Slashdot Mirror
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."
The UK is more depressing what with its annual 4 hours of sunshine and the best looking women maybe rating a 7. Who can forget the warm beer, bad food and lovable totalitarian government?
I'm not kidding. You don't think all of that stuff can have a negative affect on a persons psyche, perhaps affecting their health? Especially the warm beer...that's especially depressing.
If you ignore ACs because they are anonymous - you're an idiot.
Despite all this clever wording, Americans do not outlive Brits in the vast majority of cases.
USA - Male life expectancy 75.6 years, female 80.8 years.
UK - Male life expectancy 77.2 years, female 81.6 years.
Notice how one set of numbers are larger than the others.
There're many other factors... Such as amount of money spend on health care... For instance the US spends more than twice as much on heath care per citizen as the UK (and the US doesn't even cover all of their citizen).
That's according to OECD: http://tinyurl.com/cr9753
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.
The numbers are badly skewed by the fact that what happens earlier is highly significant.
Consider a previous study (in the 1980's I believe). It showed that Electronic Engineers in the US were far more likely than others to die in their 40's of exposure to PCBs. This lead to panic about Poly Chlorinated Biphenys, which are used in transformers.
Once the panic settled down, it was discovered that polychlorinated biphenyls are only used in power distribution transformers (ie in substations), whihc most EEs are never exposed to at all. However, almost all EEs were exposed to Printed Circuit Boards. Statistical analyists were not exposed to neither, and could not the difference between a liquid and a solid. The reason for the discrepancy in the death rate was that EEs lived much longer than their peers because they were not sent to Vietnam, and were much more likely to die of health problems in the 40's because their peers died of gunshot wounds at the atge of ne-ne-ne--nineteen.
Moral: Trust statistics only after you personally have discovered how far you can throw them. (Chucking them into a WPB is a well proven strategy).
Sent from my ASR33 using ASCII
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?
Also bear in mind in the UK we now have a foaming-at-the-mouth radical neoliberal government, the type who says "Government is terrible! And when we get elected we are going to prove it!". They are intentionally gutting the NHS from the inside in order to make it look bad so they can move in after a few years and say "Socialised healthcare doesn't work" and sell the whole think off to their Eton/Oxbridge mates.
Expect more of these lies in the future.
If we can put a man on the moon, why can't we shoot people for Apollo-related non-sequiturs?
Actually, this is quite possible.
You'll note that the "Rand Corporation" only collected data for this study from 2002-2006. That's when the life expectancy trend was really starting to show up.
Second, you'll note that for some reason, they compared the US to Great Britain. If they had used other countries with what you so quaintly call "socialized medicine" the results would show that the US was not doing quite so well in the health and life expectancy olympics.
You are welcome on my lawn.
"While poorer people are more likely to die sooner than their more well-off counterparts, researchers say their finding supports the view that the primary pathway between health and wealth is that poor health leads to a depletion of household wealth, rather than being poor causes one's health to decline. Researchers found that the substantial changes in wealth that occurred in the years 1992 and 2002 in the United States through increases in stock prices and housing prices did not alter the probability of subsequent death."
Yes, that's exactly the part I was eluding to. It doesn't tell us anything about comparative differences between the countries as regards wealth. I.e. are the differences in health care between the two countries constant across different wealth demographics or are they different, e.g. we find the the US is ahead of the UK in heatlh care for the wealthy, but the UK is ahead in health care for the median earners or the poor. That's what would be really interesting to know if we want to start examining the role of health care in more meaningful depth and by the sounds of it, they collected data relevant to this, but it is missing from their conclusions. I find it highly unlikely that the difference in health care is constant across all demographics of society.
Aide-toi, le Ciel t'aidera - Jeanne D'Arc.
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!
The fact is that the US health system costs 10 points of GDP more than socialised systems with better outcomes. So as far as efficiency goes, experience shows public health care is massively more efficient than private one.
And this is obvious: you cannot ask someone to decide objectively how much to spend on their health when their life is on the line. This is exactly equivalent to legal mugging.
Basically, you are arguing that 10% of US GDP (way more than the average deficit even with the Bush madness) is well spent just because instead of staying in the pockets of the people, goes to line the pockets of private companies? For no benefit to the public at all? Because you are not getting better outcomes, you are not getting better innovation, you are not getting more employment. You do get better catering, but if you think hospitals should be run as glorified hotels you need to look up on what is expected of a hospital.
You fail at basic logic and basic knowledge.
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!
It's not that we're better than the brits. They just considering it unethical to prolong death in the ways that we do here in the US. We can keep someone alive an extra 6-18 months with modern medicine. Quality of life during those months ia really crappy, but as long as you have an estate or medicare to draw funds from who cares?
The concern in Europe is about making end of life care as painless and dignified.
It's one of the reasons health care costs less there.
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?
Actually, it's more of the dangers of the lifestyle in general. More people are killed from more reckless behavior in the US then in the UK. We do more stupid shit on a regular basis like give some types of guns to anyone over 18 based on nothing more then their desire to have them. We allow juveniles to handle loaded firearms and other weapons (Bow and Arrows) unsupervised for extended lengths of time (while hunting) and so on. We have one of the largest recreational boating populations in the western world, some of the largest lands allotted to motorcycle, quad-atv, and other recreational uses.
But probably the number one risk that would alter the life expectancy quite a bit would be cars. In the US, there is/was about 2.28 cars per household (in 2008) while only about 1.1 cars per household in the UK (at about the time- from 2008 to 2009). This means that more people are driving in the US then in the UK. Gas is also cheaper which generally means that more people are driving for recreational uses verses more restrictive usage like necessities and so on. But something that probably would make this skewed even more would be that in the UK, you typically have to be 17 to get a drivers license and even then, you are restricted to what types of cars you can drive until your 18 or 21. In the US, it differs from state to state, but in most cases, you can start driving at 16 years of age, there is no limits on the types of cars (or non-commercial trucks) and in some areas, with certain hardships you can get a drivers license at age 14 (Ohio is one).
A reflection of this is strongly shown in the UK traffic death statistics in which they listed that in 2006, there were 5.4 road accident deaths per 100,000 population in the UK compared to 14.3 per 100,000 populations in the US. I don't car where you are, if you have almost three times as many people dieing from more or less random occurrences, the life expectancy will be lower and it won't be much on the grounds of health care provided Health care provided is equal in traffic fatalities because it's all either not in the equation (dead on the scene) or life threatening injuries in which not only does car insurance cover, it's illegal in the US for a hospital open to the public to refuse or limit emergency medical treatment based around the ability to pay.