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Life expectancy rise in rich countries slows down: took 30 years to prove

(www.nature.com)
201 points andsoitis | 8 comments | 15 Oct 24 13:39 UTC | HN request time: 2.347s | source | bottom
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defrost ◴[16 Oct 24 00:22 UTC] No.41854450[source]▶
For an interesting side piece:

    Curiously, however, for a system apparently stultified by the dead hand of government, Australia’s health system far outperforms the free market-based US healthcare system, which spends nearly twice as much per capita as Australia to deliver far worse outcomes — including Americans dying five years younger than us.
The shocking truth: Australia has a world-leading health system — because of governments

Source: https://www.crikey.com.au/2024/10/16/pubic-private-healthcar...

Bypass: https://clearthis.page/?u=https%3A%2F%2Fwww.crikey.com.au%2F...

    Overall, we now have the fourth-highest life expectancy in the world.

   This is contrary to the narrative that pervades the media about our health system — one in which our “frontline” health workers heroically battle to overcome government neglect and inadequate spending, while the population is beset by various “epidemics” — obesity, alcohol, illicit drugs.

    In fact, Australian longevity is so remarkable that in August The Economist published a piece simply titled “Why do Australians live so long?”
Other references:

The Economist: https://www.economist.com/graphic-detail/2024/08/23/why-do-a...

AU Gov Report: Advances in measuring healthcare productivity https://www.pc.gov.au/research/completed/measuring-healthcar...

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alwayslikethis ◴[16 Oct 24 00:48 UTC] No.41854605[source]▶
> the free market-based US healthcare system

market, maybe, "free" market? I doubt it.

It's not a very free market when there is such a large power differential between the buyer and the seller. You can't exactly shop around for the ambulance or the hospital when you need it, nor can you realistically circumvent the artificially constrained supply [1] of doctors to get cheaper healthcare (unless you live next to the border).

When the alternative is a one-sided market like this, government becomes rather more appealing.

1. https://en.wikipedia.org/wiki/American_Medical_Association#R...

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WalterBright ◴[16 Oct 24 06:47 UTC] No.41856252[source]▶
> You can't exactly shop around

The vast bulk of health care is by appointment, not a dash in the ambulance.

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1. davkan ◴[16 Oct 24 07:09 UTC] No.41856368[source]▶
You’re still significantly limited by your insurance carrier’s network and also the consolidation of the healthcare industry. I used to live in a city of 1 million that had essentially two hospital networks that bought everything. You could not find a specialist not associated with those two companies. Pre-natal, allergy, cardiac, two choices. When my seventy year old doctor who ran a practice out of his house retired he sold the practice to one of the two.

It’s not shopping for a tv. You can’t choose not to buy. It’s often time sensitive even if by appointment. Pricing is incredibly complex as are the details of the product. Your average person does not have the information necessary to navigate the market.

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2. Pikamander2 ◴[16 Oct 24 08:52 UTC] No.41856984[source]▶
Even more fun is when your doctor refers you to a specialist that's in-network, but your insurance comes up with a bunch of reasons to deny it.

How did we collectively decide that it's okay for insurance companies to overrule medical professionals?

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3. gruez ◴[16 Oct 24 12:47 UTC] No.41858447[source]▶
AFAIK the overruling is done by a "medical professional" as well, albeit one that's on the insurance company's payroll.
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4. nradov ◴[16 Oct 24 16:37 UTC] No.41861088[source]▶
Legally speaking the insurance company isn't overruling medical professionals. They're simply refusing to pay. Patients still have the option of paying for treatments out of pocket. (I do understand that for poor patients this is a distinction without a difference, I'm just clarifying the legal issue.)

Some states have recently passed laws which limit the authority of health plans to conduct medical reviews or deny payment for services that providers deem medically necessary. This will reduce hassles and expenses for some patients, but it will also accelerate the inflation of insurance premiums paid by everyone else.

5. jandrese ◴[16 Oct 24 18:50 UTC] No.41862432{3}[source]▶
That "medical professional" has literally 90 seconds to review your case and say yes/no. They've never met you. They don't know your doctor. All they have are some notes on the case, a billing code, and a quota to reach every day. They get bonuses based on how much money they save the insurance company.

All of that cost savings makes US healthcare cost double what it does anywhere else in the world.

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6. nradov ◴[16 Oct 24 21:41 UTC] No.41864118{4}[source]▶
I think you're a little confused about causality. All healthcare systems, including fully socialized ones, perform similar types of case review to ration care and hold down costs. US healthcare costs might be high now but would be even higher if the payers (including the Medicare / Medicaid government payers) paid every claim that came in without denying those that fail to mean plan coverage rules.

If we want to hold down costs then we'll have to put a greater focus on preventative care, stop expensive treatments for terminal patients, impose price controls on providers, and stop subsidizing drug development for the rest of the world. None of those measures are politically popular.

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7. WalterBright ◴[17 Oct 24 04:43 UTC] No.41866475{5}[source]▶
Price controls always result in shortages.
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8. nradov ◴[17 Oct 24 13:56 UTC] No.41869720{6}[source]▶
Yes, exactly. Since demand for healthcare services is essentially unlimited, creating artificial shortages is one way to ration care and hold down public spending. The US government already creates healthcare shortages in other ways, such as constraining the number of residency slots to limit Medicare spending. (I don't support this, but it is somewhat effective from a fiscal policy perspective.)