). Having read a one-page article about the report, you’ve simply declared that personal responsibility must be the primary case because that’s the explanation that resonates most with your existing biases and your own agenda. Personal responsibility certainly plays a role here, but when you look at the stats you find that the that the other “very fat countries” (VFCs) – Mexico, UK, Slovakia, Chile, Greece, Austrailia, New Zealand, and Luxembourg – are ALL comfortably on or above average performance on this cost vs. life expectancy curve. Not only that, but (if you actually read the full report) the US has pretty good outcomes/stats for many of “personal responsibility” indicators you complain about: yes, the US has high obesity rates, but it actually has low cardiovascular mortality and a diabetes rate that is very similar to other OED countries. We exercise more and eat about as well (fruit and vegetable consumption) as the other countries listed. And the US has significantly lower smoking rates than most of these countries (including the other VFCs).

    And you accuse Mark of twisting the OECDs explanation for their results in order to push a pro-socialized medicine agenda. I’m not sure how you interpret the phrase “the highly fragmented nature of the US health system, with relatively few resources devoted to public health and primary care, and a large share of the population uninsured” (the OECD’s primary explanation), but it’s pretty much exactly what Mark is saying. To break it down:

    1. “The highly fragmented nature of the US health system” – This means: “Unlike everyone else, the US doesn’t have a single-payor (aka socialized) system”.

    2. “with relatively few resources devoted to public health and primary care” – This means: “The US isn’t spending much on major public health initiatives or on making sure everyone gets good primary care”

    3. “and a large share of the population uninsured” – This means: “unlike socialized-medicine countries, the US system leaves a large number of their population without healthcare coverage”.

    And if you actually read the report (http://www.keepeek.com/Digital-Asset-Management/oecd/social-issues-migration-health/health-at-a-glance-2013_health_glance-2013-en#page1) you’ll find that Mark’s assessment, while political, is closer to the report’s findings than your “gut feeling”. Before you accuse someone of twisting a report to fit their agenda, you might want to actual read the report in question. Talk about seeing what you believe instead of believing what you see!

    • Doug Farrago
      November 24, 2013 at 10:06 pm

      There are two variables of this damn chart. The X axis is cost and I agreed we pay too much. The insurance companies and administrators and hospitals soak up a ton. Some medical specialties are overpaid too. That being said, Medicaid and Medicare also add to that x axis tremendously so praying for socialized medicine is not the answer. The Y axis is longevity. Two points put on a graph and then EVERYTHING from there is OPINION! If you had ever read this blog you would know that I am a family doc in the trenches. That is where my dog is fighting. You? You obviously have a dog in the fight. You are so slanted toward socialized medicine that is hard to take anything you say seriously. Please tell me what job you have for the administration?

      • Ben
        November 25, 2013 at 10:00 am

        As I already mentioned, I’m not particularly receptive to socialized medicine – I think they’re coasting on a one-time reduction in cost and are seeing cost-inflation that will soon put them in the same place as the US with respect to cost (the OECD report actually does touch on this). And I agree that Medicare and Medicaid add a lot to that x-axis, but they’re just doing it less effectively than other governments: they only treat certain segments of the population and they spend a lot of money contracting with private parties rather than doing work in-house like – for instance – the much more efficient VA system.

        I respect what you’re trying to do as a physician (I actually like most of what you post, and I generally agree with that you’re trying to do: there is too much specialization, too much third-party involvement, too much bureaucracy, not enough responsibility on the shoulders of patients, etc etc). However, in this particular post you accused someone of intellectual dishonesty and then – without reading the report he was summarizing – posited that the report probably agrees with your assessment more than Marks (and acted pretty superior in the process).

        Socialized medicine isn’t the solution we should pursue, but it also has proven to be at least as viable as our current mess (most stats – and the OECD report in question – suggests it is more viable) so starting from the assumption that anyone pushing socialized medicine must be a corrupt know-nothing is a pretty unfair assumption.

        • Pat
          November 25, 2013 at 11:41 am

          I’ll pitch in on the “know-nothing” question by observing that socialized care has performed over cost and below expectations everywhere it has been tried for decades. And whether or not article author Gongloff intends it, his is the rhetoric which is always used to justify restricting patient choices/access, reducing physician autonomy and yes, income, and growing the size of a parasitic bureaucracy which contributes diddly of value to anyone. So yeah, I think that any approach pushing a proven failure is indeed ignorant or corrupt.

          • Ben
            November 25, 2013 at 12:54 pm

            @Pat – your hatred towards socialized medicine is noted, but you’re not contributing to this conversation. This discussion is about a major report comparing medical costs, performance, and demographics across multiple countries. One of the conclusions it reached is that the lack of socialized care was one of the major reasons why the US lags other OED countries on several indicators (including life expectancy) despite massive expenditure. Your declaration that universal care is an obvious and unmitigated failure everwhere is a fun bit of bombast, but it’s also wrong.

            No one denies that bureaucracy and politics makes healthcare less efficient (socialized medicine involves lots of inefficiencies), but when presented with the only other currently available models (the US and Mexico) rational adults might conclude that socialized medicine – however flawed – happens to be the best system available. I disagree with this conclusion (I’d love to see a growth in direct pay, for instance), but they are at least able to provide a cogent, data-driven argument for their position… which is more than you are offering.

        • Doug Farrago
          November 25, 2013 at 12:46 pm

          Without going tit for tat forever, I will just say this. I didn’t start with a post about the report. I posted about Mark’s assessment of the GRAPH. The graph has two points which is cut and dry. Everything else (conclusions about the graph) is personal bias, opinion, politics, etc. I admit my bias. I admit what is my opinion. He did not. To him that was proof positive that we have a “terrible” healthcare system and then he used his Huffington Post forum to spread it as gospel. That’s the definition of intellectual dishonesty in my book.

          I appreciate that you like some of our stuff here. Let’s just agree to disagree.

          • Ben
            November 25, 2013 at 12:56 pm

            Thanks Doug – I appreciate it 🙂 Keep up the good work.

  2. Pat
    November 24, 2013 at 4:17 pm

    Gongloff’s interpretations reek of collectivism and class warfare, and hilariously, he wants more control given over to the authors of these problems. More government will only increase per capita health spending (got almost 5 decades of practice on that one). I’d bet that a guy bemoaning a rich-poor divide would not favor cuts in our national calorie amplification programs – food stamps, farm subsidies – and I suspect he greenily would favor more mandated mass transport, to cut down on accidents as well as save the earth. Same ol’ do-gooders, same ol’ dumb results from those who only ever see government as the fix, not the problem.

    • JRDO
      November 27, 2013 at 10:49 am

      Same ol’ knee jerk “government is always bad” rhetoric from you.

      Just wanted to give Ben a nod of approval. As a PCP I do have a dog in this fight, and I agree with Ben’s comments.

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