Comment by piltdownman | Hacker News Reader

Comment by piltdownman | Hacker News Reader

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In terms of health outcomes, the UK generally has higher life expectancy and lower maternal mortality rates than the US - but that said, even the richest Americans face shorter lifespans than their European counterparts.

The real focus and point of contention should be that the US healthcare system is exponentially more expensive per capita than any European model, but is worse for almost all health outcomes including the major litmus tests of life expectancy and infant mortality. In some cases, the wealthiest Americans have survival rates on par with the poorest Europeans in western parts of Europe such as Germany, France and the Netherlands.

https://www.brown.edu/news/2025-04-02/wealth-mortality-gap

Americans average spend on inpatient and outpatient care was $8,353 per person vs $3,636 in peer countries - but this higher spending on providers is driven by higher prices rather than higher utilization of care. Pretty much all other insights in comparing the two systems can be extrapolated from that fact alone imo.

https://www.kff.org/global-health-policy/health-policy-101-i...

This is probably incredibly naive so apologies if so - are things like differing obesity or other health problem causing conditions accounted for when looking at overall outcomes of the system?

The higher cost makes perfect sense to me but calculating an apples to apples comparison of health outcomes between potentially very different populations seems potentially very difficult? Again sorry it's probably a solved problem but figured I'd ask :)

The lower life expectancy in the US is almost entirely down to young people dying at a much higher rate than Europe due to car accidents, murder, and drug overdoses. It skews the averages pretty badly. If those individual risks don't apply to you then life expectancy is actually pretty decent.

There is a wide variance in the general healthiness of the population depending on where you live in the US, which does affect life expectancy. Where I live in the US my life expectancy is in the mid-80s despite the number of young people that die.

That's because mortality rates are only weakly correlated with healthcare quality. The US has much higher death rates in some young demographics, which skews the average, but those people didn't die due to lack of medical care.

You can have exceptional healthcare quality and relatively low life expectancy in the same population.

The Brown study I cited above concludes differently, and is strictly a longitudinal, retrospective cohort study involving adults 50 to 85 years of age.

https://www.nejm.org/doi/full/10.1056/NEJMsa2408259

Within that 50-85 cohort, among 73,838 adults (mean [±SD] age, 65±9.8 years), the participants in the top wealth quartiles in northern and western Europe and southern Europe appeared to be higher than that among the wealthiest Americans. Survival in the wealthiest U.S. quartile appeared to be similar to that in the poorest quartile in northern and western Europe.

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