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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
Being in charge of a health insurance company is like being a world leader: you are going to be making decisions that result in some people living and other people dying. There's no way around it. Your whole job is allocating scarce healthcare resources.
The scarcity is the real problem. But we'd rather murder a scapegoat, in cold blood, than face reality.
And scarcity is not going away. Not when it's possible to pour a near-infinite amount of money into eking out another year or two at end of life. Stop and think about what that means. I honestly question whether health is "insurable" even in principle.
Healthcare in America has problems but we cannot even begin as a society to discuss those problems with anything resembling sanity until we as a society learn to memento mori.
So if you're gonna murder a guy you might wanna have a better reason than some people get their claims denied.
This becomes perfectly obvious when we consider the different products that are wrapped up in Health Insurance in America.
If I wanted similar coverage for my car, I would need all of Car Insurance, a Warranty, and a prepaid Service plan. All are available on the market for most cars, all can be priced out, but they are different products completely. Comp Car Insurance makes sure that if I get into an accident, I won't be left without a car, but does not cover mechanical failures or ordinary wear and tear. A warranty makes sure that if my car breaks down, it will be fixed, but doesn't cover ordinary wear items. A Service plan allows me to bring my car into the dealer for regular service for wear items, fluids, etc, but doesn't cover those other things. Health insurance, by comparison, covers all three situations at the same time. It is true insurance, in that if I have an accident, it will cover my medical costs. It is a warranty, in that if I suffer from a genetic condition it will cover me. And it is a service plan, in that it covers my regular expected doctor's visits. But I expect to make the same payment for all three, and it is not clear how to distinguish among them.
It sounds weirdly blasphemous when you put it like that. “We take responsibility for this product not being delivered in useable condition.” I wonder if your warranty should be issued by the Church…
I guess the warrant is for your body, with your mind/soul is the intended owner, but that raises all sorts of philosophical questions.
Interestingly, the Knights of Columbus looked into offering health insurance for its members but couldn't find a good enough loophole on paying for abortifacients. This has been told to me personally by high ranking members and I'm really not sure what the relevant law(well, I guess section of the ACA) was, but that is how the Church would offer a warranty on genetic conditions, at least in the US.
I've always been curious: would refusal to pay for birth control or plan B etc actually make the plan cheaper, or more expensive?
For a single man, almost certainly cheaper. For a family, the major confound is that the knights of Columbus would expel a member who admitted to using birth control. Even if there's probably some cheating, a KofC healthplan would be covering lots of childbirths anyways.
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