13 replies to this topic

[advancedatheist]

http://www.mercola.c...health_care.htm

U.S. Spends More on Health Care but Gets Little in Return


The United States spends much more on health care than other industrialized countries, yet does not seem to get any more benefits from the increased spending, according to research.

According to experts, it needs to be determined whether Americans’ increased spending on health care translates into more resources for patients or simply higher income for health care providers. However, according to the report Americans seem to be getting fewer real resources than people in other industrialized countries.

Researchers analyzed health care spending among 30 nations that were members of the Organization for Economic Cooperation and Development (OECD) in 2000 and found that the United States spent more than twice the amount for health care as other nations.

The U.S. per capita health spending in 2000 was $4,631--13 percent of the gross domestic product (GDP)--while the median spending for the OECD members was $1,983 per capita, which is eight percent of GDP.

Further, in 2000 Americans’ private per capita health spending of $2,580, which includes health insurance premiums and out-of-pocket costs, was more than five times that of the OECD members’ median of $451.

Researchers suggested a number of factors that could contribute to the increased health care spending in the United States including higher salaries for health care workers, more expensive medical equipment and pharmaceuticals, and more “service-intensive” hospital visits.

Additionally, researchers noted that the U.S. health system may be less efficient than those of other countries, leading to higher costs such as those needed to compensate for extra administrative personnel.

Health Affairs 2003;22:89-105 (PDF File):

http://www.healthaff...y/v22n3/s16.pdf

Edited by XxDoubleHelixX, 27 May 2003 - 10:47 PM.

[Mind]

One thought...maybe our health care costs are higher because we are pushing the limits of life-extension further than other countries. Maybe they are just doing more "routine maintenance" health care in other countries.

Also a little story about third party insurance and how it drives up costs. This happenned to me just last month. I went to the optometrist to get an eye check-up and a new set of contact lenses. When I was filling out the information forms at the front desk the clerk asked me if I had an insurance card. I said yes, but my insurance does not cover eye care. She said it didn't matter and she should swipe my card anyway. I said "I don't think my card is even up to date, we switched health plans last year and I do not have a new card". She said "well give it to me anyway, you never know when the request will go through, you might get covered by accident". I was appalled. It sounded like this was common practice in their office. She was basically saying let us see if we can rip-off the insurance company, maybe through some administrative error they will cover the cost.

This type of action would certainly drive up health care costs if occurrs across the country.

Another story. My fiancee was sick with the flu or something and thought she should go to the clinic to get it checked out. When she got into the doctors office he suggested several hundred dollars worth of tests and expensive medication. When he found out she didn't have insurance he gave her some discount antibiotics and said get some rest. She went home and got better. The bill was under $100.00. Now if she had insurance there would have been a huge costs to the system without much benefit to the user. This is another problem with 3rd party insurance in the U.S.

[advancedatheist]

http://www.prospect....ne-a-05-21.html

Breathtaking Ignorance
SARS is just the beginning -- and we're not ready for what's next.

By Alex Stone
Web Exclusive: 5.21.03

When the first cases of AIDS were discovered, few virologists could have foreseen that it would develop into a global scourge capable of bringing nations to the brink of ruin. It is extremely difficult to predict how new illnesses will evolve over time, and the latest disease to spread quickly -- severe acute respiratory syndrome (SARS) -- is no exception. The virus could end up following any number of trajectories; it is impossible to tell at this stage which path it will take. But one thing that epidemiologists generally agree on is that SARS is only the beginning: The world will likely face numerous global epidemics like SARS -- and far worse ones -- in the near future.

Several factors have conspired in recent years to significantly magnify the likelihood of disease outbreaks. The rapid growth of urban areas -- on average, 160,000 people around the world move from the countryside into cities each day -- is bringing diverse populations into close proximity and creating new opportunities for microbes to find susceptible hosts. And the environmental changes -- from paving roads to damming rivers -- that accompany urbanization alter the natural habitats and reproductive patterns of disease-bearing animals, such as mosquitoes, mice and rats. What's more, the explosion of international travel and global commerce is accelerating the movement of pathogens across national boundaries. Each year, 1 billion people travel by air, and 700 million go on transnational trips. (Indeed, all it took for SARS to jump from China to Canada was for a single infected person to step on a plane.) And global trade in produce has grown by 30 percent in the last 10 years, with the United States now importing 70 percent of its fruits and vegetables. "We're seeing a big increase in the movement of viruses, both geographically, from one place to another, and cross species," notes former Centers for Disease Control and Prevention epidemiologist Clarence Peters. "There are more and more things that are favoring the emergence of new organisms."

And while the threat of new epidemics mounts, familiar diseases are recrudescing in more virulent forms. Of the 9 million new cases of tuberculosis reported each year, 5 percent are resistant to one or more antibiotics. Though still primarily a problem in developing countries, where cases of the disease are rising by up to 10 percent each year, tuberculosis could easily begin to overtake the developed world if current trends continue. It has already made some frightening inroads. An outbreak of resistant tuberculosis in New York City during the early 1990s, for example, cost nearly $1 billion to contain. "It's like watching SARS in slow motion," notes Nils Daulaire, president of the Global Health Council. "It could certainly re-emerge to become a disease not just of the poor but of everybody." Resistant strains of other major diseases, including malaria, AIDS and cholera, are also spreading, while common illnesses are increasingly showing immunity to conventional treatments. Ninety-five percent of staphylococcus infections -- and many variants of streptococci (which causes meningitis), pneumococci (which causes pneumonia) and gonococci (which causes gonorrhea) -- are impervious to "first-line" antibiotics, such as ampicillin and erythromycin. Penicillin, once a silver bullet against almost any bacterial infection, is now useless in all but a few cases.

Unfortunately, this pattern shows no signs of abating, and unless considerable progress is made in the development of new medicines, benign ailments could once more become the life-threatening illnesses they were in the 19th century, prior to the discovery of antibiotics. "We are very much used to assuming that everything is going to be OK if we go to the doctor, but that's not always going to be the case," notes Peters. "It's just going to get worse. We're going to see more and more difficulty in being able to treat common infections."

With the SARS virus, which replicates quickly and spreads easily, the medical options are even more limited. No human vaccine exists for the class of virus (known as the coronavirus) to which SARS belongs, and it will likely take three to five years to produce one -- a long time considering that the disease managed to travel across continents within a matter of weeks. "The time it takes modern technology to respond to SARS is significantly slower than the virus can move and cause a pandemic," notes University of California, Irvine virologist Luis Villarreal.

And this problem is not unique to the SARS virus, or to coronaviruses in general. Even wealthy nations have drugs for only a small fraction of known virus types, and because viruses mutate much faster than bacteria, anti-viral drugs become outdated sooner. (Hence the need to engineer a new flu shot each year.) This is especially worrisome considering that, by most estimates, another major outbreak of viral influenza is long overdue. In fact, one of the characteristics of SARS that has epidemiologists spooked is that it resembles -- in its mobility and deadliness -- the brutal 1918 "Spanish Flu" virus, which killed 20 million people worldwide, including 650,000 Americans. "SARS has all the characteristics of the 1918 influenza," notes Villarreal, "such as the respiratory spread, the high death rate, and no immunity or reagents against it." SARS may well be a portent of what's to come. According to many experts, the next Spanish Flu could be just around the corner. As a recent National Academy of Sciences (NAS) report on infectious diseases notes, "The precursor virus(es) of the 1918 virus still exist in nature, and there is nothing to prevent it or a virus of similar virulence from re-emerging."

Yet despite all the warning signs, the United States and the rest of the developed world have done shockingly little to prevent or prepare for new outbreaks. For one thing, the U.S. government and the pharmaceutical industry have made only nominal efforts to develop new anti-microbial agents. Only four major drug companies have antibiotics research programs, and not one has a new type of antibiotic in advanced development. In the last 30 years, only two new classes of antibiotics have been discovered, and one of them was obsolete before it hit the market. Vaccine production is little better. Drug manufacturers nearly failed to meet demand for influenza vaccines during the last two years -- the mildest cases of the illness in decades -- and the 11 companies worldwide that manufacture the vaccine cannot produce enough for a U.S. outbreak, let alone a global one. In addition, doctors continue to prescribe antibiotics in cases where they are not needed -- such as for minor viral infections like bronchitis, otitits and the common cold -- thus encouraging the growth of anti-microbial resistance. "We throw them around, so antibiotic resistance emerges rapidly," notes Peters.

Public-health infrastructures have also been allowed to deteriorate in recent years. U.S. hospitals lack the capacity to accommodate a massive influx of patients, adult immunization rates in America have fallen below optimal levels, and disease surveillance systems for tracking new contagions have become fragmented and outmoded. On top of that, over the last two decades the U.S. government has significantly curtailed funding for research on contagious diseases in favor of nontransmittable illnesses, including cancer and heart disease, and it has decommissioned many disease-monitoring stations throughout the world. "There's been a long period of disinvestment in the kinds of public-health infrastructure that identifies, reports and responds to diseases," explains Daulaire. "Meanwhile, as far as the bugs are concerned, they keep chugging away, and sooner or later they come up with something that breaks through our defenses."

The collective disregard for the threat of communicable diseases is largely a byproduct of the many extraordinary victories achieved during the 20th century in the fight against germs. With the advent of antibiotics, vaccines, improved sanitation and more accurate diagnostic tools, among other things, the annual death toll from microbial illnesses in the United States fell by 95 percent from 1900 to 1980, and the average life expectancy rose by nearly 30 years. Epitomizing the widespread euphoria generated by these many brilliant successes, the Surgeon General famously proclaimed in 1969, "The war against pestilence is over." But soon after, the pendulum began swinging in the other direction. Since 1980, the infectious disease mortality rate has climbed an average of 1 percent each year in America, and evidence suggests that, in the absence of a major public-health effort, things will only get worse. "We need a public-health paradigm shift," notes Joia Mukherjee, medical director of Harvard Medical School's Partners in Health. "We either do something real or massive numbers of people are going to die."

The NAS report likens the threat of global outbreaks to an encroaching hurricane of unparalleled magnitude. "A transcendent moment nears upon the world for a microbial perfect storm," the authors write. But unlike the meteorological perfect storm, which occurs only once in a long while, the microbial storm will happen again and again. The last two decades have already seen a dramatic surge in the number of new epidemics -- including AIDS, West Nile Virus, Ebola and hantavirus -- as well as a steady proliferation of drug-resistant microbes. SARS is the latest hallmark of this rising peril. "SARS is a case in point," explains Daulaire. "It's a concrete example of what many of us have been talking about in the past decade in terms of the risk that the world is facing." The only question is whether the world will heed the warning before it's too late.

Alex Stone is a reporter-researcher at The New Republic.

[Discarnate]

One other thought - maybe our health care costs are higher because we like to sue so much.

Or because our safety regs are really really complex.

Or because... Lotta reasons. Unfortunately...

[Lazarus Long]

One thought...maybe our health care costs are higher because we are pushing the limits of life-extension further than other countries. Maybe they are just doing more "routine maintenance" health care in other countries.

It would be nice if this were true Mind but it isn't. Profits and advertising drive more of the percentage of over the counter cost than R&D, which is combined with still larger "profit margins" as both net and percentage of cost as a consequence of the "volume of production and global market share."

Dee is correct that "liability" as product insurance & litigation (BOTH legitimate and spurious) drives a significant percentage of overall cost but it is not the greatest factor in any cost analysis for drugs and treatment combined, but after “operating overhead” it is second only to profit but nothing even close to equal to marketing expenditure, bureaucratic and (FDA)licensing costs, record keeping, and warehousing as a percentage of any treatment.

Countries like Cuba and China arguably provide vastly better health care as a measure of per capita EXPENSE but the expense for that efficiency needs to be measured in social terms, not just fiscal.

No liability coverage for malpractice because no malpractice. Forced organ donation from convicts and executed prisoners, lower wages for the workers who produce treatments, cheaper costs for educating physicians with less compensation as a percentage of social wealth as a reward; less investment capital for R&D but a significantly higher quality care standard as a social guarantee to the poorest sectors of society.

Lower quality controls, standardized facilities, generic drugs of averaged dose and quality, manufactured without a copyright/patent guarantees to an owner of said "rights." And civil liberties can disappear in an instant if there is a State Sanctioned “need” to quarantine and these nations also practice "tacitly enforced," as opposed to "volunteer (and poverty driven)" euthanasia.

When Cuba wanted to "purge itself" of AIDS infected convicts and gays that it didn't want to have to treat it sent them en masse to the US during a "forced" migration off island to simultaneously discredit the families and legitimate dissidents that left as the famed "Mariel Boatlift" in 1980.

Another example are the recent drug sweeps in Cuba (and China actually) that aside from arresting "political dissidents" were also aimed at rounding up drug users and infected sex workers for “(en)forced” drying out treatment and then evaluation for being put in forced labor camps or returned to society at large.

We risk adopting soon (in spite of the famous it can’t happen here chorus) some of these draconian measures as our social fear levels go up along side skyrocketing costs associated with the current strategies to fight (bio)terrorism in a recessionary economy.

Remember a lot of our "freedom" is "bought and paid for" because we are wealthy enough to accomplish it on a larger scale, and the reason these cultures in part are more draconian is to meet the significantly higher demand with far less resources to use for accomplishing the meeting of it.

Actually China & Cuba are also better at significantly reducing the cost of educating "average & adequate" doctors/nurses and providing these services to a vastly larger and poorer global population segment (in Africa/Asia/Latin America) as a "per capita" measure, in other words more doctors/nurses produced from smaller populations, at lower per student cost, distributed globally to a vastly larger segment of the most needy populations. This is an aspect of what you are referring to as “average care”, but it is not a totally valid comparison because we neglect this market segment as unprofitableand they serve the poorer segment as a universalized social contract.

The wealthier societies have a generally higher quality localized standard that is profit driven by a competitive model but is also significantly more exploitive in questionable manners and is "exclusive" by a basic "denial of care" for those unable to meet the high percentage cost of income for our more "competitive cost model" of demand; i.e. a pervasive lack of rural physicians/clinics/hospitals.

Recently a subtle consequence of the anti-(bio)terrorism effort was to force the quintupling of "ready stockpiles" on a nationwide scale for health care related consumable products (gloves, masks, dosages etc) that became a cost TO the manufacturer in order to comply with Federal edict but the PRICE for this order was another Unfunded Federal Mandate that meant these costs were passed on to consumers in general, with a token tax based subsidy and incrementally but guaranteed rising prices. The manufacturers have to now hold in reserve these perishable consumables and replace them by calendar, not market demand.

The result of these policies and recent economic shifts has been a significantly higher number of people are falling off the “standard of provided care”. Layoffs are causing many people to lose health coverage, more people are being turned away from emergency rooms and more people as a consequence are going without treatment (as a percentage of total population basis) that is increasing the risks for pandemic, counter-productive to the intent of anti-(bio)terrorism.

Get it? A penny for prevention is worth a LOT’ O dollars for treatment; and standardized care in the long run would screen more people, more often, at significantly lower cost per patient, while simultaneously vastly IMPROVING the odds of preventing pandemic by identifying problems sooner and isolating/treating them but decreasing the “profitability of care by an interventionist strategy that would result in shorter treatment periods and less demand on system overall.

Your business as usual examples are at least in part, because of the principles of a market driven capitalist dynamic that normally would be heralded as the REASON for all good, and the examples raised of corrupt bureaucratic waste are simply 'acceptable' market practice (exploitation) as petty fraud that is all too often excused as expedient and "standard cost of doing business."

Nothing's easy...

Edited by Lazarus Long, 26 May 2003 - 11:27 PM.

[advancedatheist]

Healthcare costs are increasing exponentially in part because of the aging of the population as more and more people square the survival curve, as aging experts phrase it. Basically you get rapidly diminishing returns for your healthcare dollar past the age of 75 or so, though that doesn't stop our society from spending more and more money on the declining elderly for sentimental reasons, even though a rational cost/benefit analysis would suggest better uses for those resources. And this exponential growth seems to be greater than the exponential growth of personal net worths and incomes.

If a fundamental breakthrough in longevity kept your body self-repairing and negligibly senescent well past 120 years, so that you needed considerably less expensive medical intervention, then maybe the economics would turn around, especially if you could continue to work or to live off a wealth base that wasn't being confiscated by the healthcare system. But there seems to be a daunting financial barrier between here to there.

[Lazarus Long]

Healthcare costs are increasing exponentially in part because of the aging of the population as more and more people square the survival curve, as aging experts phrase it. Basically you get rapidly diminishing returns for your healthcare dollar past the age of 75 or so, though that doesn't stop our society from spending more and more money on the declining elderly for sentimental reasons, even though a rational cost/benefit analysis would suggest better uses for those resources. And this exponential growth seems to be greater than the exponential growth of personal net worths and incomes.

This is too true too.

I have read what Marc is saying in various medical and economic journals. It is the dark side of Kass's arguments and also this is a factor driving the probable collapse of Social Security and other long term care issues like Medicare /Medicaid. But the Boomers are the ones who both paid into the contract for the guarantees and the group that will likely bankrupt it (though Gen X's & Y's are in this group too) by living the longest with the least real benefit from true longevity tech from the still nascent emerging medical technologies (geno/nano/cyber etc).

If any random person has a given health cost at 50 of X, at 60 it is likely to become X squared, at 70 X cubed, at 80 X to the fourth power. The Nazi's solved this dilemma by legalizing genocide. This is a classic asymptotic curve for increasing cost combined with diminishing return on investment and is what Mind was alluding to when he said:

…maybe our health care costs are higher because we are pushing the limits of life-extension further than other countries.

But the US isn't first on the longevity list; in fact I don't think it is fifth anymore though I thought we were still in the top ten (see post below). That statistic should be around here somewhere but it needs an update anyway. Japan I thought was still number one, and a number of smaller nations were ahead of the US as I remember vaguely like Finland. I will go hunt the updated list.

We are still socially debating the "Final Solution" problem by discussing "involuntary" euthanasia, which is still on the table along with "voluntary suicide." Let the old folks develop the lunar colony the way once we died on the hunt.

In the "bad" old days if I felt the tribe didn't need me I could try and make it on my own in the forest and die under the stars in the cold when infirmity & age made survival impossible. Now we must be strapped down and plugged in even if we refuse the rest of the tubes and needles or closeted in a facility until incapable of retaining any self-respect or starved to death if we refuse treatment.

At least there would be dignity in the struggle and a diminishing cost for risk/reward for RAD exposure and loss of procreativity. They would get the advantages of low gee and the best treatment options money, as well as experimental R&D can provide.

These elderly colonists would go outbound knowing it was a one way ticket for a struggle that gave back to the larger group a stepping stone to the stars and a reclamation o individual purpose,

Of course Leon Kass could just forget the whole struggle and pretend that the longevity techniques aren't being developed because they shouldn't be. But I bet he has a private source he wouldn't share of the best med-tech money will buy, after all as a physician he is entitled to "special professional consideration".

Edited by Lazarus Long, 26 May 2003 - 11:28 PM.

[Lazarus Long]

[!] I found it [!]

On this list the United States is the 41st nation with regard to combined gender life expectancy actuaries.
http://www.mrdowling.com/800life.html
So get a grip we folks aren't in the top ten or even close.

Myths die hard. [ph34r]

Life Expectancy Around the World

Source: CIA World Factbook, July 1, 2002
Click here for data from 2000 or 2001
Categories. Sadly the columns were not in copy/pastable format

Nation or Territory;
Total Life Expectancy;
Life Expectancy for Men;
Life Expectancy for Women;
Years women will live longer than men;
Life Expectancy in 2001;
Growth in Life Expectancy 2001-2002

World's Nation's ranked by gender averaged longest lived to shortest (the list fluctuates slightly for each gender)

Andorra 83.5 80.6 86.6 6.0 83.5 0.0
Macau 81.7 78.9 84.6 5.8 81.6 0.1
San Marino 81.2 77.7 85.1 7.4 81.1 0.1
Japan 80.8 77.6 84.2 6.5 80.7 0.1
Singapore 80.2 77.2 83.4 6.1 80.1 0.1
Australia 79.9 77.0 82.9 5.9 79.8 0.1
Guernsey 79.8 76.8 82.9 6.1 79.7 0.1
Switzerland 79.7 76.9 82.8 5.9 79.6 0.1
Hong Kong 79.7 77.0 82.6 5.6 79.5 0.2
Sweden 79.7 77.1 82.5 5.4 79.6 0.1
Canada 79.6 76.2 83.1 7.0 79.4 0.2
Iceland 79.5 77.3 81.9 4.6 79.4 0.1
Italy 79.1 76.0 82.5 6.6 79.0 0.1
Gibraltar 79.1 76.2 82.1 5.9 79.0 0.1
Monaco 79.0 75.0 83.1 8.1 78.8 0.2
Liechtenstein 79.0 75.3 82.6 7.3 78.8 0.2
Cayman Islands 79.0 76.2 81.4 5.2 78.9 0.1
France 78.9 75.0 83.0 8.0 78.8 0.1
Spain 78.9 75.5 82.6 7.2 78.8 0.1
Norway 78.8 75.9 81.9 6.1 78.7 0.1
Israel 78.7 76.7 80.8 4.2 78.6 0.1
Faroe Islands 78.6 75.1 82.1 6.9 78.4 0.2
Greece 78.6 76.0 81.3 5.3 78.4 0.2
Jersey 78.6 76.2 81.2 5.0 78.5 0.1
Aruba 78.5 75.2 82.0 6.9 78.4 0.1
Netherlands 78.4 75.6 81.4 5.9 78.3 0.1
Martinique 78.4 79.1 77.7 -1.4 78.3 0.1
Virgin Islands 78.3 74.4 82.4 8.0 78.1 0.2
Malta 78.1 75.6 80.8 5.2 77.9 0.2
Belgium 78.0 74.6 81.5 6.8 77.8 0.2
New Zealand 78.0 75.0 81.1 6.1 77.8 0.2
Montserrat 78.0 76.0 80.2 4.3 78.0 0.0
Guam 77.9 75.7 80.6 4.9 77.8 0.1
Austria 77.8 74.7 81.2 6.5 77.7 0.1
United Kingdom 77.8 75.1 80.7 5.5 77.7 0.1
Saint Pierre and Miquelon 77.8 75.5 80.1 4.6 77.6 0.2
Finland 77.6 73.9 81.4 7.4 77.4 0.2
Man, Isle of 77.6 74.3 81.2 6.9 77.5 0.1
Germany 77.6 74.5 80.9 6.5 77.4 0.2
Jordan 77.5 75.1 80.1 5.0 77.4 0.1
Luxembourg 77.3 74.0 80.8 6.8 77.1 0.2
United States 77.3 74.4 80.1 5.7 77.1 0.2
Guadeloupe 77.2 74.0 80.5 6.5 77.0 0.2
Bermuda 77.1 75.0 79.1 4.0 76.9 0.2
Saint Helena 77.0 74.1 80.0 5.9 76.8 0.2
Ireland 77.0 74.2 79.9 5.7 76.8 0.2
Cyprus 76.9 74.6 79.3 4.7 76.7 0.2
Denmark 76.7 74.1 79.5 5.3 76.5 0.2
Taiwan 76.5 73.8 79.5 5.7 76.4 0.1
Cuba 76.4 74.0 78.9 4.9 76.2 0.2
French Guiana 76.3 73.0 79.8 6.8 76.1 0.2
Anguilla 76.3 73.4 79.3 5.9 76.1 0.2
Kuwait 76.3 75.4 77.2 1.7 76.1 0.2
Costa Rica 76.0 73.5 78.7 5.2 75.8 0.2
Portugal 75.9 72.4 79.7 7.2 75.8 0.1
Chile 75.9 72.6 79.4 6.8 75.7 0.2
Puerto Rico 75.8 71.3 80.5 9.2 75.6 0.2
Northern Mariana Islands 75.7 72.7 79.0 6.4 75.5 0.2
Panama 75.7 72.9 78.5 5.6 75.5 0.2
Libya 75.7 73.5 77.9 4.3 75.5 0.2
British Virgin Islands 75.6 74.7 76.6 1.9 75.4 0.2
Uruguay 75.4 72.1 79.0 6.8 75.2 0.2
Jamaica 75.4 73.5 77.5 4.0 75.2 0.2
American Samoa 75.3 70.9 80.0 9.1 75.1 0.2
Argentina 75.3 71.9 78.8 6.9 75.1 0.2
Slovenia 75.1 71.2 79.2 8.0 74.9 0.2
French Polynesia 75.0 72.7 77.5 4.8 74.8 0.2
Netherlands Antilles 74.9 72.8 77.2 4.5 74.7 0.2
Korea, South 74.7 71.0 78.7 7.8 74.4 0.3
Czech Republic 74.7 71.2 78.4 7.2 74.5 0.2
United Arab Emirates 74.3 71.8 76.9 5.0 74.1 0.2
Slovakia 74.0 70.0 78.2 8.3 73.7 0.3
Macedonia, Former Yugoslav Republic of 74.0 71.8 76.4 4.6 73.8 0.2
Croatia 73.9 70.3 77.7 7.5 73.7 0.2
Paraguay 73.9 71.4 76.5 5.1 73.7 0.2
Tunisia 73.9 72.4 75.6 3.3 73.7 0.2
Brunei 73.8 71.5 76.3 4.9 73.6 0.2
Dominica 73.6 70.7 76.6 5.9 73.4 0.2
Yugoslavia 73.5 70.6 76.7 6.1 NA NA
Turks and Caicos Islands 73.5 71.4 75.8 4.4 73.3 0.2
Poland 73.4 69.3 77.8 8.6 73.2 0.2
Dominican Republic 73.4 71.3 75.6 4.3 73.2 0.2
Venezuela 73.3 70.3 76.6 6.3 73.1 0.2
Barbados 73.3 70.7 75.9 5.2 73.0 0.3
Bahrain 73.2 70.8 75.7 4.9 73.0 0.2
New Caledonia 73.0 70.1 76.1 6.0 72.8 0.2
Reunion 72.9 69.5 76.5 7.0 72.7 0.2
Saint Lucia 72.6 69.0 76.4 7.4 72.3 0.3
Qatar 72.6 70.2 75.2 5.1 72.4 0.2
Saint Vincent and the Grenadines 72.6 70.8 74.3 3.5 72.3 0.3
West Bank 72.3 70.6 74.1 3.5 72.1 0.2
Sri Lanka 72.1 69.6 74.7 5.2 71.8 0.3
Oman 72.0 69.9 74.3 4.4 71.8 0.2
Mexico 71.8 68.7 74.9 6.2 71.5 0.3
Albania 71.8 69.0 74.9 5.9 71.6 0.2
Bosnia and Herzegovina 71.8 69.0 74.7 5.6 71.5 0.3
Hungary 71.6 67.3 76.3 9.0 71.4 0.2
Suriname 71.6 69.0 74.4 5.5 71.4 0.2
Solomon Islands 71.6 69.1 74.1 5.0 71.3 0.3
China 71.6 69.8 73.6 3.8 71.4 0.2
Lebanon 71.5 69.1 74.0 4.9 71.3 0.2
Mauritius 71.3 67.3 75.3 8.1 71.0 0.3
Ecuador 71.3 68.5 74.3 5.8 71.1 0.2
Bulgaria 71.2 67.7 74.9 7.2 70.9 0.3
Turkey 71.2 68.9 73.7 4.8 71.0 0.2
Belize 71.2 68.9 73.6 4.7 70.9 0.3
Malaysia 71.1 68.5 73.9 5.4 70.8 0.3
Korea, North 71.0 68.0 74.2 6.1 70.7 0.3
Saint Kitts and Nevis 71.0 68.2 74.0 5.8 70.7 0.3
Gaza Strip 71.0 69.8 72.3 2.6 70.8 0.2
Seychelles 70.7 65.2 76.4 11.2 70.4 0.3
Antigua and Barbuda 70.7 68.5 73.1 4.7 70.5 0.2
Colombia 70.6 66.7 74.6 7.8 70.3 0.3
Bahamas, The 70.5 67.3 73.7 6.4 71.1 -0.6
Peru 70.3 67.9 72.8 4.9 70.0 0.3
Romania 70.2 66.4 74.2 7.8 69.9 0.3
El Salvador 70.0 66.4 73.8 7.4 69.7 0.3
Iran 70.0 68.6 71.4 2.8 69.7 0.3
Algeria 70.0 68.6 71.3 2.7 69.7 0.3
Estonia 69.7 63.7 76.1 12.3 69.5 0.2
Vietnam 69.6 67.1 72.2 5.1 69.3 0.3
Samoa 69.5 66.8 72.4 5.6 69.2 0.3
Morocco 69.4 67.2 71.8 4.6 69.1 0.3
Honduras 69.4 67.5 71.3 3.8 69.9 -0.6
Lithuania 69.3 63.3 75.5 12.2 69.1 0.2
Cape Verde 69.2 65.9 72.6 6.7 68.9 0.3
Nicaragua 69.1 67.1 71.1 4.0 68.7 0.3
Thailand 68.9 65.6 72.2 6.6 68.6 0.3
Palau 68.9 65.8 72.2 6.4 68.6 0.3
Syria 68.8 67.6 70.0 2.4 68.5 0.3
Latvia 68.7 62.8 74.9 12.1 68.4 0.3
Greenland 68.4 64.8 72.0 7.2 68.1 0.3
Trinidad and Tobago 68.3 65.7 70.9 5.2 68.0 0.3
Fiji 68.3 65.8 70.8 5.0 67.9 0.3
Tonga 68.3 65.8 70.8 5.0 67.9 0.3
Indonesia 68.3 65.9 70.8 4.8 68.0 0.3
Belarus 68.1 62.1 74.5 12.5 68.0 0.1
Saudi Arabia 68.1 66.4 69.9 3.4 67.8 0.3
Philippines 67.8 65.0 70.8 5.8 67.5 0.3
Russia 67.3 62.1 72.8 10.7 67.2 0.1
Iraq 67.0 65.9 68.0 2.1 66.5 0.5
Tuvalu 66.7 64.5 68.9 4.4 66.3 0.4
Armenia 66.5 62.1 71.1 9.0 66.4 0.1
Guatemala 66.5 63.9 69.3 5.5 66.2 0.3
Ukraine 66.2 60.6 72.0 11.3 66.0 0.2
Marshall Islands 65.8 64.0 67.7 3.7 65.5 0.3
Sao Tome and Principe 65.6 64.2 67.1 2.9 65.3 0.3
Moldova 64.6 60.2 69.3 9.1 64.5 0.1
Georgia 64.6 61.0 68.3 7.2 64.5 0.1
Grenada 64.5 62.7 66.3 3.6 64.5 0.0
Mongolia 64.3 62.1 66.5 4.4 67.3 -3.0
Tajikistan 64.2 61.1 67.4 6.3 64.1 0.1
Bolivia 64.1 61.5 66.7 5.2 63.7 0.4
Uzbekistan 63.8 60.2 67.6 7.3 63.7 0.1
World 63.8 62.2 65.5 3.4 64.0 -0.2
Egypt 63.7 61.6 65.9 4.2 63.3 0.4
Kyrgyzstan 63.5 59.2 67.9 8.7 63.4 0.1
Papua New Guinea 63.5 61.4 65.6 4.3 63.1 0.4
Kazakhstan 63.3 57.9 69.0 11.1 63.2 0.1
Guyana 63.3 60.5 66.2 5.7 64.0 -0.7
Brazil 63.2 59.0 67.7 8.8 62.9 0.3
Azerbaijan 63.0 58.7 67.5 8.8 62.9 0.1
India 62.9 62.2 63.5 1.3 62.5 0.4
Senegal 62.6 60.9 64.2 3.3 62.2 0.4
Maldives 62.6 61.4 63.8 2.4 62.2 0.4
Pakistan 61.5 60.6 62.3 1.7 61.1 0.4
Nauru 61.2 57.7 64.9 7.2 60.8 0.4
Turkmenistan 61.0 57.4 64.8 7.3 60.9 0.1
Vanuatu 61.0 59.6 62.4 2.8 60.6 0.4
Bangladesh 60.5 60.7 60.3 -0.4 60.2 0.3
Comoros 60.4 58.2 62.7 4.5 60.0 0.4
Kiribati 60.2 57.3 63.2 6.0 59.8 0.4
Yemen 60.2 58.5 62.1 3.6 59.8 0.4
Mayotte 59.8 57.8 62.0 4.2 59.5 0.3
Nepal 58.2 58.7 57.8 -0.9 57.8 0.4
Ghana 57.2 55.9 58.7 2.8 57.4 -0.2
Sudan 56.9 55.9 58.1 2.2 56.6 0.3
Cambodia 56.8 54.6 59.1 4.5 56.5 0.3
Eritrea 56.2 53.7 58.7 5.0 55.8 0.4
Madagascar 55.4 53.1 57.7 4.6 55.0 0.4
Burma 55.2 53.7 56.7 3.0 54.9 0.3
Cameroon 54.6 53.8 55.4 1.7 54.8 -0.2
Togo 54.4 52.4 56.4 4.0 54.7 -0.4
Equatorial Guinea 54.0 51.9 56.1 4.2 53.6 0.4
Gambia, The 53.6 51.7 55.6 3.9 53.2 0.4
Laos 53.5 51.6 55.4 3.9 53.1 0.4
Bhutan 52.8 53.2 52.4 -0.8 52.4 0.4
Tanzania 52.0 51.0 53.0 1.9 52.3 -0.3
Liberia 51.4 50.0 52.9 3.0 51.0 0.4
Djibouti 51.2 49.4 53.1 3.7 50.8 0.4
Mauritania 51.1 49.1 53.3 4.2 50.8 0.3
Nigeria 51.1 51.1 51.1 0.0 51.6 -0.5
Chad 50.9 48.9 53.0 4.1 50.5 0.4
Benin 49.9 49.0 50.9 1.9 50.2 -0.3
Gabon 49.6 48.5 50.8 2.3 50.1 -0.5
Guinea-Bissau 49.4 47.1 51.8 4.7 49.0 0.4
Haiti 49.4 47.7 51.2 3.5 49.2 0.2
Congo, Democratic Republic of the 48.9 47.0 51.0 4.0 48.8 0.1
Lesotho 48.8 48.0 49.7 1.8 50.8 -2.0
South Africa 48.1 47.6 48.6 0.9 51.1 -3.0
Congo, Republic of the 47.6 44.4 50.9 6.5 47.4 0.2
Kenya 47.5 46.6 48.4 1.9 48.0 -0.5
Mali 47.0 45.8 48.2 2.4 46.7 0.3
Somalia 46.6 45.0 48.3 3.3 46.2 0.4
Burkina Faso 46.4 45.9 47.0 1.1 46.7 -0.3
Afghanistan 46.2 47.0 45.5 -1.5 45.9 0.3
Burundi 46.1 45.2 47.0 1.8 46.2 -0.1
Guinea 45.9 43.5 48.4 4.9 45.6 0.3
Sierra Leone 45.6 42.7 48.6 5.9 45.3 0.3
Cote d'Ivoire 44.9 43.6 46.3 2.8 45.2 -0.3
Ethiopia 44.7 43.9 45.5 1.6 45.2 -0.5
Central African Republic 43.8 42.2 45.5 3.3 44.0 -0.2
Uganda 43.4 42.6 44.2 1.6 42.9 0.5
Niger 41.6 41.7 41.4 -0.3 41.3 0.3
Namibia 40.6 42.5 38.7 -3.8 42.5 -1.9
Rwanda 39.0 38.4 39.7 1.3 39.3 -0.3
Angola 38.6 37.4 39.9 2.5 38.3 0.3
Swaziland 38.6 37.9 39.4 1.5 40.4 -1.8
Zambia 37.3 37.1 37.5 0.5 37.2 0.1
Malawi 37.1 36.6 37.6 0.9 37.6 -0.5
Botswana 37.1 36.8 37.5 0.7 39.3 -2.2
Zimbabwe 37.1 38.5 35.7 -2.8 37.8 -0.7
Mozambique 36.5 37.3 35.6 -1.6 37.5 -1.1


Categories:

Life Expectancy -- the typical lifespan for a citizen of each nation. Click on the Life Expectancy category to sort the nations from the longest lifespan to the shortest. You will also see how men and women have different life spans.

Years Women Will Live Longer Than Men -- women generally live longer than men. If the number espressed is negative, men are expected to outlive women by that number of years in that area.

Life Expectancy in 2001 -- the typical lifespan last year.

Growth in Lifespan 2001-2002 -- developments in technology, health care, and nutrition add several months to a typical lifespan each year.

Negative growth occurs in areas where war or disease predominate.

Edited by Lazarus Long, 26 May 2003 - 01:24 AM.

[advancedatheist]

Many of the countries on this list around and ahead of the U.S. aren't even considered fully "developed," while the developed ones have social-democratic governments. Despite what American bubbas believe, when it comes to longevity and health, capitalist America doesn't have the best of everything unless you're personally wealthy.

[advancedatheist]

http://www.observer....,963066,00.html

Passport to health

The best healthcare system in the world is just a train ride away - but the train is Eurostar. As patients and staff cross the Channel and 'health tourism' grows, Jo Revill reports on what we can learn from the French

Sunday May 25, 2003
The Observer

Silence hangs over the accident and emergency department of the hospital in Lille, northern France. To Robert Thompson, a senior nurse manager who runs a casualty unit in a British hospital, such profound calm seems eerie. The emergency cases are all being seen in separate rooms. Each tiled room is immaculately clean and full of high-tech equipment. There is no noisy waiting room, no stressed-out staff, no long wait for an X-ray.
It is a world away from Thompson's busy A&E in Kent. He is proud of his department, having reduced waiting times to four hours, but sometimes he still has to put patients on trolleys. 'I deal with 150 patients a day - my French counterpart sees perhaps 30 cases,' he said. 'But they have lots of beds here, too - they seem to be running at maybe 50 per cent capacity, and there are days when we're over 100 per cent, which means more patients than available beds.'

The two hospitals are part of a unique experiment to see what England and France can learn from each other. Under a two-year project using £1million of EU funding, staff will be encouraged to cross the Channel and work in the other hospital. The British health professionals want to see how the French manage their surgery so well, to the point where waiting lists don't exist. Is it simply down to a much higher level of funding - or are they doing something different? The French are amazed by the efficiency of the NHS, and the way teams of carers can provide an important bridge between hospitals and the community.

Although the two regions share many similarities and are joined by the high-speed Eurostar, fascinating differences between the two unfold as staff take a tour of the St Philibert hospital. They are as impressed by the kindergarten set-up for the hospital staff as they are by the spotless corridors and beautifully designed palliative care unit, which has ensuite bathrooms for each patient.

Thompson is interested in the way French patients can avoid putting pressure on the hospital by making more use of their GPs and local pharmacy. 'Patients in Britain often come into casualty because they face a two-week wait to see their GP,' he said. 'Here you seem to see your doctor that day, and the GPs still do home visits at night. I don't know how the French system would work during a big emergency though. Our nurses are very skilled at dealing with all kinds of situations - they have to be - and they also have more responsibility than their French equivalents. I think we're more efficient because we have far fewer beds in which to place people.'

Thompson works at the Darent Valley Hospital in Dartford, which was only recently opened and feels more clean and well-designed than many NHS hospitals. Yet it does not have the feel of a hotel, which is the impression given by the wide, airy spaces in Lille.

For Tony Blair and his Health Secretary Alan Milburn, the question of why French hospitals offer a first-class, consumer-driven service when ours do not is causing unease. Last week the Prime Minister was caught out in the Commons when a Tory MP spoke of a constituent who recently had a successful hip operation in a clean and modern hospital. Nigel Waterson, MP for Eastbourne, congratulated the Government on Velma Paterson's happy outcome under the auspices of the NHS. The Tory benches erupted in laughter as Waterson then asked Blair: 'But can he explain why she had to have her operation in France?'

No one in the Government relishes such comparisons, but the reason for her trip to France was that Blair has pledged to cut waiting lists by sending certain types of patients for routine operations to France and Belgium to make up for the shortfalls of the NHS.

Health tourism of this kind is likely to become increasingly common as British authorities battle to meet the tight deadlines set for waiting times. Already this year 247 patients needing hip and knee operations have travelled to France, paid for by the NHS. They are accompanied by 'care advisers' who ensure they are properly looked after. Managers insist that even with the cost of travel these operations work out cheaper than in a private UK hospital because consultants' private fees here are so high.

Heart patients also benefit from the new entente cordiale. The first two British men to travel abroad for major heart surgery on the NHS are now recovering in Leeds. One of those is 73-year-old Denis Waistell, who had a double heart bypass operation in Ghent, Belgium, last month after being on the waiting list for six months in Britain. He said this weekend: 'I had a heart attack eight months ago and was told I needed a double heart bypass. When I was offered a choice I said I would go anywhere because I just wanted to get the operation over and done with.'

Patients like Mr Waistell, who are fit enough to make the journey, are the ones who currently benefit from foreign expertise, but soon the overseas teams will be coming to Britain to carry out thousands of operations. The Government will award contracts to international companies to run diagnostic and treatment centres across the country, and hopes this will make major inroads into the waiting lists. The firms, and their staff, will be French, South African, Italian or German but will be expected to meet the same clinical standards as their British counterparts. In short, it will be foreigners who come to rescue the NHS, because there is too little time to train all the staff needed to turn around the NHS under the 10-year timescale set by the Government.

Health Minister John Hutton told The Observer that the old ideological barriers to looking abroad for new ways of doing things were breaking down. Speaking during a break from a conference with his foreign counterparts to discuss health reforms, Hutton said: 'There are other countries like us that face constraints, such as Sweden and Slovenia, and we're all trying to find ways of build ing up our services to make them more responsive. The overall capacity of the NHS holds us back. We don't have enough beds or doctors or operating theatres. But it's also about the way we organise the services, and that's what we're working on. The NHS needs to be able to learn from other countries. It's important that we are prepared to listen to how others do things.'

But Hutton is not talking about the way other countries fund their health service. France enjoys a level of spending far beyond ours. Last year, 9.9 per cent of its gross domestic product went on healthcare, compared with 7.7 per cent in the UK. The money has given them nearly twice the number of beds and a larger number of doctors and other staff.

The French system was rated the best in the world by the World Health Organisation when it looked at access to healthcare, efficiency and effectiveness. But it is not the highest spender; that dubious honour goes to America, which puts an astonishing 14 per cent of its GDP into healthcare but still leaves a large section of its population without proper medical cover.

In France, every working person contributes towards healthcare, through the securité sociale which comes straight out of their pay packet, typically at around 14 per cent of their wages. Different professions also pay into insurance schemes, known as the mutuelle, which is a top-up system resulting in their healthcare being free at the point of delivery. The unemployed, elderly and children receive free care at the state's expense.

This system gives patients enormous bargaining power. They can see the doctor of their choice, whenever they want. They can go to their local GP or refer themselves straight to a specialist. Yet politicians are now looking at ways of curbing health spending, amid concern that the costs could rise and rise if there is no limit to what patients can demand. They want treatments to be based more on evidence of what works, and less on individual whim. Family doctors have far greater rates of prescribing antibiotics than in Britain, for example. Hospitals also have less incentive to encourage staff to work harder to get patients out of bed and back home because there is no pressure on bed availability.

Myriam Brunswic, a health expert at the University of Greenwich, set up the cross-Channel initiative between Kent and Lille and believes the NHS has become used to working to maximise its limited resources. 'The French health teams are just beginning to face serious reductions in funding. There is so much we can learn from each other. I think our team will be really interested in looking at how they manage their paperwork and their patients.'

Another great bane of NHS patients - the food - may also come in for inspection. British health staff marvelled at the quality of the hospital meal served to them in Lille, with a fresh salad followed by chicken escalope with macaroni, none of it overcooked. 'Do you have a cook-chill service?' asked one of the British dietitians to the French caterer. 'No, of course not,' the woman replied indignantly. 'How would patients get their fresh vegetables if we didn't prepare the food properly in our own kitchens?' It was a salutary moment for those accustomed to the cost-cutting ways of the dear old NHS.

[Mind]

The problem you have raised about the exploding cost of elderly care in the U.S. is a problem only because of the payment structure. We ask the younger members of society to pay for the older (through social security and medicare/medicaid). If everyone paid for their own health care, there would be no problem. Too many people expect the "government" to take care of them. They take no responsibility for their actions.

What I do not like about single payer or "national" health care is that I am going to pay for everyone else's bad health. I am going to pay for the smoker with lung cancer, I am going to pay for the obesity epidemic, I am going to pay for football player's injuries, I am going to pay for hypochondriacs who visit the doctor everytime they sneeze.

I take responsibility for my own actions. I expect to pay for my own health care. I am not against giving discounted healthcare to people below the poverty line, but I feel it should be done in the states, not on the national level.

[Mind]

OMG we are all going to die!!!

What is not mentioned in this article is that the human race is still alive (and larger than ever). Amazing isn't it. Given all the wicked viruses that are out there. All those killers. How did we even survive 1000 years ago without healthcare. It must have been a miracle.

The miracle is our immune system. It evolved along with all the microbes over millions of years. None of the diseases mentioned above are 100% deadly. the only reason AIDS seems like 100% death rate only because activists have defined it that way, ie. AIDS=Death.

Will natural viruses disrupt human society...for sure. Will they kill us off...no way.

I am more worried about man-made pathogens (and the psycopaths that would use them as weapons). New microbes could use artificial protiens or other methods than what our immune system has adapted to fight. That is the real threat in coming years.

[advancedatheist]

What I do not like about single payer or "national" health care is that I am going to pay for everyone else's bad health.

Unfortunately that's how insurance works in the market as well. When you buy life insurance, your premiums reflect the risky behavior of others in the insurance pool whose premature deaths cost the insurance company money. The same goes for auto insurance -- your premiums reflect all the bad drivers out there who make claims on the money held by the insurance company. Private health insurance suffers from the same problem.

It's nonetheless true that single-payer systems seem to deliver better results than the U.S. system. (Refer to my post from the Observer.co.uk about the superiority of healthcare in France, for example.) Economic libertarians assert insistently that markets deliver certain goods more efficiently than social-democratic systems, but when it comes to healthcare, the empirical results don't support that claim.

Edited by advancedatheist, 26 May 2003 - 04:13 PM.

[Mind]

Unfortunately that's how insurance works in the market as well. When you buy life insurance, your premiums reflect the risky behavior of others in the insurance pool whose premature deaths cost the insurance company money. The same goes for auto insurance -- your premiums reflect all the bad drivers out there who make claims on the money held by the insurance company. Private health insurance suffers from the same problem.

This statement is only partly true. Statistical analysis is used to determine payment rates for private insurance (medical and auto). A portion of other people's bad habits are incorporated into rates, but if a person happens to fall into a statistically "safe" category their rates are lower (for private insurance...not employer sponsored). Same for homeowner's insurance. If you live in a flood-prone or huricane-prone area your rates are higher. It makes sense. With government insurance everybody is treated the same, not only that but everybody is literally "forced" into the government system. There is no choice. There is no freedom. At least if each state had their own individually tailored health care set-up (not a national system) people could "vote with their feet". There would at least be some freedom left in health care choices.