Map of life expectancy at birth from Global Education Project.

Monday, December 14, 2009

Setting out on the Long March

It is now becoming increasingly likely that The Right Rev. Joseph Lieberman will exact his revenge on the country he hates by killing meaningful health care reform. I figure I might as well go ahead and wonk y'all out by spending whatever number of posts it takes to lay out the whole story of the mess we're in right now and what we need to do about it. This will be adapted in large part from an address I recently gave to some of the good people of Connecticut who are getting screwed by their junior Senator.

My subject is not actually all that complicated, but it seems complicated because there are some false assumptions buried very deeply in our political culture. It takes a bit of time and effort to expose them, which is why nobody has figured out how to fit the truth about health care onto a bumper sticker. (Believe me, I've been trying to figure out how to do that for more than 20 years.)

This says "Exhibit 3" even though it's Exhibit 1 here, because I stole it from an article in Health Affairs, but that's okay, they want you to do that. The black squares on the right are the states of the U.S., and the gray squares on the left are the other wealthy (and some not so wealthy) countries. It's good to be on the left because it means you're spending less on health care; and it's good to be higher up because it means you're living longer. As you can also see, there is little relationship between spending on health care and longevity in general but the U.S. is an outlier – we break what little trend there is by spending far more and dying much younger. There's a lot of variation among the states, which is also interesting and important (more on that later) but only one of them (Hawaii, if you care to know) compares favorably on life expectancy, and we can forget about the cost comparison.

In future posts, I'll say what I know about why this is, but first we'll spend a little time on getting deeper into the differences between health and health care in the U.S., and abroad. Starting tomorrow.


Daniel said...

Exhibit 1 (or 3) charts life expectancy at birth. Does any comparable data exist for life expectancy at a later age, e.g. at age 13.

I've read that the US has a serious problem with infant mortality. Is that what drives the plot of data? Would the plot of life expectancy look different if it was normalized for infant mortality?

Just a technical question, not to dismiss the seriousness of infant mortality.

Cervantes said...

I would have to do some research to get life expectancy at older ages. But the snap answer is that infant mortality makes a contribution to the difference, but it's not the whole story.

Our infant mortality problem, BTW, is mostly concentrated in African Americans. Some Latino groups -- notably Puerto Ricans -- are also at elevated risk.