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

(www.nature.com)
201 points andsoitis | 9 comments | 15 Oct 24 13:39 UTC | HN request time: 2.533s | 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. yellottyellott ◴[16 Oct 24 16:25 UTC] No.41860972[source]▶
other than normal doctor’s office visits, i have no idea what i’m going to pay when i get a small procedure done.

a basic heart ultrasound cost me over $1k while my vasectomy cost me a $60 copay. i was expecting those prices to be flipped.

and don’t get me started on labs. i’ve gotten bills for basic screens years later for thousands of dollars.

you can’t shop around if you don’t know what you’ll pay until months after it happens. if you call the insurance company beforehand you wait on a static filled line with a call center in india, and even with the CPT code they can’t give you a straight answer.

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2. WalterBright ◴[16 Oct 24 18:22 UTC] No.41862082[source]▶
> i have no idea what i’m going to pay when i get a small procedure done.

All you gotta do is ask.

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3. jandrese ◴[16 Oct 24 18:52 UTC] No.41862469[source]▶
They don't know. Nobody does until the bill is processed. There are a thousand factors that might affect your coverage. This is the nightmare I'm living through right now. Even if you have the code and doctor and patient the help desk at the insurance company can't say for sure if they will cover it or not. That comes down to the discretion of the claims adjuster. You won't know if something is going to cost $100 or $10,000 until after it is done.
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4. red-iron-pine ◴[16 Oct 24 19:37 UTC] No.41862973[source]▶
and then wait 3 weeks for them to get back to you, as they contact your insurance and work out what they can get away with billing
5. WalterBright ◴[16 Oct 24 20:03 UTC] No.41863237{3}[source]▶
> They don't know

It works every time I asked.

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6. jandrese ◴[16 Oct 24 20:10 UTC] No.41863324{4}[source]▶
The provider or the insurance company? The provider can give you the cash price, but that's a made up number with no relation to reality. The Insurance company can give you what the standard discount would be on that procedure, but they can't say if they'll cover it, give only that discount, give nothing, or anything in between.
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7. WalterBright ◴[17 Oct 24 04:44 UTC] No.41866479{5}[source]▶
The provider. And yes, I negotiate.
8. consteval ◴[17 Oct 24 20:58 UTC] No.41873721{4}[source]▶
The prices you're getting are fake, whether you know it or not. Because you're not the one paying.

This is why it's sometimes cheaper to have no insurance than insurance.

9. yellottyellott ◴[18 Oct 24 12:31 UTC] No.41878799[source]▶
if you ask the provider you will eventually get burned. they can only give you the cash price as a backstop.

if you ask the insurance company you’ll never get an answer. providers are usually more helpful about what “should be covered”, but that’s not guaranteed.

seems like prior authorization is the only way to really make sure charges are covered but takes forever. but even then, if your insurance covers $x and they bill $y, you might get a balance bill in the mail.

point is, the market is heavily skewed against the consumer.