Healthcare and life expectancy

Whenever somebody says something asinine like, "Shouldn't we do whatever we can to save even one child's life?" I think (and sometimes say), "If we had any interest in saving lives we would lower the speed limit." The point isn't that we should drive slower. The point is that there are always trade-offs, especially with "do everything" solutions.

For example, doing everything on terrorism has killed way, way, way more  innocent Americans than it has saved. Adding an hour to every flight (to get thru security) means that driving a car became faster than flying for millions of trips a year. Being in a large commercial plane is pretty much the safest place on earth (far safer than your bathroom), while being in a car is one of the deadliest places to be. More driving equals more death. Full stop.

And while they don't kill people, Amber Alerts, bike helmets, and car seat laws all cause serious problems (wasted police effort [$], more driving [CO2], and more mommie shaming [just bad]).

One of the myths that keeps doctors overpaid is the notion that our long life expectancies are down to "modern medicine." Matt Yglesias puts it well: "Lots of things kill people other than lack of health care services. Conversely, health care services do lots of useful things beyond saving lives."

Nutrition, industrial safety regulation, less industrial employment, mass understanding of the germ theory of infection, educated girls, and safer cars are all part of our long life spans. Add in antibiotics (which hardly take an MD to administer) and what remains for "modern medicine"? Maybe a year or two of our extra long lives are down to medicine.

And think about what kinds of years medicine gives us: remission from cancer, which inevitably returns.

Actually, statins should go in with antibiotics. They add a lot of good years. And advances in trauma care. But those are cheap. Statins are going off patent and ER docs are among the worst paid.

The bulk of medicine, and the overwhelming bulk of our money, gets spent not saving lives but making them better. Life saving is cheap: antibiotics, statins, and ER docs. "Medicine" really is dermatology, artificial knees, and psychiatry. And those docs are rich.

More importantly, by virtue of being American, we all deserve a little help with mental health and acne.

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