mheslep said:
Many things having zero to do with the medical system impact life expectancy, including homicides, car wrecks, gene pools. If one corrects for those factors, the US comes out at or near the top of a longevity ranking.
Rubbish.
Diet, exercise,
primary health care provision – these are the single most important factors, in fact, to raise life expectancy. The levels of obesity in the US certainly show that the first two of these factors are at a bad level for many people there, and primary health care is precisely the area that the poor and uninsured do not receive. These are linked, of course – improve primary care and diet and levels of fitness will also improve.
The factors you mention are ridiculous. Homicides will have a fairly negligible bearing. 17,000 murders in the US in 2006 – about 3–5 times the rate of most industrialised countries. So, let us call that 12,000 extra deaths due to murder. Compare that to http://prescriptions.blogs.nytimes.com/2009/09/17/harvard-medical-study-links-lack-of-insurance-to-45000-us-deaths-a-year/", which estimates that 45,000 deaths per year can be directly attributed to lack of health insurance.
As for car crashes, you haven't been to Cuba, have you? I have been to both the US and Cuba, and I can assure you that US roads are much safer. Cuba's life expectancy would probably jump ahead of the US 'correcting' for this factor. Road deaths in the US are high – 40,000 per year, a rate that's three times higher than the UK (which has a very good record), and about twice as high as Japan (which has one of the highest life expectancies, and is about average for road deaths). So, again, even comparing the US with countries with good records, you're talking about an extra 20,000 deaths. This also begs the question: How many of these deaths could have been prevented if the victims had all had good health insurance?! Is the UK's low death rate on the roads in part attributable to the fact that we all have equal access to all A&E departments? I would suspect that it is – you are taken to the nearest hospital, not the nearest hospital that your insurance will cover.
And your final factor, gene pools... I'd like to see some evidence, please. The US is largely a country of descendants of recent immigrants – there's a pretty wide gene pool in the US population. At the very least, you would need to provide some evidence for this assertion. I suspect that it is, to put it in the British vernacular, utter bollocks. In fact, it would be pretty easy to show that this is bollocks. Life expectancy among black Americans is significantly lower than the overall average. Is this because of their genes? No. How do we know that? Because we can compare the life expectancy of poor black Americans and rich/middle class black Americans and see that the difference can be fully explained by their relative positions in society.
ETA: Just to put these figures into perspective – 12,000 extra deaths due to murder, 20,000 due to car crashes – 2.5 million people die in the US each year. Even if you could show that none of these extra deaths could have been prevented with a more equitable health care system (there are strong reasons to doubt this), these are not the reasons for the US's relatively poor performance wrt life expectancy.
Please don't make stupid, unjustified assertions like "If one corrects for those factors, the US comes out at or near the top of a longevity ranking." It simply isn't true and it debases the discussion.
