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

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...

AFAIK Australian healthcare system is mixed public private with a heavy lean on private. The healthcare market is open to market forces as the government works through subsidies. Plus I think many of the hospitals are religiously run institutions which helps protect from private equity influence.

The US has massive government regulation and dysfunctional state intervention in healthcare if not directly then vicariously with rules around Medicare. The US government helps make the dysfunction that private equity later exploits.

So I’m not sure that it would be correct to use Aus and the US as examples of the either end of the private / public continuum.

I would use UK or France as an example of a public system and Singapore as a light touch private, and perhaps India or Turkey as a laissez-faire system.

The UK and France systems appear to be degrading and do not appear long term affordable and I think they will soon be adopting Canadian style Maid systems to cut cost.

Germany is a weird one because it seems like half the doctors there are homeopaths and the Germans love their insurance but I’m not sure if they get value for it.

Personally I’d prefer the Australian or Singaporean style systems but I’d classify those as mostly private.

I had private health insurance in Germany. It was quite expensive and had a very high deductible — so pretty bad incentives around routine health care, I never made a claim in 13 years.

The upside was that if you needed, say, a brain transplant for ten million Euros, as long as it was medically necessary they would pay for it.

Now I have a policy elsewhere that is cheaper, still covers me when I go to Europe, and has a much better copay structure while being 100% private. Downside is I can’t afford that brain transplant, but I’ll probably be OK for everything else.

But if a procedure is medically necessary in Germany, public insurance pays for it too (and if they deny, you can, often successfully, appeal or sue them). The biggest difference is that you’ll get an appointment much faster due to the quota system for public insurance patients, and that private insurance can cover more things that aren’t strictly necessary.