Thursday, June 16, 2011

The USA's Medical Crisis and Stalled Life Expectancy Increases

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In my view, for millions of Americans the USA's medical system is the equivalent of a car owner who continually defers routine and preventive maintenance until suddenly faced with a catastrophic and hugely expense problem that sets off a financial crisis. Millions of citizens have no access to regular preventive medical care. Their only viable options are visits to non-profit hospitals and/or Medicaid coverage. The result is that problems that could have been detected and either cured or managed go unaddressed until a major illness and grossly expensive procedures are required. Meanwhile, the rest of us are paying for this ass backwards approach through higher medical charges as hospitals pass along their unreimbursed costs for treating the uninsured and taxes that support. Now, with Medicaid funding dropping even as demand is soaring as reported by the New York Times, the problem will only get worse. One side effect is that the increase in the life expectancy for Americans is slowing and in some regions - typically so-called Red States - almost stagnated with the result that some third world nations score better. A new report by the Institute for Health Metrics and Evaluation has the details (see the map above too). First, this from the Times story:
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WASHINGTON — The Obama administration injected billions of dollars into Medicaid, the nation’s low-income health program, as the recession deepened two years ago. The money runs out at the end of this month, and benefits are being cut for millions of people, even though unemployment has increased.
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From New Jersey to California, state officials are bracing for the end to more than $90 billion in federal largess specifically designated for Medicaid. To hold down costs, states are cutting Medicaid payments to doctors and hospitals, limiting benefits for Medicaid recipients, reducing the scope of covered services, requiring beneficiaries to pay larger co-payments and expanding the use of managed care.
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As a result, costs can be expected to rise in other parts of the health care system. Cuts in Medicaid payments to doctors, for example, make it less likely that they will accept Medicaid patients and more likely that people will turn to hospital emergency rooms for care. Hospitals and other health care providers often try to make up for the loss of Medicaid revenue by increasing charges to other patients, including those with private insurance, experts say.
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“Medicaid is very much on the chopping block,” said Senator John D. Rockefeller IV, Democrat of West Virginia and chairman of the Senate Finance Subcommittee on Health Care. “Seniors vote. But if you are poor and disabled, you might not vote, and if you are a child, you do not vote — that’s a lot of Medicaid’s population. They don’t have money to do lobbying.”
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Yet despite this nightmare reality, members of the GOP oppose "Obamacare" and make the claim that the USA has the best healthcare system in the world. Talk about denying objective reality. As for the life expectacy issue, here are these highlights from the new report:
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June 15, 2011 - While people in Japan, Canada, and other nations are enjoying significant gains in life expectancy every year, most counties within the United States are falling behind, according to a new study by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
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When compared to the international frontier for life expectancy, US counties range from being 16 calendar years ahead to more than 50 behind for women. For men, the range is from 15 calendar years ahead to more than 50 calendar years behind. This means that some counties have a life expectancy today that nations with the best health outcomes had in 1957.
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The researchers suggest that the relatively low life expectancies in the US cannot be explained by the size of the nation, racial diversity, or economics. Instead, the authors point to high rates of obesity, tobacco use, and other preventable risk factors for an early death as the leading drivers of the gap between the US and other nations.
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Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind nations such as Honduras, El Salvador, and Peru. Four of those counties, along with Humphreys County, MS, have the lowest life expectancies for men, all below 67 years, meaning they are behind Brazil, Latvia, and the Philippines.

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