Back in the 1970s, Americans typically lived longer than people in other countries.
Not anymore: A new report out Thursday morning from the Organisation for Economic Cooperation and Development shows that the United States’ life expectancy is now one year behind the international average, lower than Canada and Germany and more akin to the Czech Republic and Poland.
This isn’t to say our life expectancy has gone down — quite the opposite. You can expect to live about eight years longer in the United States right now than you would have in 1970. But our life expectancy is growing a lot more slowly than that of other countries.
This 213-page, graph-laden OECD report tells the story of why. It shows the United States as a country that is spending mountains of cash on health care — but getting way less than other countries out of that investment. It exposes a country that’s great at buying fancy medical technologies, but not so fantastic at using those medical technologies to extend life. It is, in short, the story of why our health-care system is so messed up.
We’re usually atop the list when it comes to buying high-end medical machines, such as MRI and CAT-scan technology. When you look at the OECD lists on who has the highest rate of medical technology per capita, the United States always cracks the top three.
We make great use of those machines, too. Each year, more than one in 10 Americans get an MRI exam, a rate higher than any other country. In Austria, which has a life expectancy more than two years longer than that of the United States, the MRI rate is about half of ours.
We’re also great at screening patients for different diseases, such as cervical cancer. As with use of medical technology, the OECD report shows the United States typically has some of the world’s highest screening rates. More than three-quarters of American women are screened for cervical cancer, a rate higher than in any other country.
But we make fewer regular doctor visits. The average American makes four trips to the doctor in one year, compared with an international average of six visits.
That might be because we don’t find our doctor visits especially helpful. Compared with the Swiss or the British, we’re less likely to think our doctor spent enough time with us or gave easy-to-understand explanations.
In other words, we’re great at checking for problems, but less great at following through with treatment.
Although the United States, for example, has the highest rate of cervical cancer screenings, it also has a below-average five-year survival rate for the disease.
This isn’t true for every disease. The United States, for example, has the highest rate of breast cancer screenings — and the best five-year survival rate for that disease.
The health-care system doesn’t tell the full story. The United States has higher-than-average mortality rates from violence and traffic accidents, another factor the OECD points to in explaining why the country’s life expectancy has lagged.
But the health system likely plays a key role, too. The United States has the highest rate of uninsured people in the countries the OECD studied, right below Estonia and Mexico. It’s plausible to think this can make it difficult to seek follow-up treatment when a screening does identify a problem.
This brings us back to the start of this story — our slowing life expectancy growth.
“While life expectancy in the United States used to be one year above the OECD average in 1970, it is now more than one year below the average,” the authors write. “Many possible explanations have been suggested for these lower gains in life expectancy, including the highly fragmented nature of the U.S. health system, with relatively few resources devoted to public health and primary care, and a large share of the population uninsured.”
We’re spending a lot on health care. But, when it comes to life expectancy, we’re not getting much back in return.