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...

> 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...

>>the free market-based US healthcare system

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

The consumer of healthcare is doubly removed from the price of healthcare. This is the opposite of a free market.

The patient did not pay the doctor, the insurance company does. In most cases the patient does not pay for insurance their employer does.

So the normal pricing forces of a free market are removed.

Then we need to talk about certificate of need laws which restrict the supply...

The free market aspect is the insurance marketplace.

If you’re poor, you’re fucked. If you’re old you’re ok. If you work for the government or certain companies, you have access to world class care. Everyone else is on a spectrum from high quality PPO to the shittiest Cigna plan.

There is nothing free about the health insurance market. It is regulated to hell to the point where a common complaint of actuaries I know is that they are not allowed to price your health risk.

^ When the grossly overweight 60yo smoker pays the same amount as a health-conscious 30yo, we have a problem.

It's usually not the same amount. The Affordable Care Act (Obamacare) explicitly allows health plans to set premiums based on age and smoking status. However, this might not capture the full risk differential for some members.

https://www.cms.gov/marketplace/private-health-insurance/mar...

There's a deeper philosophical question here about how we should spread risks and costs across society. Like should some plan members pay more because they have a history of cancer, or because they engage in risky activities like flying light airplanes?