One of the arguments I hear most often from advocates of socialized medicine is that nations which have government-run healthcare systems live longer lives than the United States, so therefore they must have much better medical systems.
This is an argument which should instantly give you reason to pause. How many people do YOU know who have died because of preventably inadequate healthcare? No, seriously: How many have died in accidents, of untreatable cancers, suicide, crime, or of old age, versus being denied adequate medical treatment? Almost none in that second category? Only a few? That should tell you something: that life expectancy rates aren't an especially good measure of healthcare systems.
And why aren't advocates of "universal care" citing things which would bear more directly on the quality of care, like cancer survival rates (the US is much better than Europe) heart attack survival rates (the US is much better than Canada), patient satisfaction levels (the US ranks #1 in the world, apparently) or citing another more direct measure of healthcare effectiveness?
Again, the shape of the argument itself (and the facts in parenthesis) show you something is fishy.
But let's take the argument seriously just a bit more: Here are the aforementioned life expectancy rates. The "free market" United States ranks #35! For shame! But wait, what's this? Highly socialized Denmark ranks only #32? Shouldn't socialized healthcare do much better? And how much better? 78.11 years in the US versus 78.3 in Denmark — a difference of only two months? So if we converted to Denmark's healthcare system, and paid about 50% tax on most items, the argument goes, we'd all live — 60 days longer? What if we became "just like" the UK, at 79.01 years — we'd all live only 9 months longer, on average? Really, is this the argument?
And why not just run the argument the other way around? The Cayman Islands has no universal healthcare (and lacks certain important medical facilities), and yet is ranked #16 — far above Norway (#24), the UK (#36), Denmark (#46), and the EU as a whole (#41)? Shouldn't these nations all be rushing out to drop their universal healthcare systems in order to emulate the Cayman Islands?
What's that you say? Something about the Cayman Islands having different demographics? And there being other factors to consider? Why yes, indeed, how about that?
The impact of violent crime on the life expectancy of U.S. citizens far outstrips that of European nations. The social and cultural implications of violent crime, important as they are, will not be addressed by health insurance. Access to healthcare is not the same as access to a safe, crime-free environment.
And (link added):
The WHO judged a country's quality of health on life expectancy. But that's a lousy measure of a health-care system. Many things that cause premature death have nothing do with medical care. We have far more fatal transportation accidents than other countries. That's not a health-care problem.
Similarly, our homicide rate is 10 times higher than in the U.K., eight times higher than in France, and five times greater than in Canada.
When you adjust for these "fatal injury" rates, U.S. life expectancy is actually higher than in nearly every other industrialized nation.
So if it's true that once you remove certain large, non-healthcare-related factors from life expectancy rates, the US ranks almost top in the world — shouldn't we then expect those in favor of "single payer" to now change their views, based on the alleged supreme importance of having a long life expectancy?
Perhaps some truly open-minded "progressives" would. Others, sadly, will simply go looking for some other bit of evidence to justify their foregone conclusion. And, for them, average longevity suddenly moves from a very important — the most important thing ever! — to a very unimportant consideration. Which describes you? Are you open-minded to evidence? Do you care what actually helps the most people?
UPDATE: More on healthcare numbers from Greg Mankiw.