NCPA - National Center for Policy Analysis


January 8, 2010

The United States ranked 29th in the world in 2006 in life expectancy at age 50, according to the World Health Organization (WHO).  That places it more than three years behind the world's leader, Japan, and more than one-and-a-half years behind Australia, Canada, France, Italy, Iceland, Spain and Switzerland.  Currently about 4 million Americans reach the age of 50 each year, so an average loss of one and a half years per person means an aggregate loss of some 6 million years of potential life, valued at anywhere from $600 billion to $1.3 trillion annually.

In 2007, the United States spent 16 percent of its gross domestic product (GDP) on health care, by far the highest fraction of any country.  The conclusion that is often drawn from these numbers is that the United States' health care system is extremely inefficient. 

Despite the poor showing on the WHO study, the low longevity ranking of the United States is not likely a result of a poorly functioning health care system, according to researchers with the National Bureau of Economic Research (NBER).  On the contrary, the United States functions well compared to Organization for Economic Co-operation and Development (OECD) countries in terms of death avoidance:

  • Mortality reductions from prostate and breast cancers have been exceptionally rapid in the United States relative to a set of peer countries.
  • These unusually rapid declines are attributable to wider screening and more aggressive treatment of these diseases.
  • Screening for other cancers also appears unusually extensive, and five-year survival rates from all of the major cancers are very favorable.
  • Survival rates following heart attack and stroke are also favorable (although one-year survival rates following stroke are only average), and the proportion of people with elevated blood pressure or cholesterol levels who are receiving medication is well above European standards.

These performance indicators pertain primarily to what happens after a disease has developed, though. It is possible that the United States health care system performs poorly in preventing disease in the first place.  Unfortunately, there are no satisfactory international comparisons of disease incidence, says the NBER.

Source:  Lester Picker, "Low Life Expectancy in the United States," NEBR Digest, December 2009; based upon: Samuel Preston and Jessica Ho, "Low Life Expectancy in the United States: Is the Health Care System at Fault?" National Bureau of Economic Research, Working Paper No. 15213, July 2009.

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