Times Science Writer Flouts Media Wisdom on Life Expectancy, Socialized Medicine

Iconoclastic science writer John Tierney (who once took on the environmental saint Rachel Carson and her pro-environmentalist movement book "Silent Spring") again challenged the media's conventional wisdom in his TuesdayScience Times column, this time on health care and U.S. life expectancies: "To Explain Longevity Gap, Look Past Health System."

Liberals often cite the U.S.'s relatively low life expectancy compared to Europe to argue for broader health insurance coverage and-or socialized medicine. But Tierney provides some context, arguing that other factors in play make the U.S. numbers look pretty decent:

If you're not rich and you get sick, in which industrialized country are you likely to get the best treatment?

The conventional answer to this question has been: anywhere but the United States. With its many uninsured citizens and its relatively low life expectancy, the United States has been relegated to the bottom of international health scorecards.

But a prominent researcher, Samuel H. Preston, has taken a closer look at the growing body of international data, and he finds no evidence that America's health care system is to blame for the longevity gap between it and other industrialized countries. In fact, he concludes, the American system in many ways provides superior treatment even when uninsured Americans are included in the analysis.

"The U.S. actually does a pretty good job of identifying and treating the major diseases," says Dr. Preston, a demographer at the University of Pennsylvania who is among the leading experts on mortality rates from disease. "The international comparisons don't show we're in dire straits."

Tierney noted that U.S. life expectancy is about 78 years, compared to 80 in the U.K., 81 in Canada and France, and 83 in Japan. But he found reasons for the gap other than lack of universal health insurance:

This longevity gap, Dr. Preston says, is primarily due to the relatively high rates of sickness and death among middle-aged Americans, chiefly from heart disease and cancer. Many of those deaths have been attributed to the health care system, an especially convenient target for those who favor a European alternative.

But there are many more differences between Europe and the United States than just the health care system. Americans are more ethnically diverse. They eat different food. They are fatter. Perhaps most important, they used to be exceptionally heavy smokers. For four decades, until the mid-1980s, per-capita cigarette consumption was higher in the United States (particularly among women) than anywhere else in the developed world. Dr. Preston and other researchers have calculated that if deaths due to smoking were excluded, the United States would rise to the top half of the longevity rankings for developed countries.