Pharmaceutical Costs and Comparing Life Expectancy

https://www.city-journal.org/price-controls-on-pharmaceuticals

American teenagers and young adults are also more likely to die for reasons unrelated to medical care. About half of the overall longevity gap between the U.S. and other developed countries stems from its higher mortality rate below age 50, which is partly due to infant mortality but mainly to the much higher rates of homicides, fatal motor-vehicle accidents (Americans drive much more than Europeans do), and other injuries—notably, drug overdoses. In middle age and beyond, one of the chief causes of the longevity gap is the U.S. rate of obesity, which is nine times higher than Japan’s and about double the rate of Europe. When a National Academy of Sciences panel in 2011 analyzed the longevity of Americans above age 50, it concluded that obesity accounts for 20 percent to 35 percent, and possibly more than half, of the gap with other affluent countries.

An even bigger factor is smoking, which was much more common through the 1980s among Americans, especially women. Samuel Preston, a demographer at the University of Pennsylvania who was one of the editors of the National Academy report, estimated that smoking accounted for 41 percent of the life-expectancy gap among men and 78 percent of the gap among women. He found that if deaths due to smoking were excluded, the United States would rise to the top half of the longevity rankings among developed countries.

Considering all these disproportionate killers in the United States—smoking, obesity, fatal injuries, and the rest—why isn’t the life-expectancy gap even larger? Because Americans receive better treatment, particularly for cardiovascular disease and cancer, the two leading causes of death after 45. While heart disease is more prevalent in the United States than in other developed countries (no surprise, considering all the overweight Americans with a history of smoking), people with high cholesterol and hypertension are more likely to receive treatment for their condition in the U.S. than in other countries.