U.S. life expectancy: We're No. 36!

One would guess that if people in the U.S. were asked how U.S. life expectancy, and by inference the quality of health care, compares with the rest of the world, most might expect that we're somewhere among the best, probably in the top 10. The actual life expectancy in the U.S. ranks 36th in the U.N. data by country, and in the CIA data, which includes smaller areas like Monaco and Andorra, we're 49th. Interestingly, at 36th among countries we're tied with Cuba. Not many people would guess that we're on a par with Cuba in this way, a country with pervasive poverty and an ineffective communist system.

It's interesting that even two countries that have socialized medicine and notoriously limited access to health care, Canada and the U.K., do better than we do on life expectancy, at 11th and 20th.

The first reaction would then be that there must be parts of our population that don't have sufficient access to health care, for economic reasons. But Americans of Hispanic descent, a large segment of the population who as a group have lower average income and education, and more limited access to health care, have a two year longer life expectancy than non-Hispanic whites.

The next speculation might be bad lifestyle choices, by far the most devastating to life expectancy being smoking. The U.S., however, is not near the top in cigarette consumption. A number of countries with much more smoking have better life expectancy than the U.S., including Japan, which is first in life expectancy, and also Greece, Spain, Switzerland, Italy and Belgium.

The answer is that such things as access to health care are not the cause of our striking deficiency, but it's the nature of the care that's being provided. Our system is dominated by the pharmaceutical companies, who have very great influence on medical associations, medical schools, medical journals, Congress, the FDA, doctors and finally consumers, with direct advertising of prescription drugs on television, radio and in print, which is illegal in other countries. Through financial arrangements with the pharmacies and medical associations, drug companies have access to the records for the prescriptions written by individual doctors, so that their sales reps can discuss with doctors their choices for pharmaceutical products.

TRENDING: Public school has failed American kids: Student with 0.13 GPA ranks near top half of class

If the drug companies were altruistic, then their powerful influence wouldn't be a problem, but their overriding objective is naturally profit, and that often is unfortunately in conflict with making us healthy and enhancing our life expectancy.

There are myriad examples, but two classes of drugs that are way over-prescribed, have little or no benefit in the majority of cases and have horrible side effects are statin drugs and anti-depressants. For treatment of existing or potential cardiovascular disease, a large meta-analysis of numerous trials of statin drugs and of fish oil showed that those treated with fish oil had better outcomes than those treated with statins, but the billion-dollar statin products remain the standard and very aggressively promoted treatment.

There have been successful felony prosecutions of some of the major pharmaceutical companies, for example, for off label marketing, which is marketing drugs for purposes other than those for which they were approved. The resulting fines have not deterred the drug companies; it's simply one of their costs of doing a very profitable business.

It's not, of course, that all prescription drugs are inherently bad, but that many are way over-promoted and used and the side effects downplayed. This excessive use does much more harm than good, particularly considering the simultaneous combination of numerous drugs that are often prescribed.

The attempted fixes for the health-care system in Obamacare involve limitations for patient care, on payments to doctors and restrictions on insurance companies – but they generally ignore the big problem, which is the enormous influence the drug companies have on the practice of medicine. Unless that is confronted and remedied, through serious limitations on the lobbying and marketing practices of drug companies, the U.S. population will continue to suffer the serious consequences of a system dominated by their commercial priorities, and our bottom line, our life expectancy, will continue to lag other countries.

Michael Plesset has had a long career in management in high tech and in nonprofit organizations.