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Americans Less Healthy, But Outlive Brits
An anonymous reader writes with this intriguing snippet: "Older Americans are less healthy than their English counterparts, but they live as long or even longer than their English peers, according to a new study by researchers from the RAND Corporation and the Institute for Fiscal Studies in London. Researchers found that while Americans aged 55 to 64 have higher rates of chronic diseases than their peers in England, they died at about the same rate. And Americans age 65 and older — while still sicker than their English peers — had a lower death rate than similar people in England, according to findings published in the journal Demography."
Am I the only one who read the article? Ah yes, this is Slashdot. So this article is written by finance people and someone who works for RAND which is funded partly by the health care industries in the US.
So no fucking shit it finds that US healthcare industry provided healthcare is better than a socialist model.
Or have I missed something?
Why do so many American children die young?
I would posit that all American children who die do so while young.
When you're afraid to download music illegally in your own home, then the terrorists have won!
The summary is misleading. Brits, on average, outlive Americans.
http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy
This study compares the survival of people with similar diseases once they become ill.
In the US, physicians tend to emphasize curative (disease-fighting, life-extending) care. Many American physicians view the death of a patient as a personal defeat. Thanks in large part to numerous advances in medical technology over the past half-century, physicians (worldwide, but especially in the US) have become very good at "keeping people alive." That said, keeping someone alive often comes with a price - namely, the patient's quality of life. Relative to their English colleagues, American physicians are generally more resistant to moving patients from curative care to palliative care - care that focuses solely on reducing/eliminating symptoms. It comes as no surprise, then, that patients with chronic disease are living longer in the US. Saying that longer lives implies "better" healthcare is naively simplistic at best. That conclusion is indicative of a fundamental misunderstanding of the goals of medical care. The goals of quality health care demand a balance between curative and palliative care. On one extreme end of the curative-palliative-care spectrum you have the physicians (think: Kevorkian) who want to focus solely on reducing symptoms - even to the point of death. On the other extreme of the spectrum you have those who want to extend life at any cost (think: Terri Shiavo case). On this axis, American doctors lean somewhat to the "right" of most doctors worldwide. The best doctors in any country are straddling the line between "excessive" and "inadequate" care. That being said, conflating palliative care with "giving up" on the patient is an all too common issue among physicians and patients. Though I have full confidence in this research team's statistical results, they (Smith, in particular) seem to be unfamiliar with how heavily differences in culture affect healthcare, especially among patients with chronic diseases.
REAL American beer is done in microbrews.... like here in Portland, Oregon.
... and not served chilled. The whole point of chilling beer is so that it numbs your tastebuds so you can't taste how nasty it is when it's badly made.
Budweiser's "Fresh Beer Tastes Better" adverts were pulled by the ASA in the UK, because fresh beer does not, in fact, taste better. It tastes like yeasty rat piss until it has had time to mature a bit.
Also, the British thinktank who instituted this are a right-wing one, no doubt plotting to destroy the NHS alongside the Tory allies. So they publish a non-peer reviewed piece of 'research' designed to conclude what they want it to conclude. Bullshit.
The Tories recently gutted NICE, the body that evaluates the cost effectiveness of drugs to see if they should be made available on the NHS. They were doing a fine job, but got nothing but shit because they prevented pharmaceutical companies gouging into the state healthcare providers ample budget. When retards in the US talk about 'death panels' they are usually referring to these guys, and they don't get much of a good press in the UK either.
Basically, they talked to terminal patients to find out how much of their life they would be willing to give up to remain in good health for the rest of their life, and used this to calibrate a 'quality adjusted life year' which represented the value of a drug. Thus they could reject a hugely overpriced drug that added 2 weeks to the life of a late-stage cancer patient and spend the money saved on a drug that might allow a very sick child to reach adulthood. That second part *never* got a mention by the rightwing critics. When opportunity costs are being used to make the state healthcare system more efficient whilst forcing drug companies to charge realistic prices based on what their products can actually do, the right suddenly decides to reject economic language and talk shit about 'death panels' and NICE 'killing patients'.
Yes, we ration healthcare in this country - but up until now it has been based on how much extra life (across the whole population) that healthcare can give. The US rations healthcare too - based on how rich or poor you are. Our system is, frankly, better.
If we can put a man on the moon, why can't we shoot people for Apollo-related non-sequiturs?
Canadian life expectancy = 80.3 years, UK ife expectancy = 78.7 years, and US life expectancy = 78.0 years (in 2007) according to http://www.infoplease.com/ipa/A0004393.html and that's because Canada and the UK have life-long public health care.
But when medicare starts to cover US citizens at age 65, suddenly US citizens have a much better outlook. US citizens lucky enough to survive until age 65 and receive medicare coverage have a longer life expectancy than their British peers.
Actually, if you go back and study the data at http://www.infoplease.com/ipa/A0004393.html and http://www.oecd.org/dataoecd/46/33/38979719.pdf you'll discover that the US has both higher infant mortality and lower life expectancy than Canada and almost every developed European democracy (even Germany who absorbed the disaster known as East Germany a few decades back). For what its worth, the US also pays much more per capita for their lower life expectancies. I wonder if this data would change anyone's mind about the benefits of health care reform...
--- Often in error; never in doubt!
TFA is consistent with the observation that 90% of American health care dollars are spent during the last few months of the patient's life.
If USA health care invested more money in early and preventive treatment, people might not live any longer, but they would be in better health until old age problems caught up with them. That is clear from TFA when viewed within the context of the differences between USA and UK health care delivery systems.
But USA health care is profit oriented, and there is more profit to be made in selling cures and disease treatments than there is in preventing diseases. Not only does preventive health care lack as much opportunity for profit, it reduces the market for such money makers as AIDS drugs, cancer therapies, antihypertensive agents, and antidepressants.
The USA needs a major reform of health care. Even if the recent legislation is put fully into effect, it won't go far enough; it will be band aid approach to broken bones. There needs to be a break-up of the current system. Prohibiting the sale of health insurance for profit would be a good place to start.
Will
Without specifying what precise ailments she was suffering from, it's impossible to judge whether or not the NHS failed in that situation. The problem is, we never want to let our loved ones go, even when no medical technology can save them.
Last night, I was talking to a nurse who'd spent some time working in Dubai, and who had regularly encountered a particularly common form of cognitive disfunction: the belief that money can solve every problem. He was regularly confronted with people who thought that the reason that their relatives were dying was that they hadn't offered enough money. That there was an infinite sliding scale of increasingly expensive treatments, and somewhere in there there was a magic pill that would save their loved one.
The truth is, medical science has come a long way, but it still can't fix everything. So there's a possibility that she was sent home because there was nothing they could do but prolong the agony.
Rgasuya aata! : I have been coding Perl and cannot tell where my fingers are now!
If the stuff you're pushing worked the way you say it would, the doctor would be recommending it.
However, as it turns out, the research on whether or not magnesium helps with high blood pressure is inconclusive; this article seems to have a reasonable layman's summary of what's going on. Therefore, the doctor cannot in good conscience recommend that the guy take magnesium pills, as they may or may not work (for the same reason why doctors can't prescribe placebos, despite their occasional effectiveness).
Furthermore, look at the "Should I take oral magnesium supplements" and "What are good dietary sources of magnesium" sections - dietary magnesium supplements just don't work, you need to get it as part of your food. What food contains magnesium? Healthy food. What part of the doctor's recommendation are you leaving out? A diet change. No doctor would just prescribe blood pressure pills without also including a dietary intervention, that's only treating the symptoms without treating the underlying problem. This is actually something alt-med people love to accuse doctors of, probably because everyone just hears "pills" but doesn't pay attention to the "and here's how you should improve your diet, and some exercises you can do" bit. Either you or your friend didn't pay attention to the part where the doctor recommended lifestyle changes, because he certainly did (and if he didn't, he is being remiss in his care).
So why recommend blood pressure pills in the first place, if the real treatment is going to be a change in diet and exercise? Because high blood pressure is a danger now, while diet and exercise will cure the problem later (if at all - to be quite honest, few people manage to make permanent healthy lifestyle changes. It's really sad, but that's the way it is). Ideally, your friend would start taking the blood pressure pills immediately, then start in on changing his diet and getting more exercise and eventually wean himself off the pills once his blood pressure gets to a normal level.
As for potassium bicarbonate, the Cigna page on it says that you should tell your doctor if you have high blood pressure and intend to take it, as there may be side effects. The only study on its effects that I could find was this one, which had positive results but was little more than a pilot study (14 people). Further research is needed before a doctor can really recommend supplementation with potassium bicarbonate (especially when just eating more fruits and vegetables already has a significant effect, which is probably why there's been little research in this area - there's no need to recommend expensive supplements when the patient can just eat better).
There is something I don't understand in your post, though: you say that taking these alternative supplements is good, because it deprives the pharmaceutical complex of years of income (despite the fact that ideally you'd stop taking the blood pressure pills at some point) - but as your alternative, you recommend taking magnesium and potassium bicarbonate supplements. Do those poof into existence from thin air? No, they're sold by the "supplemental" complex - and you're recommending giving them years of income for treating high blood pressure, despite (again) the fact that the real treatment lies in a lifestyle change. You're basically saying "don't buy stuff that we know works from those guys, buy stuff that may or may not work from these other guys".
I wonder who is treating the symptoms here, and not addressing the causes?