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Healthcare and Life-span/life-expectancy

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How would you guys argue against this claim: Countries with single payer systems are more efficient. People living in Australia, Canada, France, Germany, Japan, Norway Sweden, England etc. have a life expectancy that is about 3 year higher than in the U.S. However, these countries spend half as much of their GDP on healthcare as compared to the U.S. Their per capita expenditure is also about half that of the U.S."

I tried to point out that those countries ration healthcare considerably, violate individual rights, and that anytime the government gets involved in an industry it becomes hugely less efficient, but the person I'm argueing against ignores these points. Are there better ways I could present my argument to make it clearer/stronger?

Thanks

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That is true for some countries you mention (Japan), not true for others (England has 79.4 years compared to the US's 79.2).

To defeat the argument for the countries it is true for, ask them to apply the same method to the difference between the UK and Japan, which both have socialized health care. The fact that it doesn't work is proof that the method is flawed, this number does not in fact reflect the quality of health care in a country. There are a lot of reasons that influence life expectancy, which do explain the drop off for the US.

The way to establish what they're trying to establish is by, surprise, looking at the quality of health care, such as waiting times for major surgery, MRI machines/1000 people, the way people are treated by their physicians etc.

Edited by Jake_Ellison
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As mentioned above, non-health related causes of death are one factor. One also has to "normalize" for things like diet.

Another factor is that much of the money in healthcare is *not* being spent on prolonging life.

For instance, many older people need cataract operations. People who are on Medicaid are allowed to get the conventional lenses-replacement. After this surgery, they can see perfectly fine is they wear prescription glasses. Not a big inconvenience, right? Well, if one has Medicare instead of Medicaid, it will pay for a lens that will adjust, so that one does not have to wear glasses. Folks on Medicaid can pay an extra $2000 - $3000 to "upgrade". The additional money does not show up in life-expectancy.

It is the same when an older pill for allergies is replaced with one that makes one less drowsy, or when a new type of surgery achieves the same bodily result as the old one, except that one can get back to work 2 weeks earlier.

A huge number of improvements in healthcare are of this type, and simply do not show up in the life-expectancy numbers.

Another important factor to consider in inter-country comparisons is the problem of averaging across groups within a country. In today's egalitarian culture people miss this. However, suppose one were to take all the people in the U.S. who pay for their own health care (including dependents), and add in Medicare folk (because they have "paid in", and are therefore from a similar cohort). The others would consist of people on Medicaid and people who -- in other ways -- do not pay for their own health care. I'd guess that the former group has a longer health-related "normalized" lifespan, and that this life-span is slightly higher than the averages in other developed countries

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Check out the Americans for Free Choice in Medicine website. They have a page that covers the healthcare fallacies. 39 fallacies about healthcare

From webpage:

"People live longer in some countries because of their socialist health care systems."

When you hear this, ask if the people in those countries didn't live longer before they nationalized their health care systems. Ask how many people in those countries died on their highways, were killed in combat, shot by criminals, addicted to drugs, were severely overweight or in poor health when they arrived as illegal immigrants.

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How would you guys argue against this claim: Countries with single payer systems are more efficient. People living in Australia, Canada, France, Germany, Japan, Norway Sweden, England etc. have a life expectancy that is about 3 year higher than in the U.S. However, these countries spend half as much of their GDP on healthcare as compared to the U.S. Their per capita expenditure is also about half that of the U.S."

I tried to point out that those countries ration healthcare considerably, violate individual rights, and that anytime the government gets involved in an industry it becomes hugely less efficient, but the person I'm argueing against ignores these points. Are there better ways I could present my argument to make it clearer/stronger?

Thanks

I remember John Stossel tackled this one in his 2007 expose. There are a number of reasons why people in other countries have a 3 year life expectancy. People shoot each other more here. People get in car crashes more.

Same thing with infant mortality. We have more infant mortality for a number of reasons. There is more violent crime in America than the countries that you have mentioned.

That tackles the universal health care argument, but someone will probably now claim that it's because of free market capitalism that there is more crime here. I can't comment on that.

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You know, I find it very interesting, that whenever you point out rationing that usually takes place in UHC, they'll usually say

"THIS ALSO HAPPENS IN THE PRIVATE SECTOR". And then go on to complain about rescission of contract

And never actually overturn when it happens in the government.

Oh, well never mind. They do address this point, but they say it's more "Ethical" for the government to ration than it is for the private sector. *Jerk off hand movement*

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How would you guys argue against this claim: Countries with single payer systems are more efficient. People living in Australia, Canada, France, Germany, Japan, Norway Sweden, England etc. have a life expectancy that is about 3 year higher than in the U.S. However, these countries spend half as much of their GDP on healthcare as compared to the U.S. Their per capita expenditure is also about half that of the U.S."

I tried to point out that those countries ration healthcare considerably, violate individual rights, and that anytime the government gets involved in an industry it becomes hugely less efficient, but the person I'm argueing against ignores these points. Are there better ways I could present my argument to make it clearer/stronger?

Thanks

The idea that government bureaucrats can be more efficient than the market has been argued for more than a century, but every, repeat, every such effort has failed, and failed badly.

"Efficiency" is what they mean by central planning, planned economies, socialism, communism. "Efficiency" was what was admired in Soviet Russia for many years.

The criticism of central planners is one of von Mises' many achievements, read Socialism or Planning for Freedom. I am sure that Andrew Bernstein and George Reisman have good passages as well. I recently finished How Capitalism Saved America. It has many examples of attempts to establish central planning for the purpose of "efficiency" in the United States, and their utter failure.

As von Mises pointed out, a "planner" is not any more intelligent than anyone else. He is (or they are) incapable of determining what to provide to whom at what price thousands of times a day. The result will be exactly like the Soviet experience of having plenty of brown left shoes, but no right ones. The market looks inefficient because it has many actors. To the person who wants power it looks like chaos. But is people acting on their own behalf, seeking their own values, cooperating with others. It is very efficient.

Another point to remember in these discussions is that what we have now is not a free market. It is terribly regulated. Further, the inflationary effect of the Medicare expenditures has distorted the medical sector. That has gone on for over 40 years. Anyone born after 1950 has no idea what a fairly free market for medicine might look like. Regaining freedom for medicine will require ripping out an amazing amount of garbage. If you haven't read Dr. Peikoff's "Medicine: The Death of a Profession", do so. It has a wealth of background and ammunition.

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  • 1 month later...
Life expectancy is not specifically dependent on health care.

Try calculating life expectancy after removing things like murders and accidents and see what you get. (link)

Article about this: http://reason.com/archives/2008/06/17/acci...rs-preemies-fat

Also differentials related to race is the 1200 lb gorilla in the room of which None Dare Speak.

Bob Kolker

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But is people acting on their own behalf, seeking their own values, cooperating with others. It is very efficient.

I've always compared it to a highway. If you're ever sitting a few hundred feet off the ground and watching traffic, it looks amazingly coordinated, controlled, and efficient. However, each driver has his own source, his own destination, his own car, his own ideas about when and how to advance through traffic, and, fundamental to all of this, he has complete control of the vehicle.

Who could honestly believe that he or another person is capable of creating and executing a plan to dictate the actions of every driver on every road in this country from now until forever? When you consider the number of transactions and valuations that occurs in a free market and liken it to that of the road, it is amazing to me that people argue in favor of government control and regulation.

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How bad is socialized medicine?

From February 25, 2010

Stafford Hospital caused ‘unimaginable suffering’:

http://www.timesonline.co.uk/tol/life_and_...icle7039285.ece

Excerpt from article:

Patients were routinely neglected or left “sobbing and humiliated” by staff at an NHS trust where at least 400 deaths have been linked to appalling care.

An independent inquiry found that managers at Mid Staffordshire NHS Foundation Trust stopped providing safe care because they were preoccupied with government targets and cutting costs.

The inquiry report, published yesterday by Robert Francis, QC, included proposals for tough new regulations that could lead to managers at failing NHS trusts being struck off.

Staff shortages at Stafford Hospital meant that patients went unwashed for weeks, were left without food or drink and were even unable to get to the lavatory. Some lay in soiled sheets that relatives had to take home to wash, others developed infections or had falls, occasionally fatal. Many staff did their best but the attitude of some nurses “left a lot to be desired”.

People who make excuses for that don't care about human beings.

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http://www.americanthinker.com/2007/12/a_c...for_univer.html

How do I respond to the notion that America pays more for their health overall than any other country, and we don't even cover everyone?

I do remember someone somewhere said that America pays for the research and development of most drugs, but I couldn't find a source to substantiate that claim

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How do I respond to the notion that America pays more for their health overall than any other country, and we don't even cover everyone?
"Covered" just means that there is some type of standing agreement that identifies who will pay the doctors or hospital. It does not mean that those who are "not covered" do not actually receive health-care services. In the U.S., a bankrupt can walk into a hospital and get all sorts of treatment for very serious health issues, running up a bill in the tens of thousands that both he and the hospital know he cannot afford to pay. Not just that: but, while this is happening, he is rarely reminded of being any different from the paying patients, and instead often gets world-class 5-star care.

Of course poor people skimp on things like primary-care visits, but when something is serious enough for a hospital visit, they're taken care of. When it comes to costs, one 5-day hospital stay with no operations, but simply some scans etc., can end up costing over $10k. So, hospital stays and serious ailments are a huge part of health-care costs, far overwhelming the amounts skimped on avoiding primary-care visits.

Probably the biggest reason U.S. healthcare is expensive is the fact that it is a "third-party payer" system where the consumer and the provider do not experience the right set of incentives that would lead to lower cost. If the third-party were to be a government entity like the NHS, and if some providers (e.g. some doctors) were government employees, costs could be controlled much more easily. Of course, one could not do this without cutting services more than one cuts costs. To put it another way, one reason healthcare is cheaper in Canada is that it is rationed: i.e. that one does not get as much of it as one wants.

Another way of putting this second point is that the U.S. has a healthcare industry with lots of privately-owned elements. However, it has many laws that ban low-cost solutions.

Edited by softwareNerd
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First I had to laugh reading the John Maynard Keynes quote. Is there any single person in history who has done more harm than that man and he makes a quote like that.

Health care is more expensive in our country because #1 Medicare has increased utilization and increased costs. Americans are getting procedures and tests that they would never get on their own. Self-pay makes us all better consumers. Since procedures and tests are done more frequently, the number of specialists doing them increases which increases costs.

The #2 reason health care costs have increased and diminished access is government regulation. We are over licensed (a tax on professions) and have agencies such as the FDA, OSHA, CLIA, and HIPPA which confer almost no benefit to the consumer and increase costs.

The #3 reason health care costs have increased is the over-regulation of the insurance industry. Every week some legislator is trying to force insurance companies to pay for the disease du jour (ie, mental health, autism, alzheimer's). Now they want to force insurance companies to offer insurance to any person regardless of risk and then tell the insurance company what to charge for that policy.

The government is the cause of our health care mess, not the savior. Maybe if we could dismantle all of the above issues we could begin to work on public education, another mess created by government intervention.

“Has any act of selfishness ever equaled the carnage perpetrated by disciples of altruism?” - Ayn Rand

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"Health care" is not equivalent to "health," nor is life expectancy primarily a function of healthcare.

Exactly. In the late 19th century the biggest single step to increasing the life span of the people of London was the building of the sewers. As soon as the system stopped putting sh*t in the Thames the occurence of typhoid and cholera diminished sharply. Most people in London were still too poor to get regular medical aid, but they lived longer. It turns out that the biggest boost to lifespan is improved hygiene, including clean water and better nutrition. Also immunization. Every one in the U.S. (almost) is immunized against certain infectious diseases whether they can afford it or not. It is a matter of public safety. Getting acute medical care helps, of course, but that is not the major factor.

People in the U.S. score poorly in lifespan for a number of cultural reasons:

1. Bad eating habits. Too much sugar and fat. Not enough fresh vegetables.

2. Bad exercise habits. Americans do not exercise enough (on average) to maintain their fitness properly.

3. Smoking (smoking is not good for one's health --- period)

4. Stress (too much stress is bad for one's health).

None of these negative factors have anything to do with access to doctors or medical treatment. The life span of the U.S. would jump five years if people got off of their butts and walked two or three miles a day, preferably in a direction that leads away from the nearest donut shop for fast food place.

Bob Kolker

Edited by Robert J. Kolker
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This is a long article from the New Yorker, June 1 2009; but, it's an excellent one for anyone trying to understand the cost of health-care in the U.S. (It is not the author's evaluations that make this a good article, but the information, even if one might come to some radically different evaluations.)

The following quote from the article is interesting:

..., the four states with the highest levels of spending—Louisiana, Texas, California, and Florida—were near the bottom of the national rankings on the quality of patient care

There's an interesting story about this article. When businessman Charlie Munger read it, he was so glad the author had written it that he sent a check for $20,000 to the New Yorker, asking it to be given to the author, in appreciation.

Edited by softwareNerd
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