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Glenza writes: "You can't buy time - except, it seems, in America. Increasing inequality means wealthy Americans can now expect to live up to 15 years longer than their poor counterparts, reports in the British medical journal the Lancet have found."

Wealthy Americans can expect to live 15 years longer than poor peers, studies in the Lancet find. (photo: Ariel Skelley/Getty Images/Blend Images)
Wealthy Americans can expect to live 15 years longer than poor peers, studies in the Lancet find. (photo: Ariel Skelley/Getty Images/Blend Images)


Rich Americans Live Up to 15 Years Longer Than Poor Peers, Studies Find

By Jessica Glenza, Guardian UK

12 April 17

 

Health insurance system – the most expensive in the world – is worsening situation, researchers find, arguing healthcare should be treated as human right

ou can’t buy time – except, it seems, in America.

Increasing inequality means wealthy Americans can now expect to live up to 15 years longer than their poor counterparts, reports in the British medical journal the Lancet have found.

Researchers said these disparities appear to be worsened by the American health system itself, which relies on for-profit insurance companies, and is the most expensive in the world.

Their conclusion? Treat healthcare as a human right.

“Healthcare is not a commodity,” wrote US Senator Bernie Sanders in an opinion article introducing the issue of the journal, which is devoted to inequality in American healthcare. “The goal of a healthcare system should be to keep people well, not to make stockholders rich. The USA has the most expensive, bureaucratic, wasteful, and ineffective healthcare system in the world.”

Sanders, like authors of the lead report, called for single-payer health insurance or what Americans might know as “Medicare for all”, a reference to an existing public health program for older Americans.

“Making sure that every citizen has the right to childcare, healthcare, a college education, and secure retirement is not a radical idea. It is as American as apple pie,” he said.

The Lancet studies looked at how the American health system affects inequality and structural racism, and how mass incarceration and the Affordable Care Act (ACA), also known as Obamacare, have changed public health.

Among the studies’ key findings: the richest 1% live up to 15 years longer than the poorest 1%; the same gap in life expectancy widened in recent decades, making poverty a powerful indicator for death; more than one-third of low-income Americans avoid medical care because of costs (compared to 7% in Canada and 1% in the UK); the poorest fifth of Americans pay twice as much for healthcare as a share of income (6% for the poor, versus 3.2% for the rich); and life expectancy would have grown 51.1% more from 1983 to 2005 had mass incarceration not accelerated in the mid-1980s.

The poorest Americans have suffered in particular, with life expectancies falling in some groups even while medicine has advanced. For example, researchers reported that the poorest fifth of women born between 1930 and 1960 statistically lived four years less than Americans in the top fifth of the socioeconomic spectrum.

All of these health outcomes arrive in the context of widening general inequality. The share of total income going to the top 1% of earners has more than doubled since 1970, making the US more unequal than all but three developed countries: Chile, Mexico and Turkey.

At the same time, the ACA brought relief to many. The number of Americans without insurance dropped from 48.6 million in 2010 to 28.6 million in 2015. The number of Americans who struggle with medical bills dropped from 41% to 35% in 2014.

Further, accounting for current public health insurance programs, military healthcare, the portion of local and state budgets used to purchase private health insurance for workers, and subsidies to employers to buy workers health insurance, researchers believe as much as 65% of health insurance nationally is already paid for by taxpayers.

The conclusions come at a tumultuous time for American healthcare.

Donald Trump’s election threw his predecessor’s market-based health laws into question. Trump promised multiple times on the campaign trail to repeal the ACA and replace it with “something terrific”.

Though Barack Obama’s signature health law insured more Americans than ever before, problems remain.

Insurance companies have increasingly passed costs on to consumers through “cost-sharing”, or asking Americans to pay more for doctor’s visits, prescription drugs and procedures before insurance kicks in. Sky-high prescription drug prices have prompted public outrage. And a requirement that Americans purchase insurance, even with government subsidies, was politically toxic.

Though Republicans promised for more than seven years to repeal the ACA – if they could only gain control of the federal government – once Trump took office, they offered a plan not conservative enough for conservatives, and not moderate enough for moderates. With an abysmal public approval rating of just 17%, the plan combusted weeks after it was introduced. Failure to pass the bill became a major loss for the Trump administration.

That has left a vacuum of ideas. Republicans tried and failed to resurrect a version of the hated plan this week. Progressives have expressed hope that single-payer reform could move into the forefront.

“I, like many others, was deeply concerned with Republican proposals that went down in flames,” said Dr David Himmelstein, a New York City doctor and co-founder of Physicians for a National Health Program, a group that lobbies for single-payer health reform. Himmelstein was also the author of one Lancet report, America: Equity and Equality in Health.

“It would have been tremendously damaging to large numbers of people in our country. So the defeat of that proposal was encouraging,” he said.

“It’s opened up much more room for debate about what there should be, so in that way, I think it’s an encouraging time that has perils but also opportunities.”

However, single-payer healthcare remains unpopular with American conservatives, who still control the government.

Robert Moffit, a researcher at the conservative thinktank the Heritage Foundation, argued that Americans would use healthcare willy-nilly if it were provided by the government.

“I mean look – you can save money with a single-payer system, don’t misunderstand me, but the quality and supply of medical services is going to be determined by government officials,” he said.

“You’re going to have inequalities in any state,” he said, calling it it “naive” to believe a “government-run system that is going to ultimately be highly politicized” would be better than a private one.

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+5 # reiverpacific 2017-04-12 10:26
“You’re going to have inequalities in any state,” he said, calling it it “naive” to believe a “government-run system that is going to ultimately be highly politicized” would be better than a private one.
Damn right it would be "highly politicized" in the US; the forces of increasingly far-right rethuglicans would block any progress with "All means" at their disposal for their frieda in big medicine, pharma and insurance (with shouldn't even BE in the equation).
Admin' costs in the UK and Canada are around 7%, whereas in the private set or run US, they are between 30% and 40%, a large part of which is dedicated to scrutinize insurance claims and discover grounds for denial of coverage.
This is the only country I've lived in where one can be bankrupted for becoming seriously ill, as in "Pay up or die!" -And I speak from bitter experience, being rushed to the ER with a bleeding stomach ulcer and nearly croaking.
Before that, I had two incidences that require non-emergency surgery, for which I flew to Scotland and had them done free.
Just for the record, to put things in some perspective, the round-trip airfare from the west coast to the UK was 1/3 less that the cost of the 26-mile ambulance run to the hospital.
And these pricks have the gaul to call themselves "Christians!"
 
 
+4 # economagic 2017-04-12 12:00
This article has many problems. I have seen the figure of 65% for the fraction of US health care costs currently paid by governments at various levels out of tax revenue. But (to cite one serious example) the share of income going to the highest-earning one percent is not a standard measure of income inequality. Furthermore, Chile, Mexico, and Turkey all fall in a different category from the US in terms of their level of "development" (industrializat ion), which is strongly correlated with overall income.

It is another non-standard statistic, but among the "less developed countries" there are a good many with greater income inequality than the United States. When adjusted for cost of living and exchange rates, the US comes out with significantly higher income inequality by all standard measures than any other of the 20-25 countries generally recognized as "highly developed."

And quoting the Heritage Foundation on any political or economic topic is quoting the fox on threats to chickens.
 
 
0 # Wise woman 2017-04-12 14:59
Yup, Reiver, that's what they call themselves. I wonder what they would call themselves if someone they knew or loved was driven into bankruptcy due to American medicine - mediocre as it is. A "neo liberal Christian when it's convenient to slip into that role? A practicing Christ like Christian really doesn't appeal to most of them.
 
 
0 # newell 2017-04-12 15:56
So, you can take it with you----for 15 years anyway. But keeping up with all those tables and medical charts is such a bother. To even things up, can't we just get the guillotines out of storage?
 

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