Unhealthier Americans Live As Long As Healthier Brits

Ever come across simplistic commentators who compare health care systems by comparing life expectancies? Most annoying. Many factors determine life expectancy aside from health care systems. Diets, exercise, even weather influence life expectancy. The need to control for these other factors make well done health care system performance comparisons non-trivial. The RAND Corp has taken an interesting approach to comparison of two health care systems: Older Americans who have more chronic diseases than similar aged older English live just as long as their English counterparts on average. This probably shows the higher amount of money spent per American patient really is buying life expectancy benefits.

Older Americans are less healthy than their English counterparts, but they live as long or even longer than their English peers, according to a new study by researchers from the RAND Corporation and the Institute for Fiscal Studies in London. Researchers found that while Americans aged 55 to 64 have higher rates of chronic diseases than their peers in England, they died at about the same rate. And Americans age 65 and older -- while still sicker than their English peers -- had a lower death rate than similar people in England, according to findings published in the journal Demography. The paper was co-authored by James Banks and Alastair Muriel of the Institute for Fiscal Studies and James P. Smith, distinguished chair in labor markets and demographic studies at RAND.

What I take away from this: If you want to maximize your life expectancy while waiting for rejuvenation therapies then choose a diet and lifestyle that will make your risk of chronic illnesses even lower than chronic disease rates in England and make sure you can afford the very best medical care. Given an ideal diet (i.e. a diet that is probably better than what you eat now), exercise, low exposure to pollutants, and other health-promoting practices you can delay the onset of chronic diseases. Then once they hit you can use cash and an excellent nearby research hospital (and, yes, quality of care varies considerably) to further delay the grim reaper.

Better to be sick in America.

"If you get sick at older ages, you will die sooner in England than in the United States," Smith said. "It appears that at least in terms of survival at older ages with chronic disease, the medical system in the United States may be better than the system in England." The study expands upon an earlier analysis by Banks and Smith that found that Americans aged 55 to 64 suffered from diseases such as diabetes at rates up to twice those seen among similarly aged people in England. The trend was observed across all socioeconomic groups.

The American health care system (really an assortment of systems) is expensive. But it delivers a number of benefits. One is mentioned above: It does a better job of managing and treating chronic diseases of old age. But that's not all. It also does not make people wait as long. A person who has, say, a bad hip who has to wait for months to get it fixed loses work (which costs both the individual and the government money) and experiences a lot of pain while waiting. The queues that are characteristic of cheaper health care systems impose costs on customers/supplicants.

My favorite advantage of the American health care system is that it presents huge incentives to the market for the development of newer and better treatments. That's what makes the biggest difference to most of us in the long run. If you are many years away from your first life-threatening illness then the speed or thoroughness with which the current health care system treats you is less important than what future treatments it will offer you 10, 20, 30 or more years from now. I favor a health care system that offers huge incentives for new treatments and low barriers to entry for those treatments.