Americans sicker but English die quicker says study

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Older Americans suffer more chronic disease than their English counterparts, but the English die earlier, according to a study on Thursday that could revive debate about whose health system is better.

Researchers at the U.S.-based RAND Corp and Britain’s Institute for Fiscal Studies (IFS) found that while Americans aged 55 and older have higher rates of chronic disease, they live longer than elderly people who get ill in England.

“If you get sick at older ages, you will die sooner in England than in the United States,” said James Smith, an economist with RAND in Santa Monica, California, who co-authored the study with James Banks and Alastair Muriel of the IFS.

"It appears that at least in terms of survival at older ages with chronic disease, the medical system in the United States may be better than the system in England.”

But that edge comes at a price.

Organisation for Economic Co-operation and Development (OECD) data show the United States spends more on healthcare than any other nation, and Banks said spending on healthcare for the elderly in the U.S. is almost double that in England.

In 2008, the latest year for which full OECD figures are available, the United States spent 16 percent of its national output or $7,538 per person on health—well over double the $3,000 per person average of all OECD countries.

British politicians leapt to defend the state-funded National Health System when it was attacked during the 2009 U.S. presidential election campaign by Republicans who used criticism of the NHS—which they called a socialist system—to stoke opposition to Barack Obama’s healthcare reforms.

Supporters of Obama’s reforms argue too many people fall through the net and are without medical insurance. Once people in the United States turn 65, however, they become eligible for Medicare, a government-run health insurance program for the elderly that gives nearly 40 million Americans access to high quality medical care.

DIABETES, CANCER, HEART DISEASE

For the study, published in the journal Demography, researchers analyzed data from two surveys of people aged 50 and over—the U.S. Health and Retirement Survey, a nationally representative sample than includes over 20,000 people—and the English Longitudinal Survey of Ageing, which contains data on around 12,000 respondents.

They looked at rates of key chronic diseases—diabetes, High Blood Pressure, heart disease, heart attack, stroke, chronic lung diseases and cancer—and at death rates among those aged 55 to 64 and aged 70 to 80. They also looked at the onset of new illnesses in these groups from 2002 to 2006.

For people in their 70s, diabetes rates were almost twice as high in the United States as in England, at 17.2 percent versus 10.4 percent, and cancer rates were more than double, at 17.9 percent in the U.S. and 7.8 percent in England.

Death rates among those 55 to 64 were similar in the U.S. and Britain, showing that although the Americans had more disease they lived just as long. In the older age group the English death rates were higher, showing that even though these Americans had higher rates of disease, they lived longer.

The researchers said the findings showed that among older people, the U.S. health problem is not in healthcare provision nor in insurance coverage but in excess rates of illness.

“The differences (in disease rates) are striking ... and that’s got to be an important priority for policy in terms of lifestyle or behavioral factors,” Banks told Reuters in London.

In a telephone interview, Smith said that while the U.S. health system does a poor job at preventing disease, it delivers more when people get ill and is better at keeping them alive.

“The criticism has been that the American medical system must be awful, but if you get treated, you actually have a better probability of survival. We are getting something from all of these dollars we put into the medical system.”

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By Kate Kelland and Julie Steenhuysen

LONDON/CHICAGO

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