Health care crisis!?

Take a look at his picture:

Life expectancy rates through time

This is from an article by “The Numbers Guy” Carl Bialik at the Wall Street Journal. The story is about how life expectancy calculators are not terribly accurate. This really isn’t much of a surprise, but the picture should be.

This is because both presidential candidates, and of course many other people, nervously claim that there is a “Health Care Crisis! We have to do something!”

Yes, it’s so bad that the people are living longer and longer and longer… This picture says that whatever the crisis is, it clearly doesn’t have to do with that part of health that keeps people alive. I would argue that that part is the most important; apparently, others disagree.

This is another example of the phenomenon that the better things get, the more people complain. Or maybe people don’t complain more, they complain at the same rate, but because things are better, the complaints are about matters and points that are increasingly trivial.

Hasn’t somebody given a name for this dynamic?

20 Comments

  1. Perhaps the problem ain’t one of dying age.

    Perhaps the problem is this:

    …and this:

    (hope the html tags work)

  2. I think it’s common to think that the most important part of health care is that which keeps people alive *and healthy* for longer, not just alive. As civilizations advance perceived issues of *quality* of life often come to dominate.

    Anyway, I think the crisis is based in a concern that the trends in the graph will be ended prematurely because people won’t be able to afford the care needed to keep up the improvement. They may well be wrong, but that’s a reasonable fear – I don’t hear many people saying “no really, I think people are living long enough thanks, let’s cap spending right here”.

  3. to me, it is the “zero-defect” game. it is easy to correct (and i am making up these numbers) 80% of the problems in any given system. as that efficiency becomes the norm, then we attack the remaining problems. 85% even 90% is achievable with smart effort over a prolonged period.

    then the rate of progress slows. 95% is won perhaps. but at some level of efficiency, it is simply no longer possible to improve any more. human nature kicks in; murphy’s law raises it head. something anything happens that will always prevent the last 5% of the problems from being erased.

    so we are left with these problems. and people complain about the same problems for years, losing sight of the solved ones. then some clown in WDC says that the system is broken and needs to be revamped totally.

  4. Paul:

    You don’t make it clear whether you think we’re succeeding or not at the quality of life issue. Personally, I think that we are. Of course, the biggest determination in quality of life is its the presence or absence thereof. And the perceived quality changes with different ages. An 80-year old able to live a quiet life, able to watch great grandchildren grow up may consider his quality of life to be high, while the same level of health in a 25 year old might be considered very poor.

    In any case, the real ‘crisis’ is that we’ve gotten really good at health care, but part of that cost is advanced technologies in the form of drugs, diagnostic and treatment paraphernalia and lots of education. And we don’t want to have to pay for all of this stuff, but at the same time, we do lots of stupid things that drive up the costs of care, such as insurance mandates and a silly tax code. The crisis will only be worsened if we follow some of the popular remedies that rely on the government to swoop in and save us all by wishing away the laws of economics.

  5. The WSJ article started with the question “what is McCain’s life expectancy” — this is not the proper graph to answer that question (this chart isn’t even mentioned in that text that I can see).

    Definitely surprising. If current trends continue, in 50 years, old people will not die 🙂

    Does anyone know the original location for this chart? Maybe they have other charts showing deaths by age group instead of over the whole population.

  6. Is that death’s of 80 year olds per 100,000 80 year olds? Or is it deaths per 100,000 total residents. If it’s the second, maybe there’s bad news. Maybe people are dying before they reach 50 and there are no 80 years olds left to die!

  7. I am with Doubter, I don’t think the graphs tell us anything of any real import. You actually need the death rate of the cohort mapped over time, not against the total population. Any rapidly growing population would generate these graphs, other things being equal.

    Doubters assertion that old people will not die is different from saying the % of those borne in 1918 who are still alive today, is markedly greater than the % of those borne in 1818 who survived to 1908.

    I do not know if our maximum lifespans as opposed to our average lifespans have increased or decreased. FOr Doubters assertion to be correct, our maximum lifespans should be increasing.

    A propos McCain and other things being equal, I would argue that old poor men who marry rich younger wives are likely to live longer than rich old men who marry poor younger wives – but then I read more than my share of murder mysteries.

  8. Those who say “but McCain is old:
    Sir Winston Churchill was about 77 when he was voted in the second time in 1951.
    It is in very poor taste to speak of the man in this way and I am surprised that even media outlets that have a democrat leaning would stoop to this sort of thing.
    Healthcare provision is a bottomless pit. The more treatments available the more patients there are queuing up to receive.
    This is true in public or private healthcare and is always forgotten. It’s not simply the length of life but the increased likelihood that even non life-threatening healthcare provision will be desired. For example the longer a person lives, the more likely they are to require orthopaedic intervention that has nothing to do with their age.
    The cost in healthcare provision is predominantly in wages by a very large margin. So, the more patients become educated or aware, the more they queue up for new tests, procedures and drugs so more staff are then required to provide the necessary care. TV and the media have a responsibility in this regard but they would rather instil fear in the public’s mind to get an interesting story than report facts responsibly and with sensitivity.
    So, the public need to cough up the money whether this is via public or private means. This is what the public does not want to do, anywhere, in any country, as far as I have noted so far.
    This is because no politician wants to break the news that healthcare is expensive however it is administered. Cost must grow to keep pace with increasing demand, the age issue is but one factor in a Bvery large picture.
    Bernie:
    Very funny,
    McCain might say “You’re only as old as the woman you feel! “

  9. IMHO the question needs to be rephrased in statistical terms, using survival functions such as distribution-free proportional hazard regression models.

    Survival analysis is pretty cool. The methodologies for evaluating lifetimes, survival times, or failure times are cutting-edge. Crudely speaking, survival analysis is useful in determining time to the occurrence of an event. That might involve human lifetimes, light bulb lifetimes, or less obvious questions such as how long does the average laid-off worker collect unemployment benefits, given age, education, and other factors. There are numerous applications in engineering, biomedical, and indeed most sciences.

    Besides the distribution-free models there are many distribution-based models, as well. And those allow development of confidence intervals, and those confidence intervals can be constructed as Bayesian posterior probability intervals. The uncertainty abounds.

    All of which are useful in inference. Are “we” really living longer? Which “we” are we talking about? And how certain are you of it?

    None of the above addresses the “quality of life” issue, which cannot be measured because it is entirely subjective. Here in Oregon we have taken that subjectivity to the limit with physician-assisted suicide. If you despair your quality of longevity, move to Oregon. We can fix your problem. Crisis solved.

  10. All,

    Everybody’s caveats are right on. I would not use this data to forecast the life expectancy of anybody, and it surely is of limited use.

    But it does have some use, and that is to show what everybody already knows: people are living longer. We can’t say better, but anecdotal evidence (my own experience), says better. On average.

    Mike, Oregon is a dangerous place.

  11. Matt:
    For your assertion to be correct the chart needs to be labelled “per 100,000 of the age cohort” otherwise it is impossible to infer what it means. On the other hand it has to mean this or the death rate would be approx 25,000 per 100,000 US Residents! Just an imprecise legend, I guess.

  12. Congressmen have higher life expectancies than people of the same age in the general population. That’s partly due to the selection effect that Congressmen have to have been healthy enough to run for office in the last two years, senators have to have been healthy enough to run for office within the last 6 years.

    Presidents, on the other hand, have LOWER life expectancies than people of the same age in the general population- A. McIntire

  13. Alan McIntire,

    Your comment about presidential longevity is an interesting one.

    Oddly, presidential age-at-death is kind of bimodal if you plot it out in a time series.

    Our founding fathers all lived at least into their late 60s, with John Adams, Jefferson and Madison all living well into their 80s. Obivously, this is much much longer than the general population. It seems with all the talk about the disparity between haves and have-nots today, our founding fathers had qualities of life that were head and shoulders above their fellow citizens.

    Then, around the mid 19th century, something started to happen. A long string of presidents started to kick off in their 50s and 60s. From Polk to Coolidge (19 presidents), only one (Buchanan lived to over 75). Of course, you have to take into account that there were three assassinations in this period.

    More recently, Hoover, Truman, Eisenhower, Nixon, Ford and Reagan all lived to be over 75, and Carter and Bush I are both well-over 80.

    So, ‘tho I’m not a statistician (but I DID play around with Excel last night), here are some quick numbers.

    Washington – Tyler, avg age at death, 77.9, stdev 7.5
    Polk – Coolidge, avg age at death, 64.3, stdev 6.1
    Hoover – Ford (plus Reagan), avg age at death, 77.7, stdev 16.4 (note, includes Kennedy, who was assassinated at 46.5)

    Wonder what happened the late 19th/early 20th century, other than lots of assassinations.

  14. Long Live Obama. Long Live NcCain. Oh, let me do it in a frequentist way.

    Long Live Obama. Long Live NcCain.
    Long Live Obama. Long Live NcCain.
    Long Live Obama. Long Live NcCain.
    .
    .
    .

    That’s all I can muster today.

  15. So, ‘tho I’m not a statistician (but I DID play around with Excel last night)

    Clever: Even lousy advertising copy can create a cultural motif, a la “where’s the beef”. Perhaps we have the basic idea for a new Briggsian competition.

  16. Briggs: “Hasn’t somebody given a name for this dynamic?”

    How about the Lomborg Effect? 🙂

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