Compared to other developed nations, United States has better survival and life expectancy rates for cancer, heart disease and stroke according to analysis of validated registry and clinical data. When absolute differences in smoking are controlled for, life expectancy after age 50 in the US is better still. The critical difference: Americans are receiving more effective treatments more often.
So if you want to claim just the opposite: that spending on health care is not related to life expectancy or want to show that the US healthcare system needs to control costs by allowing the government to "coordinate care?"
You do what Sherry Glied and Peter Muening did in their widely publicized article in Health Affairs, "What Changes In Survival Rates Tell Us About US Health Care". You come up with a 15 year survival rate which understates the effect of treatment since most studies track 5 year survival rates after diagnosis and treatment and overstate behavioral issues. Then you simply assert -- because there is more spending in the US than Europe -- that the difference is the result of our lousy, inefficient system of care.
content.healthaffairs.org/cgi/content/full/hlthaff.2010.0073v1#SEC1
How do the authors get away from making the exact obvious conclusion that the rest of the epidemiological literature has shown? One reason is that Health Affairs is carrying a torch for Obamacare and whatever peer review took place was passive or unconcsious. Another reason: such statistical skewing is easy to get away with because most in the media simply report the conclusion without looking at the methods.
The authors state: "We measured fifteen-year survival rather than life expectancy because the latter can be biased by the survival experiences of a small number of elderly people, among whom coding errors are common. Focusing on survival also allowed us to distinguish between the experiences of specific cohorts. We explored fifteen-year survival for men and women separately because risk-factor profiles differ greatly by sex and country.
By looking at overall survival after 15 years the authors can go back to a time when medical innovations essential to survival by disease were non-existent but detection in the US was more prevalent The effect of higher levels of detection -- in the absence of innovations -- are what appears to be lower rates of survival. At the same time they ignore mortality rates because the US had a faster decline in mortality from major diseases (many of which Glied and Muenning ignore) than in other countries.
This hatchet job has yet to be questioned by anyone in the media. If anyone is interested they can compare the Health Affairs j'accuse with other studies that are less biased. In particular, look at Low Life Expectancy in the United States: Is the Health Care System at
Fault? by Samuel H. Preston and Jessica Y. Hoy of UPenn.
repository.upenn.edu/cgi/viewcontent.cgi
So if you want to claim just the opposite: that spending on health care is not related to life expectancy or want to show that the US healthcare system needs to control costs by allowing the government to "coordinate care?"
You do what Sherry Glied and Peter Muening did in their widely publicized article in Health Affairs, "What Changes In Survival Rates Tell Us About US Health Care". You come up with a 15 year survival rate which understates the effect of treatment since most studies track 5 year survival rates after diagnosis and treatment and overstate behavioral issues. Then you simply assert -- because there is more spending in the US than Europe -- that the difference is the result of our lousy, inefficient system of care.
content.healthaffairs.org/cgi/content/full/hlthaff.2010.0073v1#SEC1
How do the authors get away from making the exact obvious conclusion that the rest of the epidemiological literature has shown? One reason is that Health Affairs is carrying a torch for Obamacare and whatever peer review took place was passive or unconcsious. Another reason: such statistical skewing is easy to get away with because most in the media simply report the conclusion without looking at the methods.
The authors state: "We measured fifteen-year survival rather than life expectancy because the latter can be biased by the survival experiences of a small number of elderly people, among whom coding errors are common. Focusing on survival also allowed us to distinguish between the experiences of specific cohorts. We explored fifteen-year survival for men and women separately because risk-factor profiles differ greatly by sex and country.
By looking at overall survival after 15 years the authors can go back to a time when medical innovations essential to survival by disease were non-existent but detection in the US was more prevalent The effect of higher levels of detection -- in the absence of innovations -- are what appears to be lower rates of survival. At the same time they ignore mortality rates because the US had a faster decline in mortality from major diseases (many of which Glied and Muenning ignore) than in other countries.
This hatchet job has yet to be questioned by anyone in the media. If anyone is interested they can compare the Health Affairs j'accuse with other studies that are less biased. In particular, look at Low Life Expectancy in the United States: Is the Health Care System at
Fault? by Samuel H. Preston and Jessica Y. Hoy of UPenn.
repository.upenn.edu/cgi/viewcontent.cgi
