Sure there will be lots of hypotheses for why this is the case. In my experience, though, you can almost ignore longevity and just look at these sociological differences that make the quality of life better for the English:
1. You could easily argue that frequenting a pub shortens your lifespan, but I just loved "pub culture" when I visited colleagues in England. It's a great antidote to loneliness.
2. You can argue all you want that the NHS has loads of problems, but even some rich people in the US, when faced with serious medical issues, their first thought is "will this bankrupt me" or "will I get hit with a giant unexpected medical bill"? Our healthcare system in the US is simply indefensible.
3. Cities and towns in England are just much more walkable, "congenial" in general, e.g. row houses instead of separate, fenced off suburban houses with yards in the US.
In the US rich people can get worse healthcare because doctors have incentive
to provide unnecessary operations and medications due to
A) legal liability
B) marketing of treatments and medications to the public means patients demand them. Patients shop doctors until they find one that gives them what they want.
C) money incentive.
For example, US opioid epidemic stems from legal opioid prescriptions.
It seems pretty likely that the US healthcare decisions at the federal level are to blame. This data suggests it isn't the access to healthcare that is to blame as much as the governance of the entire system is forcing bad outcomes. The effect here is too widespread to be "pub culture".
I could see city planning being a contributor. But the effect is so extreme the place to start is deliberate policy. It would be hard for that to be the case without high-level standardisation on terrible ideas. The US does link healthcare and employment so that might be the root cause; it is a stupid link.
Nailed it. The tying of healthcare to one's job is its primary problem in the USA. This idiotic relationship arose because of incompetent legislation during WWII that was never fixed. The government applied wage caps, but failed to anticipate employers' substitution of "benefits" for wages. So companies sweetened the pot with health insurance to work around wage caps, and the government neglected to close that loophole. Huge and disastrous mistake.
Today, millions of Americans are deluded into thinking that their "employer-provided" insurance is free. Because the true cost is buried in pay-stub line items that nobody looks at (if it's even required to be there; I don't know), it's huge.
This "system" serves corporations, not people. Big companies get a workforce replete with people chained to dead-end jobs by their healthcare; insurance companies get fat, fat payouts; and small businesses and individuals get screwed.
My best friend runs a small business in the USA that actually makes things in a factory and employs people. Why the hell should be be an insurance broker as well? And if you're self-employed... Obamacare is the only thing saving your ass. And if your income isn't in the sweet spot, it's not really affordable either.
So we are really screwed hard. You'll never get Republicans to defy their corporate owners and lobbyists to reform this shitshow, nor will you get their base to comprehend that they're being ripped off and demand such reform.
Employer-funded insurance should be taxed out of existence and replaced by employer-provided CHILD CARE. Now that's something that keeps people out of the workforce and actually makes sense for an employer to provide.
Because it requires physical facilities and it benefits from proximity to one's workplace. I don't necessarily think this is appropriate either, but it's the only tiny grain of hope for getting "conservatives" to go along with it. You have to make it an issue of, hey, if you're so desperate to pump out babies, you have to give people a way to do so and still work.
> It seems pretty likely that the US healthcare decisions at the federal level are to blame. This data suggests it isn't the access to healthcare that is to blame as much as the governance of the entire system is forcing bad outcomes.
What is your basis for that? Does it vary by state - I'm pretty sure states that invest less in health get much worse outcomes. And how can people without health insurance somehow get sufficient healthcare?
I've been in communities where many people lack health insurance (and note the bubble HN is in, where those people are seldom here to speak for themselves - for most people, it's like I visited a foreign country). I remember one person, after a car accident with many broken bones, spending 13 hours in an ER, in extreme pain, waiting to be seen. One older parent described to me removing maggots they found on their diabetic adult child's legs.
> I could see city planning being a contributor
Based on what? A dislike of city planning?
Obviously the US does not provide healthcare to its citizens, unlike every other wealthy country. You don't need much creative, insightful thinking to find the problem here. Citizens want it, the Democrats want it, almost every other major political party in the developed world supports it afaik. Like climate change, gun control and safety, and more, only the GOP opposes it; that's the problem.
This is a fundamental misunderstanding of how the political structure of the US works. The individual States are responsible for regulating healthcare, the Federal government has little jurisdiction as a Constitutional matter.
There are many single-party States that nonetheless have broken healthcare systems. You can’t legitimately blame the intransigence of any political party in those States, they control their own outcomes. I live in a single-party State (Democrat) and the systemic incompetence and corruption in healthcare is evident without any Republicans in sight.
Americans have very little contact with Federal law. The legal environment they live in is set by the States, by design. If you don’t like the laws where you live, or the competency with which they are executed, that is on the State.
Ad 2. - freelancers/contractors have the same problem as regular employees in the US, no? E.g. one gets long covid, can't work for 12 months, runs out of money, then loses any medical insurance due to inability to pay anyway?
1. You could easily argue that frequenting a pub shortens your lifespan, but I just loved "pub culture" when I visited colleagues in England. It's a great antidote to loneliness.
2. You can argue all you want that the NHS has loads of problems, but even some rich people in the US, when faced with serious medical issues, their first thought is "will this bankrupt me" or "will I get hit with a giant unexpected medical bill"? Our healthcare system in the US is simply indefensible.
3. Cities and towns in England are just much more walkable, "congenial" in general, e.g. row houses instead of separate, fenced off suburban houses with yards in the US.