The performance of the United States health care system and society in terms of life expectancy is very poor, far below the average of other high income countries. It is poor in terms of level of life expectancy in years of life. It is poor in terms of average annual growth rate in life-expectancy. So, it is poor in terms of both achievement and progress. It is certainly not the best in the world.

The performance is poor for both sexes. It is poor at birth, at age 40 and at age 65. It is poor compared to the average performance of other high income countries and the performance of other specific countries that could be models for US health care (IMHO: Australia, New Zealand, and Switzerland). It is poor compared to other systems that could be adapted into good systems for the US, but may be politically infeasible here (Canada and France).

Table 1 shows recent ten year average growth rates of life expectancy for other high income countries, for the US, the rank of the US average growth rate among high income countries, and the rank of US life expectancy, in that order.

Table 2 shows the same statistics for recent five year average growth rates. Tables 1 and 2 show that the average growth rate in life expectancy in the US has been below the average of 22 high income countries for both the ten and five year periods, with exactly one exception.

The sole exception, shown in Table 2, is that the average five year growth rate (to 2006) in life expectancy for women at age 65 in the US rose to slightly above average of other high income countries, though the rank of the US was still only mediocre: 8 out of 22 countries. Seven countries had higher growth rates: Denmark, Finland, Greece, Ireland, Norway, Portugal and Spain. So, even the best recent performance of the US is not nearly the ‘best in the world’.

Note that for men at birth and age 40, and women at age 40, the growth rates in life expectancy are stagnating or slowing down. Contrast that poor performance with other countries.

It is difficult to see what factors unrelated to the health care system could explain such a poor performance. The violent life-style of the US has been used as an excuse: the US has a higher rate of death due to violence and accidence than most (but not all) other high income countries. But violence and accidents cannot explain the poor performance for people age 40 and 65.

The poor growth rates of the US cannot be due to maxing out potential for growth in life expectancy because of a high level of attainment. The US ranks low in the level of life-expectancy in years, as well as growth rates. Other countries have higher growth rates with higher levels of life expectancy in years. This seems remarkably inefficient for the best healthcare system in the world. One could understand having a low growth rate in life expectancy over time, if the life expectancy itself was very high compared to other countries: further growth might be restrained against some kind of limit of medical technology or healthcare practice. But to be bad in both the level of life expectancy, and in the growth rate, and to be much worse than average over extended periods of time seems like some kind of FAIL to me.

Table 4 shows the level of life expectancies by age group and sex for five other countries that have what the GOP and their minions call ‘government run health care’. The US has the lowest life expectancy of them all, at all ages and for both sexes.

It is interesting to note that for those age 65 is where the US performs best (though not the near the best among other high income countries). The average growth rates in life expectancy for all age groups in other high income countries seems to be accelerating, while it is stagnating for younger groups in the US, except for young women. However, both elderly men and women have accelerating growth rates in life expectancy, though, again, the growth rate is not among the best.

This relatively better performance among the elderly gives evidence in favor of healthcare reform. Two of the three groups with accelerating life expectancies in the US are the elderly, who have near universal coverage. The high levels of life expectancy and the accelerating growth rates give evidence that more regulated government financed universal health care system does not mean poorer care for the elderly.

Remember that other high income countries provide universal care for all ages, and perform better at all ages and for both sexes, and at lower cost.

If people are going to sling disgusting charges of euthanasia and eldercide around, then I propose the following response, backed up by data. The current US system has gone one step better than eldercide and has adopted a policy of saving money by killing off people before the get elderly. The current system shows more variety and sparkle than a glum gray socialist dystopia that would kill all of the elderly. The US system was killing off old women for twenty years, until around 2000. Since then it has switched modes into killing off old men, who seem to have had it too good for a long while, and perhaps were getting swelled heads.

Table 1.–Ten year growth rates in life expectancy and rank of US.
……………………………..Growth Rates (% per year)…….US Ranking, out of 22
Category………………other high income………..US…….growth rate…life expectancy
Women at birth………………0.27…………………0.20…………18……………..21
Men at birth…………………..0.41…………………0.32………….19……………..21
Women at 40…………………0.39…………………0.24………….17……………..20
Men at 40………………………0.61…………………0.52…………12……………..15
Women at 65…………………0.81………………….0.67…………15……………..16
Men at 65……………………. 1.27………………….1.03…………18……………..11

Table 2.–Five year growth rates in life expectancy and rank of US
……………………………..Growth Rates (% per year)……US Ranking, out of 22
Category……………..other high income………..US…….growth rate…life expectancy
Women at birth………………0.30……………….0.22………….17……………….21
Men at birth…………………..0 42………………..0.27………….21………………21
Women at 40…………………0.38………………..0.24………….17………………20
Men at 40…………………….. 0.67……………….0.49………….16………………15
Women at 65…………………0.88………………..0.91…………..8……………….16
Men at 65……………………. 1.30………………..1.19………….15……………….11

Table 3.–Life expectancy in years, 2004-2006
Category…………………..AU……….CA………FR………NZ……..CH……..US
Women at birth…………83.3………82.8…….83.9…….82.0…….84.0…….80.5
Men at birth……………..78.4………78.1…….76.9…….77.7…….78.8…….75.3
Women at 40……………43.7………43.3…….44.0…….42.6…….44.0…….41.4
Men at 40………………..39.4………38.9…….37.6…….38.8…….39.3…….37.1
Women at 65……………21.3………21.2…….22.1…….20.5…….21.8…….20.1
Men at 65………………..18.1………17.9…….17.8…….17.7…….18.3…….17.2
AU: Australia, CA: Canada, FR: France, NZ: New Zealand, CH: Switzerland, US: United States

(sorry about the ragged tables, only way I could figure out how to do it on short notice)

Details
Countries included in the analysis are Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Japan, Luxembourg, Netherlands, New Zealand, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom, and United States.

Ten and five year average growth rates calculated to 2005/6 for life expectancy at birth and at age 65; and calculated to 2002/3 for life-expectancy at 40. Level of life-expectancy in years is average of last three years of data. Data for UK is lagged on year due to lack of data for most recent year.

Source: OECD Health Statistics 2007 and 2009.
http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_1_1_1,00.html