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What’s behind improvements in U.S. life expectancy?

By Sally Pipes - Guest Columnist | Nov 17, 2020

Pharmaceuticals have added about a year to U.S. life expectancy since 1990, according to new research published in Health Affairs by scholars from Harvard and the University of Michigan.

Yet Americans don’t live as long as their counterparts in Canada and the United Kingdom. British life expectancy is over 81 years; for Canadians, it’s 82 years. U.S. life expectancy is just 78.6 years.

Fans of Medicare for All believe that’s proof of the superiority of socialized medicine. Dig a little deeper, though, and it’s clear that life expectancy is an imperfect measure of the quality of a nation’s healthcare system.

In fact, by rationing cutting-edge pharmaceuticals — or not providing them in the first place — socialized medicine could actually be depriving Canadians and Britons of extra years of life.

The Health Affairs study found that U.S. life expectancy increased 3.3 years between 1990 and 2015. Pharmaceuticals were responsible for 35 percent of that gain.

This is only the latest study to confirm that we have medical innovation to thank for our steadily increasing lifespans. According to research from Columbia University professor Frank Lichtenberg, average life expectancy across 52 countries increased by almost two years between 1986 and 2000. New pharmaceuticals were responsible for 40 percent of that increase.

In the United States, cancer mortality has declined 29 percent since 1991. Lichtenberg attributes most of that decrease to new drugs.

Britain and Canada have not fared as well against cancer. In the United Kingdom, cancer mortality has gone down only 17 percent since the 1970s. The United States posts better five-year survival rates for breast, colon, prostate, and lung cancers than either Great Britain or Canada.

It’s no coincidence that American cancer patients have access to more cutting-edge drugs than their peers elsewhere. Seventy-four new oncology drugs were launched worldwide between 2011 and 2018. Americans had access to 70 of them. Britons could get 55 of them; Canadians, just 43.

The story is much the same for drugs that treat other diseases. American patients had access to 88 percent of the 243 new medicines launched between 2011 and 2018. Residents of the U.K. had access to less than two-thirds, and Canadians, less than half.

If cutting-edge pharmaceuticals extend life, and Americans have access to more of them than their British and Canadian peers, then why do Americans die sooner?

Factors that have nothing to do with health care explain a lot. For example, the United States unfortunately has a much higher murder rate — more than quadruple Great Britain’s and more than triple Canada’s, according to data from the World Health Organization.

Drug overdoses are also more common in the United States. Then there are traffic accidents, which are sadly more common in the United States.

America’s comparatively high murder, drug overdose, and car-crash rates are serious problems. But they don’t tell us much about the quality of the American health care system.

Thanks to the widespread availability of innovative pharmaceuticals, there’s likely no better place to get sick than the United States. If America were to follow the example of Canada and Great Britain, and embrace government-run care, that would no longer be the case.

Sally Pipes is president, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. This piece originally ran in The Forum.

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