Health

The Myths About U.S. Life Expectancy

Time for absolute clarity on what's driving declining survival rates

Health care spending in the United States has grown to 17.8 percent of our GDP (gross domestic product), over a sixth of our country’s economic output. And this number is expected to rise in future years.

Spending over $10,000 per person per year on health care means that as a country we must be quite healthy. Right?

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But is most of this money being sucked into a bureaucratic black hole of waste, fraud, and abuse?

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Life expectancy is one measure of a country’s health. And the U.S. does not compare well to other developed countries. U.S. life expectancy is 79 years, compared to an average of 82 years for major European and Asian countries — countries that spend a much smaller percentage of their GDP on health care.

More attention needs to be devoted to the societal issues driving down U.S. life expectancy.

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Ask any Democrat about this and the reason given will be that we don’t have European-style, socialized, single-payer, government-run health care. After all, that’s what Europe has and most Europeans are outliving us. But there is more to the story.

Life expectancy is influenced by more than health and disease. Car crashes claim nearly 100 lives per day in the U.S. The city of Chicago had 762 homicides in 2016 alone. Take fatal injuries out of the mix when measuring a country’s health — and America jumps from the middle of the pack in life expectancy to the top.

Murders and accidents represent social and cultural problems, not the fundamental effectiveness of a country’s health care system.

Another perhaps more meaningful measure would be the likelihood of survival from a particular disease or event, rather than the average life expectancy of the entire population. The Centers for Disease Control and Prevention says that the five-year survival rate for breast, colon, and prostate cancer is higher in the U.S. than our peer countries.

What about heart attacks, the leading killer in our country? Have a heart attack in the U.S. versus Canada — and your chance of being alive in five years is higher if you live here.

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At the other end of the life cycle is premature birth. In the U.S., 12 percent of births are premature, which is on a par with Kenya, Thailand, and Honduras. Most European counties, Canada, and Australia fall into the 7-9 percent range. Despite high-tech medical care, many of these premature babies don’t survive. More premature birth in the U.S. lowers our overall life expectancy rate — but, as with homicide, it’s a cultural issue, not a health care problem.

Leaving the statistics aside, where do patients from around the world want to go for their health care — assuming they have the means to travel and to pay for medical care outside of their home country?

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Cleveland Clinic has a special department for international patients called Global Patient Services. Mayo Clinic has a similar International Services Department. The Bascom Palmer Eye Institute in Miami has an International Patients Department catering to patients traveling to the U.S. for their eye care. Despite the U.S. life-expectancy numbers, patients vote with their feet and their dollars, traveling to the U.S. to receive the best care.

Clearly the U.S. health care system has deficiencies in regard to cost and access. Social and cultural problems in the U.S. mean more individuals require health care services. The solution is not emulating the health care delivery systems that, beneath the superficial statistics, fail to provide better care. Instead, more attention, although often politically incorrect to talk about, needs to be devoted to the societal issues driving down U.S. life expectancy.

Brian C. Joondeph, M.D., MPS, is a Denver-based physician and writer.

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