Life Expectancy Indicates U.S. Health-Care Outpaces International Peers

In my last article, I dissected the idea that single-payer healthcare will save the country money. While anything is possible, it’s not possible to do so in the United States for less money while maintaining the quality of care we currently enjoy.But single-payer advocates often attack the quality of care in the United States, trashing our health outcomes as compared to that of other nations. They point to lack of single-payer as the reason for our struggles. Rather than take it for granted that the U.S. health-care system is barely better than going to a medieval barber for a bloodletting, I did a bit of research to discover how we really compare with the rest of the world, especially the industrialized nations advocates always say we need to be more like. How did we do?Firstly, I had to come up with a metric. As I’m not a statistician or epidemiologist, I needed to settle on a simple proxy for health outcomes, so I chose average life expectancy. While quality of life is hard to measure and infant mortality, while frequently cited, is not useful since its measured differently in the United States than in the rest of the world, life expectancy works well because it’s clear and objective. Someone is either alive or dead (until we are forced to tweak the definition for live people that “identify as dead”).On first glance, the United States is not great in this metric, placing 43rd in the world at 79.68 years, nearly a decade behind number one on this list. We are, in fact, behind many other industrialized countries, such as Japan (2), Switzerland (9), Italy (14), Canada (18), France (19), Spain (21), and the United Kingdom (33). Even Greece, which has seen its economy fall apart over the last half-decade, ranks 34th.So, time to ban insurance companies and turn it all over to the state, correct? Not so fast. These numbers fail to explain why the United States falls where it does. A few comparison points immediately popped out at me: population size, ethnic diversity, and how emigrants from those same nations fare in the United States.Let’s Examine Population SizeProviding health care for people is not easy. Providing health care for even more people is even harder. Even Sen. Bernie Sanders could agree. So while the United States is just 43 on this list, not a single bigger nation outranks it. In fact, of any nation with 130 million or more people (the top ten countries by population), the next best-performing country is our neighbor to the south, Mexico (which has a single-payer system), at a much lower 75.65 years, ranking 95, with less than half our population. The only nations bigger than ours, China and India, rank 99 and 163, respectively.Of course, both China and India aren’t just bigger, but much bigger, at more than four times the size of the United States. So if we acknowledge treating and insuring more people is harder, then it’s easy to understand why we struggle to do this comparatively in the United States. It also helps explain why the United States, with 330 million people, fares so poorly.Looking at some of the places ahead of it on the list, it would be very hard to apply the health care system of, say, Iceland, to the United States , since Iceland has just 334,000 people, about the same as Aurora, Colorado. Many others in the top 10 aren’t nations at all but microstates, such as Singapore (3), Macao (4), San Marino (5), Hong Kong (7), and Andorra (8).While people often cite the United Kingdom as a country to emulate, nations within it such as Guernsey (10) or Jersey (17) are rarely used as examples despite much better outcomes. And if we are going to emulate other nations, we might as well emulate No. 1 on the list, Monaco, whose life expectancy is a whopping 89.52 years, despite all the premature deaths caused by frequent James Bond visits.In fact, you can take the cumulative population of about half the places ahead of the United States on this list and the total population is still fewer than California alone. Amazingly, if you have fewer people, you can spend more to keep each alive. But it’s not just the total population that matters, as its makeup is very important as well.Now for Comparing Ethnic DiversityAnother thing that matters a great deal is how diverse a population is. If a population is more uniform culturally, doctors would know better how to approach and treat their patients. If a population is more uniform linguistically, doctors and health advocates can better communicate with patients. If a population is more uniform ethnically, genetics will be more uniform and doctors will be more familiar with the diseases their patients get and how to treat them.How diverse is the United States? With about 197 million whites, it has the largest white population on earth by far. But there are also more than 50 million Hispanics, also more than any other nation on earth. There are nearly 38 million blacks, more than all but eight other countries. Even Asians in the United States…

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