What is the root cause of America’s healthcare disadvantage?

The US Centers for Disease Control and Prevention (CDC) recently updated its estimates of how the COVID-19 pandemic affected life expectancy in the United States, and the news is not good.

We were already aware that 2020, the first year of the pandemic, was catastrophic in the United States, causing more deaths than in any other country. The decline in U.S. life expectancy in 2020 was the largest the nation has experienced since World War II. The CDC now reports that U.S. life expectancy declined further in 2021. Taken together, the two years produced a 2.7-year decrease in life expectancy, the largest decline in a century.

The decrease in U.S. life expectancy in 2021 was avoidable. We know this because no other high-income country experienced such losses. In fact, many countries saw their life expectancy increase. Throughout the COVID-19 pandemic, Americans have died at much higher rates than people in other rich countries. According to one study of the United States and 19 peer countries, U.S. life expectancy decreased by 1.9 years in 2020, compared to an average loss of 0.6 years in the other countries.

In 2021, when COVID-19 vaccines became available, most countries recovered their losses, and life expectancy increased an average of 0.3 years, but U.S. life expectancy continued to plummet.

The poor performance of the United States in 2021 could have multiple explanations. Some countries performed better in distributing and administering COVID-19 vaccines and in maintaining pandemic control measures, such as wearing masks. Their populations were often more compliant, whereas many Americans resisted such measures. Many governors overtly blocked pandemic control measures.

Americans lack universal access to the health care system, which was overwhelmed by surges, affecting not only the treatment of COVID-19 but also other medical problems. According to the CDC, only 74 percent of the decline in U.S. life expectancy in 2020 was due to COVID-19. Deaths from chronic illnesses, like heart disease and diabetes, also increased during the pandemic. Drug overdose deaths broke records.

It’s tempting to view this calamity as a one-time anomaly and to assume, now that the pandemic seems to be waning, that U.S. health outcomes will return to normal. Eventually, U.S. life expectancy will return to pre-pandemic levels, but returning to “normal” leaves the United States in a precarious place.

The tragedy of Americans dying at higher rates than people in peer countries is hardly a new phenomenon. It began decades ago. Although life expectancy has been increasing over the past century, the increase began to slow in the United States in the 1980s. U.S. life expectancy fell below the average for high-income countries in the 1990s, plateaued in 2010 and then began to decline — while it continued to climb in other countries.

According to one study, the gap in the life expectancy between the United States and 16 peer countries grew from 1.9 years in 2010 to 3.1 years in 2018. The U.S. death toll during the COVID-19 pandemic further widened the gap. According to another study, by 2021 the gap between the U.S. and 19 peer countries had widened to 5.3 years.

Source: The Hill

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