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tptacek

Life expectancy differences between the US and other countries are dominated by just a few factors:

* Car accidents, because we drive much more and are much more spread out than other countries.

* Drug overdoses, though other countries are starting to catch up to us there.

* Homicide, because of our gun policy and the universality of firearms (which also bears on our suicide stats).

* CVD.

That last item sounds like an indictment of the US health care system, but it isn't. If you break CVD out by state, northeastern states like Massachusetts have outcomes resembling the Nordics, and Mississippi has outcomes like a developing country. But the structure of the health care system is the same in both places.

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> Car accidents, because we drive much more and are much more spread out than other countries.

Somewhat off-topic, but I think this explanation of the car accidents misses the mark. It might be part of the cause, but car accident deaths were dropping in the US and Europe until around 2010 when they kept dropping in Europe, but flatlined and then rose back up in the US.

I don't think we were driving less and less and are now driving more and more. We changed policies. (I think it's mostly bigger cars, plus less focus on traffic infra/systems/rules that prevent fatalities.)

Sure, I'd buy any hypotheses like this. We just have way more traffic fatalities; I don't have a strong take on the underlying cause.

I'm sure there are qualifiers and rationalizations when comparing cancer survival statistics as well. As someone already pointed out, uninsured Americans aren't necessarily included. They cited sources, you rebutted without sources.

I believe a single payer system is a matter of when not if. It works just fine in other countries. In our country, the healthcare industry has evolved into extracting as many dollars as it can from the economy. This is because when someone is sick and needs treatment, healthcare providers hold all of the cards.

Uninsured Americans are in fact universally included in death statistics and in cancer survival outcomes; we have top-tier cancer outcomes.

Europe has several universal coverage systems without single payer. The original sin of the US system isn't private insurance, it's employment-based coverage; that's the thing nobody else has.

Again, you cite zero sources. Survival rates for lung cancer in the USA, the most common cancer in the world, are much lower than Japan and South Korea. South Korea is single payer and Japan has strict government regulation of healthcare costs.

The second most common cancer is Breast Cancer. The USA is "top-tier" but so is pretty much every other Western Country. Australia, also famously single-payer is a mere 0.4% behind the USA.

This is the only source of modern survival statistics by country:

https://pmc.ncbi.nlm.nih.gov/articles/PMC5879496/

Compiled into an easier to read format:

https://worldpopulationreview.com/country-rankings/cancer-su...

Take note of two things: First, some states weren't even included in the study and second, there is no mention of insurance. The statistics are only tracking people who were diagnosed with cancer. It's reasonable to assume that some people who had cancer symptoms did not seek treatment because they didn't have insurance and died without being diagnosed.

Start with CONCORD-3.

I'm not saying that the US is better than every other country. I explicitly said somewhere else on this thread that there's a common critique of our outcomes that we just do detection better, and that our life expectancy outcomes aren't materially better.

What I am saying is that it's difficult to make a case that US life expectancy is materially altered by our health insurance system. You won't be able to use cancer to make that case, because the US has in fact quite good cancer outcomes. That's it: that's the whole argument.

Again, though: this repeated claim that "the uninsured aren't included in survival statistics" --- I don't know where that's coming from. It's not true.

I literally posted a link to the CONCORD-3 paper and made arguments using it and you rebutted it with "start with CONCORD-3".

I'll restate my argument so it's clear: CONCORD-3 does not mention insurance status anywhere in the paper. It does state that the statistics require diagnosis. It's reasonable to assume that if you can't afford healthcare, you're less likely to seek treatment or diagnosis.

You understand that CONCORD-3 is about tracking people who enter the healthcare system. Isn't it reasonable to assume that if healthcare is free or very affordable, there would be higher participation? And on the flipside, if it's outrageously expensive, there would be lower participation?

Sorry, I'm talking about US overall outcomes, which is what I thought you were arguing with all this breast cancer stuff. I am not taking seriously your axiomatic argument that the uninsured are systematically not captured by the US cancer statistics, and was not bothering to rebut that, nor will I.

There are no "overall" outcomes listed in CONCORD-3 or any other paper. Everything is measured by cancer type.

You're argument that uninsured are included is just as axiomatic. Zero evidence or sources. I guess we'll agree to disagree.

I don’t see a source being cited other then the assumed llm.

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