Dr. Andy

Reflections on medicine and biology among other things

Saturday, January 23, 2010

US Death Rates

From the same article in the previous post about US demographics in 2007:

Age adjusted death rates (death per 1000) over time

1915 21.7
1950 14.5
1980 10.4
1990 9.4
2000 8.7
2006 7.8
2007 7.6

So age-adjusted mortality has improved by

13% since 2000
19% since 1990
27% since 1980
47% since 1950
69% since 1915

I think those first 3 numbers are eye opening. Some combination of healthier living (e.g. less smoking) and better health care are really making a difference. Perhaps we are getting a better deal for the 1/7 or whatever it is of GDP we are spending on it.

US demographics

The January edition of Pediatrics summarizes much interesting information about US demographics in 2007:

Births: 4.3 million
Deaths: 2.4 million

with a life expectancy at birth of 77.9 years.

The birth rate (per woman 15-44) is actually rising currently at 66.9 births/1000 and this is above the population replacement rate, meaning we don't seem to be facing the demographic time bomb to the same extent as Japan and much of Western Europe. I figure these kids will start paying social security taxes about when I retire.

An old post details how badly Allergy fellowship applicants fare when asked to estimate the number of births in the US each year.

Wednesday, January 20, 2010

Healthcare reform

From David Leonhardt in the NY Times an argument that the current bills on healthcare reform under consideration in the Congress are middle of the road. Really? With no malpractice/tort reform? This is like a church where believing in God is optional.
The one big conservative idea that’s largely missing is malpractice reform. But the White House said several times that it was willing to negotiate on this issue. And think about it: Rahm Emanuel, the Obama chief of staff, likes to say the only thing that’s not negotiable is success. Don’t you think Mr. Obama would have gladly taken some heat from trial lawyers in exchange for passing health reform with bipartisan support and making himself look like a transformational leader?
Maybe now would be a good time to do more than says they'd be willing to negotiate. Maybe Obama should get out there and affirmativiely offer to put in malpractice reform in exchange for Republican support. He is President after all. And I am willing to apportion blame for HCR's likely failure to Republicans if they weren't/aren't willing to support HCR for political reasons even if Dems and Obama would compromise on malpractice reform.

And what about low-cost, high deductible plans that primarily provide catastrophic coverage? Those are not only not part of the current reform plan, but outlawed by it.

I'll be sorry to see HCR die (we do really need it) but I don't think you can excude the 2 biggest "conservative" ideas about how to do it.