The author misses that most OECD countries game these statistics (eg decrease childhood mortality by requiring 3 breaths to issue birth certificate) in response to internal political pressures you just don’t see in the US.
Can you give evidence of a developed country where that’s the case?
Because I grew up right on the Canadian/US border, I have family and friends on both sides. It’s really easy for me to see why Canadians live longer than Americans. Poor Canadians have access to preventive medicine in a way poor Americans don’t because of our universal healthcare system. This prevents a lot of illness that are easily to stop in early stages but hard to stop in late stages from killing people.
But it’s a really common thing for Americans under the influence of their radical corporate propaganda to wave things like universal healthcare away and just say with no evidence that other countries are cheating with numbers. No need to disrupt the amazing profits of your corporate health providers just to do something silly like save the lives of poor people —- they should really have worked harder if they didn’t want to die of cancer anyways.
You know what my lived truth is? Before Canada had more advanced health cards and systems for keeping patient records, it was a common thing in my city for poor Americans to try to defraud our health system just so they could get basic treatment.
But yeah buddy, keep believing the lies that we’re just counting infant mortality differently.
The article suggests that wealthier subsets of the populations live longer in other wealthy countries than America and wealthy Americans generally do have access to healthcare[1]. And immigrants to the US also live particularly long so maybe they are wealthy and get good healthcare or maybe there’s something else to it.
The article also suggests some issues may be due to the way cities in the US are laid out which doesn’t really result from some kind of corporate propaganda or conspiracy, but then Canadian cities are quite similarly laid out.
It seems like a pretty messy nuanced topic that can’t be reduced to single US policies.
[1] perhaps their wealthy groups were eg 80%ile of the population by wealth and biased differently due to how people make money in different countries, or perhaps you need a smaller group for wealthy Americans to perform better, or perhaps they picked some dollar threshold so the American group was proportionally poorer or broader as America is richer in general. I don’t really know how that comparison was made though.
that sounds like just about the only thing on that list that you could imagine to be a statistical artifact rather than self-evidently true. You know what you just don't see in Japan, Korea or Europe? Anything else on that list. The rate of obesity, gun deaths, car accidents, entire regions ravaged by opioids and so on.
In the entirety of England and Wales, that's 60 million people, the police has about 0-3 fatal shootings per year.
I have a hard time to remember when was the last school shooting. It must have been around 10 years ago. In the us my guess would be at maximum a month ago and that is an optimistic guess.
So the majority of OECD countries is cheating at statistics except the US? Do you have the exceptional evidence to go along with such an exceptional claim?
"what's going on here is that the US is actually reporting "pregnancy related mortality," a formally separate concept, and that's why literally every international organization puts like 19 asterisks after the US data and says DO NOT COMPARE"
This is an interesting link and the story seems plausible. I’m glad you commented it. It’s also not related to how child/adult mortality in general are calculated, or to other countries ‘lying’ anymore than if one country produced statistics for 18-30 year olds and another for 21-30 year olds: the data is just not directly comparable.
Yes it’s much narrower in scope than GP’s sweeping claim, but the prior should be that there are general differences in data between US and EU owing to lack of universal IT systems and differing attitudes towards privacy.
That actually sounds fairly reasonable as a threshold of “this is a live birth”. I’m not going to spend hours debating in my head whether it should 1, 3, 5, or 0-with-other-criteria, but someone has to make that determination.
But if the US is using different criteria than other countries, then it isn't really fair to compare those numbers. It's not clear to me if the statistics in that paper used the same criteria for considering a birth to be a live birth in the US as in europe.
It might be fair to say that statistics vary a bit on definitions, but mother mortality is defined by the UN and the difference is much more pronounced because of US "internal political pressures".
> Expanding the number of primary-care physicians would reduce the chances of treatable conditions, such as moderate hypertension, blooming into costly maladies, such as heart disease.
By itself, I don't think that would solve the problem. I am afraid of going to the doctor for anything that isn't pretty serious because not only will it be expensive, I have no idea how expensive it will be. Sure, a trip to my GP might catch something early, but it is much more likely I'll end up paying hundreds of dollars just to be told there is nothing wrong. Having more general practitioners might maybe decrease price due to more competition, but probably not enough to make a significant difference with how the health care system is currently structured.
The article gets the right answer, but doesn't seem to tie it all together.
Depression/despair. There are very few happy, well adjusted people on opioids. Or obese. Exceptions exist, but both seem to root from incredible amounts of unhappiness and/or lack of purpose.
I don't know the answer to the problem...taxing soda isn't it. We need to give people hope and opportunity, and not just smack their hands when they do something bad.
I'm not sure to what extent this applies to America vs. world, but deaths from despair (actually a technical term) can be helped by religion (the study considered any weekly religious services) to the tune of a 68% (in women) reduction [1]. In the journalism surrounding this study, I've seen health professionals say things like "if we could prescribe it as medicine, it would be the most revolutionary treatment in the last 100 years". I'd be morbidly curious to see scientists relate the decline in religious service attendance to the increase in deaths from despair. I'm a religious person, and I have definitely experienced the implied improvements in my outlooks on the basic concepts of "hope", "joy", and "purpose".
I grew up in an extremely religious environment - utterly toxic, in fact. I’m a better and healthier person for leaving it.
BUT: I still find myself missing it sometimes.
What it boils down to (for me) is community - I miss having easy, abundant community. Religion tends to be a communal thing, and it’s not surprising to me that community yields health benefits.
I don’t think America in particular has much in the way of non-religious community. I wish we did.
I think you hit the nail on the head. I think people on the whole are, consciously or not, lonely as hell. I had -some- community as a child, family and neighbors who all were at each other's house at any time.
It's all gone for me today, and I find myself wishing for it and missing it. People seem more insular and isolated than ever.
I enjoy the joke "the worst part of drug addiction is becoming religious" because recovery from alcoholism/addiction is ultimately what lead me to a religious life. My beliefs provide joy and purpose that get me out of bed in the morning. The friendships I've made because of my beliefs are nice, but they're only part of my experience.
I expect that a sense of community plays a large role in the outcome of the study. For me, and I would think for religious folk in general, there's more to it than just community.
The part of this article that I really appreciate is that it takes a political minefield where nobody knows what is going on and presents it as a mess of different effects, none with an identified main cause. And reasonably non-judgmentally.
It is fascinating that the problems around health particular persist despite all the factions acknowledging that it is a disaster. The US partisans need to learn how to negotiate, they obviously aren't very good at it.
What I as an European always found weird is the fact that this is a political minefield in the US. As if there are not enough nations that have shown how health care can be organized in a good way for the benefit of all, for decades, all while having thriving economies.
It happened more than once to me that in online discussions an US-american told me a thing was "not possible" that I grew up with my whole life. I am not sure if I would've become a freelancer if I had to worry about my state just letting me die if things don't work out.
The best explanation I can come up with (as an American) is that a large portion of Americans are incapable of rational thought when it comes to healthcare policy. They've somehow been led to believe that their system is run by the "market" and that that no system could possibly function better. The fact that many other countries do better does not matter. I find it best to analyze these people as if they were religious zealots rather than rational thinkers.
They're just misinformed. The US health care industry is among those most heavily enmeshed with government at all levels (regulation, gatekeeping employment, funding/subsidizing, etc.). Whether you think it's good or not, most everyone would agree that level of involvement would result in a heavy distortion from what the free market would provide on its own.
One rhetorical approach might be to say that since this is already the case, let's acknowledge that reality, then decide whether to increase/decrease/alter that reality.
I don’t think it’s just that they’re misinformed. It’s the fact many can’t even consider that they might be wrong. Often they take a critique of the American system as a critique of them personally. It’s totally counterproductive to any potential improvement of society. I find it quite depressing.
> It’s the fact many can’t even consider that they might be wrong.
What you mean like saying that the only explanation for disagreeing with them is not being capable of rational thought?
This is a major problem in American politics, maybe the biggest problem. Neither side is willing to accept they might be wrong, or even partly wrong. Or even really listen to the other side's position.
I agree with you that that other countries have better healthcare, and we should try and make ours like theirs. But ad hominem attacks on the other side are not productive and do nothing to convince them.
> What you mean like saying that the only explanation for disagreeing with them is not being capable of rational thought?
Honestly, what are you talking about? What am I disagreeing with exactly? Could you be a little more specific?
> I agree with you that that other countries have better healthcare, and we should try and make ours like theirs. But ad hominem attacks on the other side are not productive and do nothing to convince them.
How is this an ad hominem? I’m making these statements in general to a certain audience on hacker news. I’m not making it to any specific individuals. Just because I think many Americans are idiots doesn’t mean I tell them that directly. I pretend like their nonsense isn’t nonsense because they’re more receptive to that. In other words, I do basically the opposite of ad hominem attacks when engaging with these people. I talked to them quite patiently. But yes I do believe many of them are morons.
Edit: The more I read your post the more confused I get. What side am I on exactly? The side that believes that American healthcare outcomes could be better? I could hold that opinion even if I thought more—not less—deregulation is necessary. I’m not complaining about people who want to improve American healthcare even by making things “more free market”. I’m complain about idiots (and yes they are idiots) who can’t fathom that other systems might have better outcomes because they are “socialist”. They don’t even consider statistics and analysis they just conclude the US is better because our system must be. That is inexcusable and basically incompatible with any progress in society.
I see, I misunderstood what you were trying to say, because I have never encountered anyone who didn't think the American health care system could be better. Although, I don't doubt that such people exist.
You haven’t met Americans who think European systems are worse because they are “socialist”? Seriously? It’s a pretty common political talking point. I’m kind of amazed you wouldn’t have been exposed to these ideas.
Sure, but they don't think that american health care is good. They think the solution is for the government to be less involved in healthcare, or at least make it more competitive.
You misunderstood my point. Whether a system is "socialist" or "market" says nothing about whether a system is good or whether it is better than another. The only way to measure whether a healthcare system is good is by looking at the outcomes of that system. The comparison to programming would be if people declared a program written in rust to be better than a similar program written in python simply because of the language. That makes no sense. It is certainly possible to produce programs written in rush that are worse than ones written in python.
The point is that the measure of the quality of healthcare systems shouldn't be whether they are socialist or something it's looking at life expectancy, efficacy, cost, etc. Those are the things that actually matter. Hence "but they don't think that American health care is good" is missing the point. A common talking point in the US is that American healthcare is better because it's not socialist (or some essentially equivalent argument). It's total nonsense. An introspective American with a little humility might wonder "I've been led to believe my system is better because it is not socialist, but outcomes in other systems I consider socialist seem better". An introspective American might wonder if this belief "the solution is for the government to be less involved in healthcare, or at least make it more competitive" is truly worth holding given that so many supposedly less competitive systems have better results.
Maybe in summary, think in terms of actionable information about systems and not nebulous undefined dogmas such as "socialist" or "market".
I know many people who oppose "socialized healthcare", and they definitely agree that the current system is broken, but they think the solution is to decrease government involvement and/or make it more competitive.
Hey, but you can buy smartwatch monitoring your health for 1000 bucks... and there is abundance of "health" coaches and "healthy" diets. Doctors though? They would rather never touch or even see you. Only Bill, Jeff, Zuck and your other palls can afford their attention.
Judging the US discourse on that topic the issue is, that many of you would rather self medicate and risk their own health before paying a penny that might go to the health of someone else.
If you are in a society where a part would rather have it worse themselves than support a stranger, you will not be able to have the nice things.
Social systems and insurances operate on best effort and "help most needy" first. Every time I'm paying full price, full monthly contributions, and every time I'm placed at the end of the queue...
People buy smartwatches and go on diets in rich non-American countries too. I don’t really know what your point is though? It’s possible to have a hard time seeing doctors in wealthy countries with socialised healthcare (eg the current situation with the nhs in the U.K.) and it is patently that you need to be one of the richest ~10 Americans to see a doctor. I think a great deal of the American readers of this site will have ‘good’ health plans to the extent that they could reasonably easily see a generalist doctor at short notice.
There are obese people that go and get a heart bypass. The problem is that they will never stop going. One day they will get their second and third. This is very expensive for not much effectiveness.
47 comments
[ 3.3 ms ] story [ 96.8 ms ] threadBecause I grew up right on the Canadian/US border, I have family and friends on both sides. It’s really easy for me to see why Canadians live longer than Americans. Poor Canadians have access to preventive medicine in a way poor Americans don’t because of our universal healthcare system. This prevents a lot of illness that are easily to stop in early stages but hard to stop in late stages from killing people.
But it’s a really common thing for Americans under the influence of their radical corporate propaganda to wave things like universal healthcare away and just say with no evidence that other countries are cheating with numbers. No need to disrupt the amazing profits of your corporate health providers just to do something silly like save the lives of poor people —- they should really have worked harder if they didn’t want to die of cancer anyways.
You know what my lived truth is? Before Canada had more advanced health cards and systems for keeping patient records, it was a common thing in my city for poor Americans to try to defraud our health system just so they could get basic treatment.
But yeah buddy, keep believing the lies that we’re just counting infant mortality differently.
The article also suggests some issues may be due to the way cities in the US are laid out which doesn’t really result from some kind of corporate propaganda or conspiracy, but then Canadian cities are quite similarly laid out.
It seems like a pretty messy nuanced topic that can’t be reduced to single US policies.
[1] perhaps their wealthy groups were eg 80%ile of the population by wealth and biased differently due to how people make money in different countries, or perhaps you need a smaller group for wealthy Americans to perform better, or perhaps they picked some dollar threshold so the American group was proportionally poorer or broader as America is richer in general. I don’t really know how that comparison was made though.
In the entirety of England and Wales, that's 60 million people, the police has about 0-3 fatal shootings per year.
[1] https://en.wikipedia.org/wiki/List_of_school_shootings_in_th...
https://twitter.com/lymanstoneky/status/1555923442112815105
"what's going on here is that the US is actually reporting "pregnancy related mortality," a formally separate concept, and that's why literally every international organization puts like 19 asterisks after the US data and says DO NOT COMPARE"
This mortality figure is a disgrace, especially with the longevity technology we now have in humanity.
By itself, I don't think that would solve the problem. I am afraid of going to the doctor for anything that isn't pretty serious because not only will it be expensive, I have no idea how expensive it will be. Sure, a trip to my GP might catch something early, but it is much more likely I'll end up paying hundreds of dollars just to be told there is nothing wrong. Having more general practitioners might maybe decrease price due to more competition, but probably not enough to make a significant difference with how the health care system is currently structured.
Depression/despair. There are very few happy, well adjusted people on opioids. Or obese. Exceptions exist, but both seem to root from incredible amounts of unhappiness and/or lack of purpose.
I don't know the answer to the problem...taxing soda isn't it. We need to give people hope and opportunity, and not just smack their hands when they do something bad.
[1] https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
BUT: I still find myself missing it sometimes.
What it boils down to (for me) is community - I miss having easy, abundant community. Religion tends to be a communal thing, and it’s not surprising to me that community yields health benefits.
I don’t think America in particular has much in the way of non-religious community. I wish we did.
It's all gone for me today, and I find myself wishing for it and missing it. People seem more insular and isolated than ever.
I expect that a sense of community plays a large role in the outcome of the study. For me, and I would think for religious folk in general, there's more to it than just community.
It is fascinating that the problems around health particular persist despite all the factions acknowledging that it is a disaster. The US partisans need to learn how to negotiate, they obviously aren't very good at it.
It happened more than once to me that in online discussions an US-american told me a thing was "not possible" that I grew up with my whole life. I am not sure if I would've become a freelancer if I had to worry about my state just letting me die if things don't work out.
One rhetorical approach might be to say that since this is already the case, let's acknowledge that reality, then decide whether to increase/decrease/alter that reality.
What you mean like saying that the only explanation for disagreeing with them is not being capable of rational thought?
This is a major problem in American politics, maybe the biggest problem. Neither side is willing to accept they might be wrong, or even partly wrong. Or even really listen to the other side's position.
I agree with you that that other countries have better healthcare, and we should try and make ours like theirs. But ad hominem attacks on the other side are not productive and do nothing to convince them.
Honestly, what are you talking about? What am I disagreeing with exactly? Could you be a little more specific?
> I agree with you that that other countries have better healthcare, and we should try and make ours like theirs. But ad hominem attacks on the other side are not productive and do nothing to convince them.
How is this an ad hominem? I’m making these statements in general to a certain audience on hacker news. I’m not making it to any specific individuals. Just because I think many Americans are idiots doesn’t mean I tell them that directly. I pretend like their nonsense isn’t nonsense because they’re more receptive to that. In other words, I do basically the opposite of ad hominem attacks when engaging with these people. I talked to them quite patiently. But yes I do believe many of them are morons.
Edit: The more I read your post the more confused I get. What side am I on exactly? The side that believes that American healthcare outcomes could be better? I could hold that opinion even if I thought more—not less—deregulation is necessary. I’m not complaining about people who want to improve American healthcare even by making things “more free market”. I’m complain about idiots (and yes they are idiots) who can’t fathom that other systems might have better outcomes because they are “socialist”. They don’t even consider statistics and analysis they just conclude the US is better because our system must be. That is inexcusable and basically incompatible with any progress in society.
The point is that the measure of the quality of healthcare systems shouldn't be whether they are socialist or something it's looking at life expectancy, efficacy, cost, etc. Those are the things that actually matter. Hence "but they don't think that American health care is good" is missing the point. A common talking point in the US is that American healthcare is better because it's not socialist (or some essentially equivalent argument). It's total nonsense. An introspective American with a little humility might wonder "I've been led to believe my system is better because it is not socialist, but outcomes in other systems I consider socialist seem better". An introspective American might wonder if this belief "the solution is for the government to be less involved in healthcare, or at least make it more competitive" is truly worth holding given that so many supposedly less competitive systems have better results.
Maybe in summary, think in terms of actionable information about systems and not nebulous undefined dogmas such as "socialist" or "market".
If you are in a society where a part would rather have it worse themselves than support a stranger, you will not be able to have the nice things.