Americans are sicker, die younger while spending the most on health care; what South Korea can teach us.

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The News:

Typically, the more a developed country spends on health care, the longer its people live. The US, which spends the most on health care, defies that tendency another study compiled by Bloomberg confirms.

Compared to the 35 countries in the Organization for Economic Cooperation and Development (OECD), which promotes policies to improve social and economic well-being, the US life expectancy of 78.8 years ranks 27th. It has the fourth highest infant mortality rate in the OECD, the sixth highest maternal mortality rate and the ninth highest likelihood of dying at a younger age from a host of ailments, including cardiovascular disease and cancer.

The US is the most obese country in the OECD, leads in drug-related deaths and ranks 33rd in prevalence of diabetes. Yet 88% of Americans say they are in good or very good health, according to OECD statistics. Only 35% of Japanese, who have the highest life expectancy in the OECD, regard themselves as healthy or very healthy.

Unlike other countries in the OECD, the US mostly relies on voluntary health insurance to fund healthcare costs. Public health insurance, such as Medicare and Medicaid, accounts for 27% of coverage. By contrast, the 10 countries with the highest life expectancy depend on voluntary insurance for an average of less than 6% of their costs, and government spending for nearly half.

One big reason US healthcare costs are so high: pharmaceutical spending. The US spends more per capita on prescription medicines and over-the-counter products than any other country in the OECD.

Bloomberg ranked the OECD countries by total expenditure on health, which is the amount each country spends for both individual and collective services.

Infant mortality refers to the number of deaths of infants under one year old. Compulsory/contributory health plans include social health insurance, compulsory private insurance and compulsory medical savings accounts.

Source: OECD, The World Bank, World Health Organization, International Diabetes Federation and Diabetes Atlas

Steve’s Take:

The data team at the Economist notes that population forecasting is not simple. Still, their findings closely parallel the Bloomberg report cited above and serve to prove the US healthcare system is fundamentally flawed and unworkable at present.

What’s clearly needed is a workable approach, along the lines of those adopted long ago by other OECD countries that have flown past America in the results they have achieved both in longer and healthier lifespans.

Demographers use mortality data—information about when people die and why—to estimate the likely life expectancy of people still alive. The UN, the World Health Organization (WHO) and others produce periodic forecasts that are fairly similar.

Wealthy countries such as Japan, Switzerland and Australia have the highest life expectancies, though the estimates vary slightly depending on the methodology used. But a recent study of 35 rich countries by researchers at Imperial College London and the WHO, and published in the Lancet uses a combination of 21 statistical models, instead of just one. The results, say the authors, are more reliable. They are also surprising.

By 2030, they now judge, South Korea will have seen the biggest gains in life expectancy for both men and women. A girl born there in 2030 is likely to live past her 90th birthday, seven years longer than one born in 2010. South Korean men are expected to live to just over 84, bounding over 18 other countries to the top of the ranking.

South Korea’s flight path has been extraordinary. Its annual GDP per person is more than 20 times the level in 1960. America and Britain saw only a three-fold gain over the same period. These economic achievements have improved the nation’s health.

In 1985 life expectancy in South Korea was more than four years lower than in America for both sexes; by 2010 it had caught up for men and risen to three years higher for women. The main reasons were big reductions in child mortality, deaths from infections and deaths from diseases related to high blood pressure, which include cardiovascular disease and stroke.

The share of South Koreans who have raised blood pressure is lower than in any other country. Few South Koreans suffer from obesity, which increases the chance of several chronic illnesses, including diabetes, heart problems and cancer. Smoking rates among women remain low.

Other countries expected to do well are improving for similar reasons. Few women in France and Switzerland are obese. By 2030 Hungarian men are expected to live 7.5 years longer on average than they did in 2010, partly because fewer drink too much or smoke. New Zealand, Australia and Canada have low rates of infant mortality and death from traffic accidents, and good records in preventing and treating heart disease and cancer.

But the Lancet’s authors predict far less progress elsewhere. In some less wealthy countries, such as Macedonia and Serbia, average life expectancies are low and predicted to improve only modestly. Sweden and Japan can also expect relatively small gains, though that may be unavoidable since they already sit near the top of the table.

The most conspicuous anomaly is America.

The world?s biggest economy is among the bottom five countries in expected gains for both men and women. At 77 years for men and 81 years for women in 2010, American life expectancy is already among the lowest in the rich world.

That is partly because America is the only country in the OECD that does not have universal health care, meaning poorer health for poorer people. It also has the highest maternal and child mortality rates, so fewer people reach old age. High obesity and homicide rates shorten lifespans as well.

As a result, the study predicts that life expectancies in far poorer countries will eventually overtake America?s. It finds that men born in the Czech Republic will live as long as those born in America by 2030, as will women in Croatia and Mexico.

Worse yet, projections of life expectancy in America may need to be revised downwards. The researchers use actual American mortality data to 2013, with forecasts beyond that point. In fact, American life expectancy fell in 2015.

If Republicans’ quest to repeal the Affordable Care Act, also called Obamacare, winds up reducing access to care, this trend might accelerate.

Lancet researchers point out that as recently as 2000 it was thought impossible that a country’s average life expectancy would ever exceed 90. That so many developed countries can expect people to live beyond 80 is testament to healthcare successes.

The next challenge for governments will be to ensure there are sufficient health and social care policies in place to support fast-swelling older populations.

Bottom Line:

This writer finds it inconceivable that, collectively, we are still determined to be among the unhealthiest population among rich countries. These recent studies prove this.

Steve's Take: Scrapping #Obamacare, cutting #Medicaid, and #tax cuts for the rich is plain nuts Click To Tweet

The attempt to scrap Obamacare, take nearly a trillion dollars out of Medicaid and shift that money to the wealthiest 1-2% of Americans in the form of a tax cut is plain nuts. Study after study proves that the longer poorer Americans are forced to wait to seek medical care, the sicker they are by then and the more it costs to care for them, usually in an emergency room setting, and the sooner they die in any event.

Is this what we really want?

Why this doesn’t make sense to our legislators despite the vast majority of Americans believing in universal health care, is not just unfathomable, it’s infuriating. Because it’s our tax dollars–yours and mine–that are being thrown at the richest amongst us while legislators debate whether women should be permitted to get routine breast-cancer screening so they can be treated successfully earlier, which benefits all of us. Well, except for the wealthiest, who, with a few notable exceptions, apparently don’t give a hoot.

What do we need to do to turn this abomination around? More of the same action that led some courageous legislators like Sen. Susan Collins (R-ME) to vote down the GOP Obamacare repeal bills saying, “I did not come to Washington to hurt people.” I can hope that others follow her lead, but I’m sure not expecting anything.

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