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In his 261 word "manifesto"[1], the UnitedHealthcare CEO assassin cited that the US is 42nd in the world in life expectancy but first in health care spending. Cremieux reviews it in more detail here and makes something similar to the RCA argument that the US spends more because it's wealthier and gets more medical procedures done and offers alternative explanations for why the US has low numbers.
By coincidence, while this CEO shooter drama was going down, I was listening to Peter Attia's podcast where he interviews Saum Sutaria, the CEO of a health care system[2]. He drops the following claim (copied from the show notes):
He further argues that US life expectancy is reduced by factors like cultural issues: gun violence, car accidents, etc. Indeed, the US has high infant mortality but also high rates of teenage pregnancy, which are risk factors for higher infant mortality. This echoes Crimeiux from earlier.
Anyway, I went about looking for a source for the claim that longevity rankings increase as we age in the US and found one in Ho and Preston (2010)
US life expectancy at birth sucks versus peer countries, and even still sucks around age 40. But as you get into retirement years it reverses, and the US eventually climbs to 4th place among the 18 countries
The paper tries to explain this but mostly doesn't find anything satisfying.
One interpretation (not from the study, mine and perhaps the Tenet Health CEO's) suggests if you don't get murdered, or into a car wreck, or overdose, or kill yourself, or your mom didn't attempt a home birth at age 16, you actually have good survival odds. The best in the world. The health care system can actually help you. That's what that $10k/capita is all about.
There's some obvious alternate explanations too. Maybe those extra ten years of life are when you're stroked out and have a pretty terrible quality of life and it would've actually been great to meet a health care system with a death panel that said "mmmm actually, there's no treatment available for this condition. so sorry" and you could die with dignity and your family (or someone's family, or maybe collectively) could have an extra $400,000.
Whatever this is, I think it's pretty clear that the health care system in the US exists and can deliver results. Whether or not these results translate to best QOL is more murky and we can debate that effectiveness. Either way, that doesn't have the same revolutionary zeal!
Coming up for air here, and approaching the
#assassinbaestory from a different angle, at what point can we consider misinformation surrounding this life expectancy vs health expenditure chart as stochastic terrorism? I don't know a single left-of-center person who has more than 2 brain cells to rub together who doesn't allude to this as Exhibit A in every discussion about how corrupt the US health care system clearly is[3]. And it's arguably wrong. And it's now getting people murdered. It's not quite as psychotic and singular as Alex Jones, but it's definitely something sinister. Maybe even more dangerous if it's the start of a trend.people are beating him up for writing such a short and lame manifesto but he might not have intended it as a manifesto, more of a confession
guessing this is the last we're going to hear from a CEO of a health care system for quite awhile, so this was well timed
which isn't to say it can't be corrupt, just, again, the health care system failing to save people from high rates of car accident deaths and also for maybe keeping grandpa alive because their family doesn't want them to die is not exactly a stinging indictment of health care itself
You can't mention this without mentioning obesity rates & dietary habits.
Americans, the fit ones too, have culturally poor diets. Vegetables & simply prepared meats (poaching, raw fish, sautee) are shunned in favor of unhealthy cooking methods (frying), fat based sauces (ranch) and simple carbs (potatoes). India has a similar problem with culturally poor diets.
That's my anecdotal observation. The US is excellent at helping you stay alive in misery. Aging is one example. But, disability, drug use, depression, chronic pain get the same treatment. No one cares to fix you. They want to get you back to your base level of misery until you come back again.
Another and often ignored factor is how sedentary american culture is. Driving is ubiquitous with more people commuting by bicycle in Copenhagen than in all of the US. American grocery stores are surrounded by a sea of parking while in the rest of the world most people would walk to their local store. One thing that struck me in the US was how common escalators are. Lawn mowers nearly always have an engine in the US and are often ones the user sits on. In other places a person mowing grass is more likely to walk. Even fit Americans don't move that much. Fit Americans tend to be sedentary nearly all the time except for four hours a week of vigorous fitness. Gym culture is bigger in the US than in much of Europe. What is missing is movement in every day life.
It's why I am adamant on living in the few dense pockets of American cities. I've started step tracking and the difference is stark. If I take public transit to work & do groceries on foot, it's trivial to pass 10k steps. If I am in-and-out of a car all day, then it's hard to crack even half that. Have you tried to make up for a 5k step deficit ? It takes a whole hour of walking on the treadmill !
It shouldn't be too hard. All a family needs is -
There are practically zero places in the US that satisfy all these requirements.
Some parts of Greater-Boston & NYC are the only 2 that semi-satisfy this requirement, and they're definitely borderline for #5. I'm also cheating on public schools for NYC/Boston proper because all the good public schools are competitive exam-schools which your child may not get into. I'm lucky. Bellevue WA is the worst I have had to deal with. Can't imagine how bad it is in proper suburbia.
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