Good Column on Life Expectancy

September 28, 2009

Thank you Mary Josee-Kravis for this excellent debunking of the use of life expectancy as a measure health care effectiveness.   Some key words:

U.S. life expectancy at 65 (17.1 more years for males and 20 for females) is higher than in the U.K. and Germany. The more important point, however, is that life expectancy reflects not only health care but also diet and lifestyle. A raw match of life expectancy against health care spending is naive.

Take road fatalities: The U.S. holds the unenviable record of one of the highest rates in the developed world. Its road mortality rate is 15 per 100,000 people compared with 6.6 in Japan, partly because we drive more. Would universal health care shorten commutes or stop speeding? Would driver-distracting cell phones be shelved and more seat belts worn if there were universal health insurance?

Here are some stats I haven’t seen elsewhere:

The Organisation for Economic Co-operation & Development reports that 32.2% of Americans are obese. The OECD average is 14.6%, with Japan at 3%, France 9.5%, Germany 13.6%, Canada 18% and Australia 21.7%. Obesity isn’t caused by the health care system, but it does reduce life expectancy. It’s a lifestyle choice whose expenses are borne by everyone. Costs attributable to obesity account for almost 10% of health care spending in the U.S. In Canada the corresponding figure is from 2% to 3.5%.

Obese Americans spend an average of 36% more for health services and 77% more for medications than people of normal weight. They are 20 times as likely to develop diabetes, 2.5 times as prone to heart disease and twice as vulnerable to cancer, hypertension and asthma. Will health care reform cut portion sizes? A more pertinent question: Will obesity be classified as a preexisting condition preventing insurance companies from providing incentives for healthier life choices?

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