Do countries with better medical systems have higher Covid-19 death rates?

Asked for his theory on why death rates from Covid-19 varied so much from country to country, a Dutch friend said that he thought that countries that had “better” health care systems, in the sense that they were able to keep more “zombies” alive, would end up with a higher death rate. “Nigeria doesn’t have a lot of 90-year-olds on permanent life support,” he pointed out, “so coronavirus is going to have a tougher time killing people there.”

2 thoughts on “Do countries with better medical systems have higher Covid-19 death rates?

  1. That explanation makes little sense:
    1. Despite much younger demographics, Nigeria has more +85 yo citizens (>700k) than the Netherlands (<400k). Maybe they’re all super 90 yos instead of zombie ones.
    2. Japan has an equally good health system, ageing and more numerous population: they have 5.6m people aged +85. Yet, there have been 749 deaths in Japan and 5680 deaths in the Netherlands.
    3. According to [1] 1/4 of the deaths are below 65 yo and another 1/4 are 65-75.
    4. Ecuador has 1.7x the population of Portugal (an ageing demographics and good healthcare, yet 2.2x the number of deaths.

    So no, 90 year old zombies aren’t a credible explanation.


  2. I saw the following passage skimming through Medical School 2020:

    > Our next consult is a 45-year-old diabetic man suffering a perianal abscess. Weighing in at 450 lbs., he has not walked in several years, bed-bound in a nursing home. We roll him down to the OR in a special heavy-duty patient transporter. It takes the entire OR team with the special bean bag mover to get him onto the OR table. It takes about 30 minutes for us to get his legs in the lithotomy position to fully expose the anus. The attending exclaims: “Any other county this patient would be dead. Go USA!”

    This is a very American point of view. One of my friends was going on about how compassionate the US is for spending ~18% of GDP on ventilating COVID patients who are near death. But really I don’t see how this can be as compassionate as e.g. Vietnam or Mongolia taking swift action to prevent a single resident of their countries dying from coronavirus. Likewise, I would question how many other countries would allow a man under supervision in a nursing home to reach the weight of and/or stay at 450 pounds for several years. Someone has to be feeding you for that to happen. Really it seems like someone at the nursing home should be facing felony charges for this.

    Similarly, I think any notion that the American healthcare system is one of the best in the world should have been completely shattered watching our experience with coronavirus. We already knew that we spend more than any other country but get worse results than a lot of them, but it’s rare to be able to directly observe it as clear as we can now. Specifically, the US underspends on public health and oversubsidizes junk food (e.g. through subsidies to grow corn and insufficient controls on food stamps), and then spends enormous amounts of money cleaning up the results. 10% of food stamp dollars go towards sugary beverages [1] and then the government spends ~$160 billion a year [2] treating the 10% of the population that’s diabetic.

    [2] (“$237 billion in direct medical costs” times the reported 67.3% paid for by the government)

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