The United States spends a lot more per person on health care than other economically advanced countries, yet has lower life expectancy and higher infant mortality rates than many of those countries. The problem, says Bernie Sanders and others, is that we don’t have Medicare for All. But, writes Robert Moffit, non-medical factors and bad statistics, are the real sources of these variations in outcomes:
In a 2017 study for the Journal of the American Medical Association, researchers found that 74% of American variation in life expectancy—indeed, the largest source of variation—was attributable to behavioral and metabolic risk factors.
The recent annual declines in American life expectancy, based on data from the Centers for Disease Control and Prevention, werelargely attributable to increased drug overdoses (opioids) and suicides.
Then, there is the special category of infant mortality. “Our infant mortality rate, kids and babies who are dying, is the highest,” says Jayapal, the Washington lawmaker.
The truth is more complicated. In their 2018 study, the JAMA researchers report that American infant mortality is indeed higher than in 10 other high-income countries. Notably, however, the researchers also found that when adjusting for low birth weights, the U.S. statistical ranking improves significantly.
They write: “When adjusting neonatal mortality to exclude deaths of infants born weighing less than 1,000g [about 2.2 pounds], the United States ranked fifth relative to the other countries, with 1.61 deaths per 1,000 live births, compared with a mean of 1.70 for all 11 countries.”
Comparisons of infant mortality between the United States and other countries are often flawed because definitions of terms and measurements are different.
As Sally Pipes, president of the Pacific Research Institute, notes, “The United States … counts every live birth in its infant-mortality statistics. But France only includes babies born after 22 weeks of gestation. In Poland, a baby has to weigh more than 1 pound, 2 ounces to count as a live birth.
“The World Health Organization notes that it is common practice in several countries, including Belgium, France, and Spain to ‘register as live births only those infants who survived for a specified period beyond birth.”
Note also that the United States has high rates of pre-term births. American medical professionals, including those participating in Medicaid, will thus intervene in complex and difficult cases and literally spend hundreds of thousands of dollars to save the life of a premature infant.
Medical professionals in other countries do not necessarily make the same moral and financial commitments.
[Robert Moffit, “Ignore Medicare for All Advocates’ Claims on Life Expectancy in US. Here Are the Facts.” The Daily Signal, April 18]
