Isn’t it just barely possible that the reason that Americans have life expectancies after 65 comparable to the French, Germans, Britons, and Canadians that Americans older than 65 are genetically more similar to the French, Germans, Britons, and Canadians than our younger population is? Only about 15% of all Americans over 65 are either black or Hispanic. I think that Harold Meyerson is using misdirection to argue for healthcare reform.
I’m completely in favor of healthcare reform. My opposition to the PPACA, “ObamaCare”, had two bases: a) it was obvious to me that its reform was phony, not the reform that we need and b) the history of healthcare reform in the U. S. is that after a major reform bill is passed a very long period, fifteen to 25 years, goes by before we have the stomach to tackle it again and I didn’t think that we could wait for the outcome of a useless reform to become apparent before reforming healthcare in a productive direction.
I can give you the formula for increasing life expectancies at birth in the U. S. in three words: end gang violence. Easy to write, hard to do.
I’m not as convinced as Mr. Meyerson is that increased spending on healthcare makes us that much healthier. I think lifestyle changes are more important. Said another way, I think that extraordinary spending on the elder sick results in days, weeks, or months of additional vigorous, productive life while healthier lifestyles result in additional months or years of productive life.
What are the implications of lower birthweight babies due to maternal drug or alcohol abuse for the life of these infants after 70? Assuming they make it to 70. That’s a greater problem here, too, as I’ve written before. I would presume that it isn’t nothing and a national health service would do very little about that but would spend a lot of money doing it.
U. S. per capita healthcare spending is twice that of France. We spend a higher proportion of GDP on healthcare and, if anything, we need to spend less. Of itself going to a single-payer system like Germany’s, a system like France’s, or even a full-on national health system like Britain’s won’t cut our spending. Only cutting our spending will cut our spending and until we develop the political will to do that all we will do is wait for the inevitable crash.
Meanwhile, if we keep doing what we’ve been doing, we’ll tax young blacks and Hispanics who won’t live to 70 to pay for the increasingly pricey healthcare of old, white people.
Doesn’t the life-expectancy of those over sixty-five put the lie to the idea that Americans are not receiving benefits from its high healthcare costs? It would seem that in countries where doctors receive less financial compensation, but may receive more reasonable work hours, that this might impact healthcare outcomes.
I think the under sixty-five lifespan differentials result from the lifestyle choices the author mentions, as well as the demographic ones you mention. But I think one also needs to consider healthcare access in terms of America’s geography; its far more spread out than the European comparisons.
That’s only if you think in terms of artisanal medicine. More automation, telemedicine, and more extended use of nurse practitioners or other non-MD people doing what MDs are doing now come to mind.
I’m mainly thinking about emergency care because of Meyerson’s focus on the relative under-sixty-five lifespan. He concedes American’s have made different lifestyle choices than other countries that increase our deaths from accidents, violence and diet, but to lay that out on the doorstep of medical care, you have to get them into a medical care facility timely.
“Increased journey distance to hospital appears to be associated with increased risk of mortality. Our data suggest that a 10â€km increase in straightâ€line distance is associated with around a 1% absolute increase in mortality.”
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464671/
we’ll tax young blacks and Hispanics who won’t live to 70 to pay for the increasingly pricey healthcare of old, white people.
You can’t squeeze blood out of a turnip. Blacks and Hispanics face lower employment and lower wages than whites, so there’s not enough money there to tax away wealth for old white people. When you subtract transfer payments to blacks and Hispanics, you won’t have much left.
My own advice toward reducing is making sure that everyone executes an advance directive before every hospital admission. That will reduce unnecessary ICU costs.
A fine old friend of mine developed an infection after surgery on a callous on his foot. My husband died of infection, too. After days on life support.
That sort of thing is hard on everyone involved, including the nurses and other personnel in ICU.
Well, except for the attending physicians and the hospital itself.
My husband didn’t execute one because he could be a stubborn sumbitch, not because he wasn’t capable at the time.
Don’t make that an excuse.
1) PD is correct that equal life expectancies at age 65 is partially the result of near universal health care, like other OECD countries, at age 65.
2) We are now one of the leaders in our state in the use of Advanced practice nurses, but it does help in some cases. I am sending one of my guys down to North Carolina soon to help expand this into new areas of the hospital we are being asked to take over. It doesn’t save nearly as much as you might think. You pay less per person, but you need a lot more. It does not cut down on the really expensive part of medicine, the procedures and therapies, so far. Telemedicine is a cure looking for a disease. Of some use in decreasing imaging costs. Have some hopes for it with critical access hospitals where the savings may offset the costs.
Steve
But I think it’s better medicine, Steve. There’s nothing to to be gained by watching your loved one’s extremities turn blue while he bouncing to the machine’s rhythm.
My husband was an extremely interesting man. I watched the dead cat bounce.