If one wanted even more value, I suspect one may travel to India and save yourself ~>$18,000 out of $19,000 for the same value in whatever that platinum package may entail.
It could be a nice baseline to have in a very very limited situation (I’m thinking <1% of people will get a lot of value), especially if it was 100x cheaper, but otherwise, I suspect it will end up being falsely reassuring, especially if a non-radiologist physician is too quick to assume there’s nothing wrong because they don’t often read or understand how radiology slides work.
I don’t know how many people have lived outside the US. One thing you notice when returning is how ungodly fat Americans are! Nothing like it anywhere else in the world.
We could speculate on causes for this (USDA food pyramid e.g) but it needs to be addressed.
Covid could have been a lot less severe if the government had focused on helping people learn how to eat right and exercise but…
We created three “bins” of treatments, sorted according to their health benefit per dollar of spending. The category with the greatest benefit includes low-cost antibiotics for bacterial infection, a cast for a simple fracture, or aspirin and beta blockers for heart attack patients. Not all treatments in this category are inexpensive. Antiretroviral drugs for people with HIV may cost $20,000 per year, but they are still a technology home run because they keep patients alive, year after year.
A second category of technology includes procedures whose benefits are substantial for some patients, but not all. Angioplasty, in which a metal stent is used to prop open blocked blood vessels in the heart, is very cost-effective for heart attack patients treated within the first 12 hours.
A third category includes treatments whose benefits are small or supported by little scientific evidence. These include expensive surgical treatments like spinal fusion for back pain, proton-beam accelerators to treat prostate cancer, or aggressive treatments for an 85-year-old patient with advanced heart failure. The prevailing evidence suggests no known medical value for any of these compared with cheaper alternatives. Yet if a hospital builds a $150 million proton accelerator, it will have every incentive to use it as frequently as possible, damn the evidence.
So it’s not just “technology” that is driving our rising health-care costs; it’s the type of technology that is developed, adopted, and then diffused through hospitals and doctor’s offices. Much of the increase in observed longevity is generated by the first category of treatments. Most of the spending growth is generated by the third category, which the U.S. health-care system is uniquely, and perversely, designed to encourage. Unlike many countries, the U.S. pays for nearly any technology (and at nearly any price) without regard to economic value. This is why, since 1980, health-care spending as a percentage of gross domestic product has grown nearly three times as rapidly in the United States as it has in other developed countries, while the nation has lagged behind in life-expectancy gains.
One can get a real big amount of life extension from say $1,000,000 CAR-T therapy or getting an organ transplant by gaming the system with tons of money (legally, and sometimes illegally).
America has greater inequality than most other countries, but resourceful people know how to make best use of inequality. Per capita numbers are not great when you want to look for the most resouceful people.
It also matters that America has way lower air pollution than Europe, esp b/c it’s way easier to eat healthy than escape air pollution
The estimates confirm the trend for longevity: lifespans are getting longer.
Globally, life expectancy has increased by more than 6 years between 2000 and 2019 – from 66.8 years in 2000 to 73.4 years in 2019. While healthy life expectancy (HALE) has also increased by 8% from 58.3 in 2000 to 63.7, in 2019, this was due to declining mortality rather than reduced years lived with disability. In other words, the increase in HALE (5.4 years) has not kept pace with the increase in life expectancy (6.6 years).
So by living those 20 years, globally, we got about 30% back! I hope that trend continues.
I also find it interesting that the USA has a very short HALE - Healthy Lifespan - ranked 70th just behind Iran and most South American countries. Japan and Singapore have the highest followed by most of Europe. Canada has the highest in the Americas.
The United States just has so many extra risk factors. Obesity rates are 2x higher than the EU, number of hours spent in cars is 2x higher than the EU, illicit drug use rate is 2x higher than the EU, gun violence is 22x higher than the EU… it’s amazing that our life expectancy is as good as it is, really.
Economic growth isn’t the only way to compare how well countries are doing
This is hardly a new question. People have argued for decades that GDP is an insufficient measure of national prosperity or living standards, but attempts to come up with something better tend to end up rather mushy.
It would be better to make it simple. For my money, life expectancy is the most important supplementary measure of how a country is doing. It is a solid quantitative metric based on mortality rates, and few things matter more than life and death. It is also influenced by other factors people care deeply about, such as the treatment of babies and mothers, the quality of food, healthcare, education, pollution, jobs and crime. One could argue that “healthy life expectancy”, a measure of the years people live in decent health, would be even better, but the data available right now is too subjective to compare trends robustly across countries.
Of course, policymakers do care about life expectancy already. But what might the world look like if politicians compared these statistics as obsessively and anxiously as they do their GDP trends? By this measure, the US would not be envied by the rest of the rich world. Even as its economy grows, the life expectancy of its people falls further behind that of its peers. In 1980, life expectancy was roughly the same in the US as it was in Italy and France, and higher than in the UK and Germany. It had sunk to the bottom of that pack by the 1990s, and now it is being overtaken by much poorer countries in terms of GDP per head. For all the ink spilled about when (or if) Chinese GDP will overtake America’s, Chinese life expectancy has already quietly achieved that feat(opens a new window).
