By now, how many Americans haven’t heard of death panels, and the Big Bad Government interfering with end-of-life decisions that would send granny to the gallows? And who doesn’t know about Canada’s “socialized” medicine where people are dying on the streets because that country “rations” care? To paraphrase Comedy Central’s Stephen Colbert, imagine all those corpses strewn across the Canadian tundra. But granny actually lives longer in Canada than in the U.S., according to some interesting stats put together by Rutgers research professor Louise Russell, who is familiar to Campaign Desk readers for revealing how, contrary to popular belief, preventive care does not save money.
In an op-ed which was turned down by every newspaper to which it was submitted—The New York Times, USA Today, The Boston Globe, The Philadelphia Inquirer, and the Los Angeles Times—Russell looked at different age groups among the elderly populations in both countries, and found that death rates for the elderly are lower in Canada than in the U.S. Russell broke down different age groups among the elderly and examined the number of deaths per thousand among people between the ages of sixty-five and sixty-nine; seventy and seventy-four; seventy-five and seventy-nine; eighty and eighty-four. In each of those groups, the death rates per thousand were lower in Canada than in America.
For instance, among people age seventy to seventy-four there were twenty-six deaths per 1000 people in the U.S. compared to twenty-one per 1000 in Canada. Between age eighty and eighty-four, Russell found sixty-five American deaths per 1000 compared to fifty-nine deaths per 1000 Canadians. For people eighty-five and older, rates were virtually the same. Everyone eventually dies.
Her analysis is important for journalists and the public because she effectively challenges a wild claim by the wildly popular Bill O’Reilly. Last month, on the O’Reilly Factor, a Canadian letter writer named Peter asked: “Has anyone noted that life expectancy in Canada under our health system is higher than the USA?” To which O’Reilly simply replied: “Well, Peter, that’s to be expected. We have ten times as many people as you do.” That kind of statistical nonsense would surprise the heck out of any researcher or health and medical reporter worth his or her salt.
Precisely because differences in population size exist, researchers interpret numbers using a level playing field to make meaningful, apples-to-apples comparisons. One way to do that is to calculate rates of death, or anything else, using a standard base such as per 100 people—or, as in Russell’s analysis, per 1000 people. Without such a uniform basis of comparison, the numbers don’t mean very much, except as fodder for outlandish and misleading statements like the one O’Reilly made.
Newspaper editorial editors are, of course, deluged with all kinds of worthy op-eds, and these days have little space to accommodate all that deserve to be published. But we thought Russell’s analysis was worth passing along—not only to help reporters challenge such claims as O’Reilly’s, but also to help his viewers understand that, yes, Canadians do live longer than Americans, for a variety of reasons. These include not only the country’s medical insurance system, but what are known as the social determinants of health—poverty, workplace stress, where people live, and so on.
For the record, Russell consulted the Central Intelligence Agency’s World Factbook and found that 2009 estimates indicate that all Canadians are expected to live 81.2 years on average, compared to 78.1 years for Americans—a three-year advantage in the land of strewn corpses and “socialized” medicine.
C'mon, Trudy. Give me a population of Canada's demography and culture, and I'll give you higher 'average' lifespans than the infinitely more complex U.S., no matter how your health system is financed. Is any advocate of Obamacare or single-payer or whatever willing to state forthrightly and categorically that life expectency rates will increase relative to Canada if their political vision is realized? Will Trudy Leiberman guarantee that the percentage of GNP spent on health care in the U.S. will decline if these 'reforms' (a greater control of health car policy by our relentless aspiring administrators of society) are instituted? I've seen plenty of 'answers' to critics of importing U.S. health care policy from France or Britain or wherever. What I haven't read, and will not read, is any measure by which advocates of this direction can admit trade-offs or even that they were wrong about some of the promised improvements. The terms presented for 'reform' do not admit real benchmarks by which the reforms can be judged to be failures or successes.
Thus, the life-span differential you cite is almost entirely due to an American populationi of teenage girls with poor pre-natal habits generating a higher level of infant mortality rates, as I suspect you know. I suspect you also know that health insurance schemes will not change this. And, by the way, the CIA estimate is on the high side of any I've seen for life spans, but never mind - there is a mathematical problem that some people seem to have here. Do Canadians who have reached the ages of 40, 50, 60, 70 live longer than Americans? I suspect not, because our health care dollar is spent mostly getting people from age 75 to age 85 - because, we, as consumers, both demand it and have the capability to see it done. Haven't seen these questions addressed in your many posts.
A lot of what some Americans admire in overseas health-care systems is really a function of those countries' fundamental culture and personal habits - they think the politics is a cause, not an effect. Another cognitive problem common to political 'progressives'. In this case, they do silly things like 'refute' Bill O'Reilly or some other easy political target for CJR's presumptively left-leaning readers, while ignoring the tough questions about real trade-offs. Maybe this strategy is the root of the public's skepticism toward Obama, single-payer advocates, and other politically-motivated campaigners for greater political involvement in the lives of individual Americans - can life really be this simple? After all, we've heard in the past that greater federal involvement in housing, education, etc., was going to work all kinds of wonders, too.
#1 Posted by Mark Richard, CJR on Wed 2 Sep 2009 at 12:21 PM
Mark -
You asked: "Do Canadians who have reached the ages of 40, 50, 60, 70 live longer than Americans? I suspect not, because our health care dollar is spent mostly getting people from age 75 to age 85 - because, we, as consumers, both demand it and have the capability to see it done. Haven't seen these questions addressed in your many posts."
The last paragraph of the article you disagree with, "... 2009 estimates indicate that all Canadians are expected to live 81.2 years on average, compared to 78.1 years for Americans."
You do bring up an interesting issue: America has more guns and violent assults per person than Canada and Europe. That may explain one reason there is a three year gap and that those 40,50 60 and 70 year olds are dying earlier. And Obamacare doesn't address that either.
#2 Posted by dlamour, CJR on Wed 2 Sep 2009 at 01:02 PM
Do Canadians who reach the age of 65 live longer than Americans who get to that age? The answer is an unequivocal yes. The statistics I put together were the death rates for people who reached the age of 65, broken down by 5-year age groups -- 65-69, 70-74, 75-79, 80-84, and 85 and older. In every one of those age groups, the death rate is lower for Canadians than for Americans. That means that people who reach that age survive longer, on average, in Canada than in the US
Interestingly, Canada also breaks out the death rate for people 85-89 (and then 90 and older) in its official statistics. The US does not. Maybe that's because so many more people survive to 85 and beyond in Canada.
#3 Posted by Louise Russell, CJR on Wed 2 Sep 2009 at 04:38 PM
Do Canadians who reach the age of 65 live longer than Americans who get to that age? The answer is an unequivocal yes. The statistics I put together were the death rates for people who reached the age of 65, broken down by 5-year age groups -- 65-69, 70-74, 75-79, 80-84, and 85 and older. In every one of those age groups, the death rate is lower for Canadians than for Americans. That means that people who reach that age survive longer, on average, in Canada than in the US
Interestingly, Canada also breaks out the death rate for people 85-89 (and then 90 and older) in its official statistics. The US does not. Maybe that's because so many more people survive to 85 and beyond in Canada.
#4 Posted by Louise Russell, CJR on Wed 2 Sep 2009 at 04:39 PM
Is there a link to Prof. Russell's oped piece? Also, dio you have any insight into the reasons that the oped was rejected?
#5 Posted by Kim Pearson, CJR on Wed 2 Sep 2009 at 05:08 PM
Not yet, but I am working on getting it posted and will let you know the link when it is. I don't know why the oped was rejected. None of the papers give reasons -- they say upfront that they don't have time -- and only two even sent a message saying thanks, but no thanks. The others tell you that if they haven't contacted you within X days, they don't want it.
#6 Posted by Louise Russell, CJR on Wed 2 Sep 2009 at 07:22 PM
To Louise Russell, I'll have to take your point that the average person 70 years old in the U.S. will not live as long as someone 70 years old in Canada. I believe this does not account for wide disparities within the United States, and I believe I suggested that longer average lifespans in any country are much more a function of the demography of culture than of what kind of health-insurance plan exists; after all, lifespans increased dramatically in the 20th century before the NHS or single-payer or Medicare ever came into being. No one can reasonably oppose scalpel-like measures to gain better outcomes for the health-care dollar, but are you really willing to assert that the adoption of Canada's system of financing health care would really produce the same outcomes in life expectancies, mortality rates, and so on?
#7 Posted by Mark Richard, CJR on Thu 3 Sep 2009 at 12:56 PM
To Louise Russell, I'll have to take your point that the average person 70 years old in the U.S. will not live as long as someone 70 years old in Canada. I believe this does not account for wide disparities within the United States, and I believe I suggested that longer average lifespans in any country are much more a function of the demography of culture than of what kind of health-insurance plan exists; after all, lifespans increased dramatically in the 20th century before the NHS or single-payer or Medicare ever came into being. No one can reasonably oppose scalpel-like measures to gain better outcomes for the health-care dollar, but are you really willing to assert that the adoption of Canada's system of financing health care would really produce the same outcomes in life expectancies, mortality rates, and so on?
#8 Posted by Mark Richard, CJR on Thu 3 Sep 2009 at 02:23 PM
For those who would like to see the op-ed I submitted to newspapers, it is now available at http://www.ihhcpar.rutgers.edu/downloads/Grandma%20Lives%20Longer%20in%20Canada.pdf. The first submissions were under the title "Canada's Corpse-Strewn Landscape." After three rejections I tried twice more with the current title, "Grandma Lives Longer in Canada," which refers to the claims that other countries 'pull the plug on Grandma."
#9 Posted by Louise Russell, CJR on Thu 3 Sep 2009 at 03:17 PM
For those who would like to see the op-ed I submitted to newspapers, it is now available at http://www.ihhcpar.rutgers.edu/downloads/Grandma%20Lives%20Longer%20in%20Canada.pdf. The first submissions were under the title "Canada's Corpse-Strewn Landscape." After three rejections I tried twice more with the current title, "Grandma Lives Longer in Canada," which refers to the claims that other countries 'pull the plug on Grandma."
#10 Posted by Louise Russell, CJR on Thu 3 Sep 2009 at 03:18 PM
The URL in the preceding messages doesn't work. Our computer expert tells me it's because I put a period at the end (thinking of it as a sentence). Here's another try:
http://www.ihhcpar.rutgers.edu/downloads/Grandma%20Lives%20Longer%20in%20Canada.pdf
#11 Posted by Louise Russell, CJR on Thu 3 Sep 2009 at 05:30 PM
To Mark Richard -- I'm not trying to assert that adopting Canada's health system would get us Canada's results. The purpose of my op-ed was to point out that their system does not control costs by letting elderly people die, as so many have claimed.
#12 Posted by Louise Russell, CJR on Fri 4 Sep 2009 at 11:38 AM
> Give me a population of Canada's demography and culture, and I'll give you higher 'average' lifespans than the infinitely more complex U.S., no matter how your health system is financed.
I keep hearing this 'greater complexity and disparity' argument and yet I have yet to see a shred of evidence that supports it.
The only part of it that is true is that Canada, with a population of 33 million people, is about nine percent the size of the United States.
Presumably this would mean that the economics of scale are on the American side, then.
What about diversity and complexity? Canada, unlike the United States, is a multi-lingual country by statute - we have two official languages. And, like the United States, we have speakers of pretty much every other language on the planet.
Canada has a history of population increase by immigration, which means that it is a very diverse nation, with people from all cultures and all ethnicities. It cannot be argued that the United States is more demographically compelx than Canada.
Where there _is_ a big difference is in the extremes of wealth and poverty. Canada has nothing remotely resembling American slums, not because it doesn't have large cities (it has three of the largest cities in North America) but because of generations of social policy - including public health care - intended to address such problems.
Canadian demographics - at least in terms of socio-economic status - are the *result* if policies like health care, and not an explanation of why the Canadian system is ineffective.
#13 Posted by Stephen Downes, CJR on Mon 7 Sep 2009 at 06:46 PM