Politics: Healthcare Population Statistics

I spent a lot of time on The Incidental Economist recently—it was wonderfully informative. One fact from Dr. Aaron Carroll’s excellent How Do We Rate the Quality of the US Health Care System—Population Statistics [1] stood out to me, although it wasn’t mentioned in the article or the comments: the trend lines make the US look even worse. Population statistics are usually dismissed as indicative of the quality of a country’s healthcare system because so many things affect them. I can understand this: there might be some genetic or lifestyle causes for one country’s being better than another. But looking at the trends tend to remove this objection. Over the last 20 years, most of the countries have improved more than the United States.

Take, for example, the “Life Expectancy” chart:

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All of the countries have had fairly linear increases, yet the increase for the US is smaller. Thus we see two countries that had roughly equal life expectancies in 1990, now have values over two years greater than the US. (The colors on the chart make it difficult to determine which country is which—especially Italy and UK.) Even Japan, which starts 3.5 years ahead, ends almost 5 years ahead. I don’t see how this can be brushed off as genetics or lifestyle.

We see much the same thing with infant deaths, but it is more interesting to look at the changing trends:

<%image(20110623-Infant-Mortality.jpg|450|230|Infant Mortality)%>

In this case, it is stark. The US (along with Canada—I think) looks very much like it is bottoming out. Virtually all of the change occurred between 1990 and 2000. Any change since then looks like noise. Again: I can’t think of anything but our healthcare system to explain this.

The number of maternal deaths speaks for itself. Other than France, all other nations look like random noise about the 5 death mean. There are some small trends before 2000, but since then: zip. The US looks as if some fundamental change occurred in the system (again) around 2000.

The “Potential Years of Life Lost” chart seems the most damning of all the charts, just on its face:

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The trends make it even worse. The only country with a smaller trend is Japan, and it isn’t by much. Most of the countries have lowered the number of deaths by roughly one graph line (1750 deaths); the US has lowered it 2/3; Japan, 3/5. As seen before, most of the change for the US was in the first half of the period. After 2000, there is the smallest of trends.

Although population statistics may not show that the US is doing a poor job regarding healthcare, the trends certainly do. Life is getting better in other countries at a faster rate than in the US.


[1] All the charts in this article are from Dr. Carroll’s article.