Trump Hands Democrats a Gift with Effort to Kill Obamacare

I often make the statement that Trump and the Republican Party want to create a new Gilded Age where the wealth of the richest Americans soared to obscene levels - thinks of the Rockefellers, Goulds, Vanderbilts, etc. - while the majority of Americans struggled to survive.  One study found as follows as to what happened to life expectancy during the rise of the Gilded Age:

"an average white ten-year-old American boy in 1880, born at the beginning of the Gilded Age and living through it, could expect to die at age forty-eight. His height would be 5 feet, 5 inches. He would be shorter and have a briefer life than his Revolutionary forebears.” “Infant mortality worsened in many cities after 1880.”

Part of the problem of the Gilded Age was a lack of safety and environmental regulations - things that were eventually remedied.  Yet now, Trump and the GOP are steadily rolling back such regulations so that big business can reap larger profits. Now, Trump has declared war on the Affordable Health Care Act and seeks to deprive millions of access to healthcare.  Even before this latest action, as a Washington Post story reported, the USA was going backwards in terms of diminished life expectancy and infant mortality.  Here are excerpts:

The Centers for Disease Control and Prevention, for example, reported in November [2018] that life expectancy for the average American ticked downward for the third year in a row. The news attracted a storm of attention . . . . Other trends, however, passed by more quietly. In health care, for example, maternal deaths inched up slightly this year to 20.7 per 100,000 live births, according to data from the United Health Foundation. In fact, giving birth in the United States has become increasingly deadly over the past few decades, placing our country in the same category as developing nations such as Afghanistan and Swaziland. And the rates are even worse for mothers of color.

The latest CDC data released this year shows that U.S. infant mortality rates, after steadily falling over the past few decades, haven’t decreased significantly for five years. Today it stands at 5.9 deaths per 1,000 births, far higher than the average rate of 3.9 deaths for developed countries. Again, it’s even worse for infants of color.

Given these statistics, increasing access to health care would be the moral thing to do.  Sadly, to Trump and Republicans (and evangelical Christians), most of us simply do not matter.  Indeed, it appears that they'd prefer that Americans - especially minorities and the poor - simply die while the rich rake in an ever larger share of the nation's wealth. How else to explain the Trump administration's latest effort to destroy health care access for millions.  A piece in Politico looks at this disgusting development and the Democrat response to such immorality.  Here are highlights:

House and Senate Democrats on Tuesday seized on the Justice Department’s endorsement of a federal court ruling to eliminate Obamacare in its entirety, immediately renewing attacks on the GOP for trying to gut the law’s popular protections and rip health coverage from more than 20 million Americans.

The administration’s surprise decision — a shift from its prior stance that only parts of the Affordable Care Act should be thrown out — offered a unifying moment for Democrats still grappling with the news that Mueller would not charge President Donald Trump with any crimes and comes as the party readies a fresh legislative offensive on health care.

“It’s disgusting. It’s horrible,” said Rep. Ben Ray Luján of New Mexico, the No. 4 House Democrat. “It’s what they were trying to do during the repeal of the Affordable Care Act, it’s what Republicans were doing when they filed the lawsuit. The president’s been clear about his position the whole time.”

And even as Democrats decried the move, they also saw it as a political gold mine.

[L]awmakers were privately ecstatic about the Trump administration’s decision to essentially to trample all over its own good news cycle and turn the attention back to an issue that Democrats used to win back the House.

“It’s really outrageous. I don’t understand if Republicans weren’t present for the last election, but if there was an issue that was deeply critical, it was health care,” Rep. Pramila Jayapal (D-Wash.), co-chair of the Congressional Progressive Caucus, said after the meeting. . . . It’s “not only immoral, it’s a really bad political decision for them,” she added.

“We’re going to introduce a bill to protect and strengthen the ACA. That’s the responsible thing to do,” said Rep. Donna Shalala (D-Fla.). “They’re being irresponsible, and they’re putting 20 million people in this country at risk.”

Indeed, House Democrats had planned a pivot to health care even before the Trump administration late Monday announced its support for a federal judge’s December ruling that the entire ACA should be invalidated because Congress eliminated its individual mandate penalty in the GOP tax law.

Democrats are rolling out a wide-ranging Obamacare package aimed at shoring up the law’s benefits while reversing several of the Trump administration main health priorities — a bid to follow through on the campaign-trail vows that helped propel them into the House majority.

The package is largely a rehash of policies that Democrats pitched last year, like expanding the Obamacare subsidies meant to help Americans afford health coverage and restoring outreach funding that Trump slashed over the past two years. It would also rescind regulations expanding cheaper, skimpier health plans that the administration has touted for providing greater choice, but Democrats have derided as “junk” insurance.

Their plan gained new significance in the wake of the Trump administration’s legal action, providing vulnerable Democrats with concrete legislation to hype for their swing-district voters and a powerful tool to use against Republicans who refuse to endorse any Obamacare-related measures even as they insist they want to protect patients with pre-existing conditions.

For Republicans, meanwhile, the Justice Department’s move threatens to put them back on the defensive just days after what was arguably their biggest victory of the Trump era.

[M]ost Republicans have so far remained fairly quiet in the aftermath of the DOJ filing in a case that few view as politically advantageous — even as Trump appeared to celebrate the decision. . . . GOP lawmakers who did have an initial reaction expressed exasperation at the disconnect between the Trump administration and the Hill on health care.

[T]he issue is a new headache given the new Senate map: Democrats have gone from defending 10 states that Trump won in 2018 to launching campaigns against incumbents in places like Colorado, Iowa, North Carolina and Maine. Sen. Susan Collins (R-Maine) has been particularly outspoken in opposition to the administration’s support of the lawsuit.

[N]either the Trump administration nor Republicans in Congress have any ready replacement for Obamacare if it is ultimately wiped out. . . . with a serious battle for Senate control developing in purple and blue states, Democrats say they have the political upper hand on an issue their House counterparts used to devastating effect in 2018.

This move by the Trump administration to take away health care will prove far more detrimental to the administration and the Republican Party than any gains they might have made by the [findings] of Mr. Barr’s letter,” said Senate Minority Leader Chuck Schumer (D-N.Y.).

Even Doug Jones of Alabama, by far the most endangered Senate Democrat next year, was singing the same tune as party leaders. “I’m outraged. It’s going to hurt my state really bad if that were to go forward,” Jones said in an interview. “They couldn’t do in this chamber what they wanted to do, which is completely dismantle and disintegrate it. So they’re trying to blow it up in any way possible.”

Being a Republican and being a decent and moral person are becoming increasingly mutually exclusive.

Life Expectancy is Increasing Except in the U.S.

America has the most expensive and least efficient healthcare system of any advanced nation.  On average Americans - at least those who can pay - pay two to three times more for heathcare notwithstanding Republican lies that the free market will lower costs.  History has shown, the opposite has been the case.  Now, even with Obamacare helping millions, the results are showing: life expectancy is increasing everywhere except in America.  The policies so extolled by the GOP simply aren't working.  The irony, of course, is that in many cases those most harmed by the GOP agenda voted Republican thanks to calls to racism and religious extremism.  A piece in the Washington Post looks at this sad picture.  Here are highlights:

 Here's a rare bit of good news: People are living longer than ever.

According to a new Lancet study, life expectancy will jump across much of the industrialized world in the next two decades. By 2030, women in South Korea can, ahem, expect to live to 90, up from 84 in 2010. Women in France, Japan and Spain on average will hit at least 88 or 89 years, up from around 85. Men in South Korea, Australia and Switzerland will also see big gains, living to about 84 by 2030. Fellows from Canada, Spain, New Zealand and the Netherlands will also make gains.

But one country is stuck treading water: the United States. According to experts who studied 35 countries, Americans will see only a small boost. In 2010, average life expectancy for men here was 76. By 2030, they can expect to live just three more years. For women, life expectancy will jump just two years, from 81 in 2010 to 83 in 2030.

Researchers said our low performance is notable because “life expectancy at birth is already lower than most other high-income countries, and is projected to fall further behind such that its 2030 life expectancy at birth might be similar to the Czech Republic for men, and Croatia and Mexico for women.” It's worth noting, too, that the researchers only looked at data until 2013 — so they missed the unprecedented decline in life expectancy that hit two years later.

Experts attribute the lag to economic inequality, particularly when it comes to health care. The United States is one of the only industrialized nations without universal health care. “This means that some groups are getting left behind, and it’s pulling the average down,” James Bennett, a researcher in the department of epidemiology and biostatistics at Imperial College London, told Vox. Americans also suffer higher rates of death from alcohol, drug use and mental disorders. We also have high rates of obesity, homicide and infant mortality, which drags down our average.

Other countries with high projected life expectancy include Australia, Canada and New Zealand. Researchers credit their high-quality health care, along with low smoking and traffic accidents. France and Switzerland did well because they had some of the lowest rates of obesity.

Yes, America is exceptional alright, but not in a good way!

The Death of the American Dream - It’s Now the Canadian Dream

With three children of my own, I like so many do not believe that my children will have the opportunities that I had for to achieve the so-called American Dream, much less the opportunities that my parents had.  Why?  Because, in my view, America is headed in the wrong direction economically and to some extent socially.  Once upon a time, there was more of a sense of "we're all in this together" and that when the country built infrastructure, we all benefited.  Now, if the GOP had its way, America would be a completely cruel Ayn Rand world  where everyone simply fought to keep what was theirs and there would be no concept at all of the common good.  Add in globalization of the economy and the USA is headed for a situation like Great Britain found itself in following WWII.  Ironically, the far right blames "socialism" for America's predicament, yet Canada, our neighbor to the north is far more socialistic and it is now the nation that has taken over the dream that was once America's.  Even "Old Europe" now has more social upward mobility.  A column in the New York Times looks at America's decline, much of which has been self-induced.  Here are excerpts:

It was in 1931 that the historian James Truslow Adams coined the phrase “the American dream.”

The American dream is not just a yearning for affluence, Adams said, but also for the chance to overcome barriers and social class, to become the best that we can be. Adams acknowledged that the United States didn’t fully live up to that ideal, but he argued that America came closer than anywhere else.

Adams was right at the time, and for decades. When my father, an eastern European refugee, reached France after World War II, he was determined to continue to the United States because it was less class bound, more meritocratic and offered more opportunity.

Yet today the American dream has derailed, partly because of growing inequality. Or maybe the American dream has just swapped citizenship, for now it is more likely to be found in Canada or Europe — and a central issue in this year’s political campaigns should be how to repatriate it.

A report last month in The Times by David Leonhardt and Kevin Quealy noted that the American middle class is no longer the richest in the world, with Canada apparently pulling ahead in median after-tax income. Other countries in Europe are poised to overtake us as well.

In fact, the discrepancy is arguably even greater. Canadians receive essentially free health care, while Americans pay for part of their health care costs with after-tax dollars. Meanwhile, the American worker toils, on average, 4.6 percent more hours than a Canadian worker, 21 percent more hours than a French worker and an astonishing 28 percent more hours than a German worker, according to data from the Organization for Economic Cooperation and Development.

Canadians and Europeans also live longer, on average, than Americans do. Their children are less likely to die than ours. American women are twice as likely to die as a result of pregnancy or childbirth as Canadian women. And, while our universities are still the best in the world, children in other industrialized countries, on average, get a better education than ours.

[S]everal studies show that a child born in the bottom 20 percent economically is less likely to rise to the top in America than in Europe. A Danish child is twice as likely to rise as an American child.

Three data points:

The top 1 percent in America now own assets worth more than those held by the entire bottom 90 percent.

The six Walmart heirs are worth as much as the bottom 41 percent of American households put together.

The top six hedge fund managers and traders averaged more than $2 billion each in earnings last year, partly because of the egregious “carried interest” tax break. President Obama has been unable to get financing for universal prekindergarten; this year’s proposed federal budget for pre-K for all, so important to our nation’s future, would be a bit more than a single month’s earnings for those six tycoons.

It’s time to bring the American dream home from exile.

The irony is that much of the path for America's decline tracks to failed GOP policies.  More ironically yet, the decline corresponds to the rise of the selfish, anti-knowledge Christofascists in the Republican Party.   The far right loves to talk about American exceptionalism, yet it is they who are killing it.

Worlds Apart: Income Gap, Education Gap and Life Expectancy Gap

A piece in the New York Times looks at the contrasts - indeed, different worlds - between Fairfax County, Virginia, and McDowell County, West Virginia.  The contrast could likewise have been made between affluent, educated and much healthier Fairfax County, and rural counties in Southwestern Virginia that have more in common with McDowell County than with Fairfax County.  What the have not counties have in common is that they are poor, uneducated and, although the article doesn't focus on it, culturally backwards and  not welcoming to outsiders or diversity.  Indeed, these have not counties represent a perfect storm that makes them among the least likely places that new, progressive businesses would seek to locate or expand.  As a result, they remain captive to the coal industry which devastates many lives just as it devastates the environment.  And this backwardness and associated poverty literally is costing lives in the form of much lower life expectancies.  Yet these areas - and their typically Republican politicians - refuse to grasp that their rejection of modernity is one of the causes of the areas' plight.  Here are article highlights:

Fairfax County, Va., and McDowell County, W.Va., are separated by 350 miles, about a half-day’s drive. Traveling west from Fairfax County, the gated communities and bland architecture of military contractors give way to exurbs, then to farmland and eventually to McDowell’s coal mines and the forested slopes of the Appalachians. Perhaps the greatest distance between the two counties is this: Fairfax is a place of the haves, and McDowell of the have-nots. Just outside of Washington, fat government contracts and a growing technology sector buoy the median household income in Fairfax County up to $107,000, one of the highest in the nation. McDowell, with the decline of coal, has little in the way of industry. Unemployment is high. Drug abuse is rampant. Median household income is about one-fifth that of Fairfax.

One of the starkest consequences of that divide is seen in the life expectancies of the people there. Residents of Fairfax County are among the longest-lived in the country: Men have an average life expectancy of 82 years and women, 85, about the same as in Sweden. In McDowell, the averages are 64 and 73, about the same as in Iraq.

There have long been stark economic differences between Fairfax County and McDowell. But as their fortunes have diverged even further over the past generation, their life expectancies have diverged, too. In McDowell, women’s life expectancy has actually fallen by two years since 1985; it grew five years in Fairfax.

Living in Fairfax is different than living in McDowell. In Fairfax, there are ample doctors, hospitals, recreation centers, shops, restaurants, grocery stores, nursing homes and day care centers, with public and private entities providing cradle-to-grave services to prosperous communities. 

Coal miners[in McDowell County]  still dig into and blast off the tops of steep Appalachian hills. But the industry that once provided thousands of jobs is slowly disappearing, and the region’s entrenched poverty has persisted. The unemployment rate is 8.8 percent, down from more than 13 percent in the worst of the recession. The current number would be even higher if more residents hadn’t simply given up looking for work.

 

Government assistance accounts for half of the income of county residents. Social workers described shortages of teachers, nurses, doctors, surgeons, mental health professionals and addiction-treatment workers. There is next to no public transportation.

[T]he contrast between McDowell and Fairfax shows just how deeply entrenched these trends are, with consequences reaching all the way from people’s pocketbooks to their graves.

Having traveled through and taken cases for those in Southwest Virginia, I do not see how the diverging trends can be halted - at least not until there is a major change in the mindset in rural areas of Virginia.  No one who has the option to move away will likely stay and the downward spiral will continue.  Meanwhile, businesses and jobs will located to more accepting and open minded areas.  And for gays living in these rural areas, flight or suicide will likely remain attractive.  Ignorance and backwardness carries a terrible price.

New Study: Homophobic People Die Earlier

The findings of a new study cannot help but make one think that perhaps there is divine justice after all.  Why?  Because extreme homophobes seemingly die younger that non-gay haters.  Perhaps Tony Perkins, Brian Brown, and a host of others might want to rethink their hate filled anti-gay bigotry.   Again as note, given the harm homophobes do to others, it is perhaps appropriate that they go to earlier graves.  MetroWeekly has coverage.  Here are some story highlights:

The findings of a study called "Anti-Gay Prejudice and All-Cause Mortality Among Heterosexuals in the United States", led by Mark L. Hatzenbuehler of Columbia University, in the February issue of the American Journal of Public Health. The study included 20,226 respondents between 1988 and 2008 -- 4,216 of those involved had passed away by the end of the study. The study found that there existed a "2.5-year life expectancy difference between individuals with high versus low levels of anti-gay prejudice." Homophobia specifically was "associated with increased risk of cardiovascular-related causes of death."
 
The study used four questions to establish the personal biases of participants:

• If some people in your community suggested that a book in favor of homosexuality should be taken out of your public library, would you favor removing this book, or not?
• Should a man who admits that he is a homosexual be allowed to teach in a college or university, or not?
• Suppose a man who admits that he is a homosexual wanted to make a speech in your community. Should he be allowed to speak, or not?
• Do you think that sexual relations between two adults of the same sex is always wrong, almost always wrong, wrong only sometimes, or not wrong at all?

I have long argued that bigotry carry a price and now we know that it means foul homophobes die younger than non-haters.

The GOP Lie About Health Care in America

One of the continuing lies that the GOP and Tea Party lunatics disseminate is that Americans will lose the best health care system in the world if the Affordable Health Care Act isn't repealed.  America has the best health care in the world only if one is tremendously wealth or is currently employed by a company that provides a Rolls Royce health insurance plan.  The rest of us?  We are just one step away for no coverage if we lose our job or an insurance carrier decides to drop us because we might actually file significant claims under our existing plan.  Medical bills remain one of the primary reasons individuals are forced into bankruptcy.  When one of my children had a catastrophic illness over a decade ago, even with a top of the line health insurance plan ALL of our savings were wiped out and it took me another four years to pay off the balance of the bills.  People truly do not understand how vulnerable they are under the system the GOP wants to maintain.  They also do not understand that compared to other modern nations, we pay far more for health care yet are in worse health and die younger.  NBC News looks at reports that reveal the lie of the GOP's claims.  Here are excerpts:

House Speaker John Boehner trashed president Obama’s health care plan again Thursday, accusing him of wrecking the world’s best health care system.  “This is going to destroy the best health care delivery system in the world,” Boehner said Thursday morning before President Obama announced a plan to fix the fallout over canceled health insurance policies.   But is it really?

Two studies out this week — and studies going back 15 years or longer — show quite the opposite. Americans pay more per capita for health care than people in any other industrialized country. In return, we are sicker, die younger and are unhappier with the system.

The Commonwealth Fund, which does research on health care and health reform, has shown year after year in its regular surveys that Americans spend a lot more on health care than anyone else. Right now it’s $2.7 trillion a year — that’s $8,508 a head, compared to $5,669 per person in Norway and $5,643 in Switzerland, the next-highest-spending countries. New Zealanders spend just $3,182 per person.

And Americans aren't getting more or better care for that money. The U.S. has the eighth-lowest life expectancy in the Organization for Economic Co-operation and Development, which groups developed nations.

In the latest survey of more than 20,000 people from Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, Britain and the U.S., Commonwealth researchers found that 37 percent of Americans went without recommended care, did not see a doctor when sick, or failed to fill prescriptions because of costs, compared to as few as 4 percent to 6 percent in Britain and Sweden.

And 23 percent of U.S. adults either had serious problems paying medical bills or were unable to pay them, compared to fewer than 13 percent of adults in France and 6 percent or fewer in Britain, Sweden, and Norway, Commonwealth reported Wednesday in the journal Health Affairs.

“The U.S. spends more on health care than any other country, but what we get for these significant resources falls short in terms of access to care, affordability, and quality,” said Dr. David Blumenthal, president of the Commonwealth Fund, Americans also wait longer to see primary care doctors; 76 percent in Germany said they could get a same or next-day appointment, and 63 percent in the Netherlands, compared to 48 percent in the U.S. Only Canada scored worse, with 41 percent saying they could.

And the U.S. has more patients than anywhere else using the emergency room.
Even the U.S. Institute of Medicine says U.S. health care is a mess, with tens of thousands of Americans dying from medical errors and drug overdoses, and with the system wasting $750 billion in 2009.

And on Tuesday, a report in the Journal of the American Medical Association looked at improvements in the U.S. health care system. The upshot? They’re not really keeping up with the rest of the world.

This is the "best health care delivery system in the world"?  I think not and its time John Boehner and others in the GOP stop blatantly lying to Americans.

Another Indictment of America's Faux Exceptionalism

Many, especially on the far right and among Christofascist/Tea Party circles, like to bloviate about American exceptionalism.  American exceptionalism is, of course, a myth used by the ignorant and xenophobic to make themselves feel good about themselves and superior to others much as the Christofascists focus on condemning others rather than face the reality of their own hypocrisy filled, miserable lives.   But, as this blog has looked previously, there is one area in which America is exceptional, but in a very negative and unflattering way:  we have the shortest life expectancy of any developed nation and we have the least efficient health care system as well despite spending more on health care than any other nation.  The irony is that the policies that lead to this horrible distinction are those championed by those who most wrap themselves in patriotism and feign worship of Christianity.  A column in the Washington Post looks at this ignominious distinct held by America and offers an indictment of the nation's failing health care system and those responsible for the true "culture of death."  Here are excerpts:

January has turned out to be a banner month for fans of American exceptionalism. As documented in voluminous detail in a 404-page report released last week by the National Research Council and the Institute of Medicine, Americans lead shorter lives than Western Europeans, Australians, Japanese and Canadians. Of the 17 countries measured, the United States placed dead last in life expectancy, even though we lead the planet in the amount we spend on health care (17.6 percent of gross domestic product in 2010 vs. 11.6 percent each for France and Germany). We get radically less bang for the buck than comparable nations. If that’s not exceptionalism, I don’t know what is.

Americans die young. The death rate for Americans younger than 50, the report showed, is almost off the comparative charts. A range of exceptionally American factors — car usage and lack of exercise, junk-food diets, violent deaths from guns, high numbers of uninsured and a concomitant lack of treatment, the high rate of poverty — all contribute to this grim distinction.  

The study enumerates other key, if unsurprising, factors in our shortness of life. “Americans are more likely to find their health care inaccessible or unaffordable,” it concludes. “Americans benefit less from safety net programs that can buffer the negative health effects of poverty and other social disadvantages.”

But a funny thing happens to Americans’ life expectancy when they age. The U.S. mortality rate is the highest of the 17 nations until Americans hit 50 and the second-highest until they hit 70. Then our mortality ranking precipitously shifts: By the time American seniors hit 80, they have some of the longest life expectancies in the world.

What gives? .  .  .  .   the larger part of the answer is that at age 65, Americans enter a health-care system that ceases to be exceptional when compared with the systems in the other 16 nations studied. They leave behind the private provision of medical coverage, forsake the genius of the market and avail themselves of universal medical insurance. For the first time, they are beneficiaries of the same kind of social policy that their counterparts in other lands enjoy. And presto, change-o: Their life expectancy catches up with and eventually surpasses those of the French, Germans, Britons and Canadians.

The big question raised by the data in this study is how Americans have allowed themselves to sink to the bottom of so many indexes that measure the quality and duration of our lives. What’s truly exceptional about America, it turns out, is the indifference we show to our compatriots, the absence of the kind of national solidarity more evident in the nations that surpass us on all these lists. Mitt Romney may have lost the election — thankfully — but his relegation of 47 percent of his fellow Americans to history’s scrap heap evinces a spirit that suffuses all too many of our institutional arrangements and social relations. 

Yes, it is damning and all too accurate.  Even more damning is that the policies that are the root cause of this disgrace track directly back to the GOP and its supposedly :godly Christian" base.  They are indeed modern day Pharisees.  They most certainly are not true followers of the Gospel message.

U.S. Life Expectancy Lags Other Advanced Nations

A new report by two of the nation's leading health research institutions not surprising has found that life expectancy for Americans lags that of other economically advanced nations.  Why is the finding no surprise?  Simply put, because(i)  the U.S. has off the charts gun violence and deaths compared to other advanced nations, and (2) no other advanced nation treats so many of its citizens as disposable garbage when it comes to access to health care, especially preventive care.  For once America is exceptional, but in a very negative and unseemly way.  And of course those most responsible for both causes are precisely those who hold themselves out as "godly Christians" and conservatives.  A piece in the Virginian Pilot looks at the report findings.  Here are highlights:

The United States suffers far more violent deaths than any other wealthy nation, due in part to the widespread possession of firearms and the practice of storing them at home in a place that is often unlocked, according to a report released Wednesday by two of the nation's leading health research institutions.

For many years, Americans have been dying at younger ages that people in almost all other wealthy countries. In addition to the impact of gun violence, Americans consume the most calories among peer countries and get involved in more accidents that involve alcohol. The U.S. also suffers higher rates of drug-related deaths, infant mortality and AIDS.

The result is that the life expectancy for men in the United States ranked the lowest among the 17 countries reviewed, at 75.6 years, while the life expectancy for U.S. women ranked second lowest at 80.7 years. The countries reviewed included Canada, Japan, Australia and much of Western Europe.

The report found that U.S. health disadvantages aren't limited to the poor and uninsured. Even white, college-educated, and wealthier Americans tend to be in worse health than their peers in other developed countries.

The nation's health disadvantages have economic consequences. They lead to higher costs for consumers and taxpayers as well as a workforce that remains less healthy than that of other high-income countries.

Researchers noted that the U.S. has a large uninsured population compared to other countries with comparable economies, and more limited access to primary care. And although the income of Americans is higher on average than that of other wealthy countries, the United States also has a higher level of poverty, especially among children.

The National Rifle Association did not immediately return calls seeking comment about the report, but in the past gun-rights advocates have fought any suggestion that firearms ownership has public health implications, and they have won cuts in the government's budget for such research.

They estimated that homicide and suicide together account for about a quarter of the years of life lost for U.S. men compared to those in those peer countries. Homicide, they noted, is the second leading cause of death among adolescents and young adults aged 15-24. The large majority of those homicides involve firearms. The researchers said there is little evidence that violent acts occur more frequently in the United States than elsewhere. It's the lethality of those attacks that stands out.

"The size of the health disadvantage was pretty stunning. The fact that our risk of death from homicide is seven times higher and from shootings 20 times higher is pretty dramatic, but I would add that was probably just as important to us was the extent of the health disadvantage in young Americans that had nothing to do with violent injuries."  Woolf cited the statistics regarding premature babies and the high prevalence of illness among teenagers as equally disturbing as the statistics on guns and violence.

These sad figures highlight the toxicity of the fruits of conservative and Christianist policies promoted by today's Republican Party.  It is a shameful disgrace.

The USA's Medical Crisis and Stalled Life Expectancy Increases

Click image to enlarge

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.

Growing American Inequality

UPDATE: The New York Times also has an article that looks at the health care system in the USA that looks at a lot of failings even though Americans spend more than twice as much on healthcare costs as in other nations. That story can be found here.

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One thing that has struck me for many years - and often was an outright embarrassment at times when I traveled extensively overseas as in-house counsel based on the boorish behavior or moronic statements of some Americans - was the blind belief by some Americans that the USA is superior to all other countries and that there is only one perspective on issues: their own. Worse yet, no objective data can convince them that maybe, just maybe, they might need to re-evaluate. Not surprisingly, many of these folks are the same crowd that has remained in the GOP and blindly supported the Chimperator and his failed policies. Am I anti-America? No, definitely not. I am however, against closed minds and stupidity. A new story in the Independent gives plenty of reasons why Americans need to wake up and open their eyes. Some of the data and statistics are quite revealing, if not outright shocking. Sadly, under the Chimperator's regime NOTHING has been done to change this situation. I doubt McCain would do any better. Before one can fix a problem, you need to recognize that it exists. Simply not wanting something to be true does not make it untrue. Here are some highlights.

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The United States of America is becoming less united by the day. A 30-year gap now exists in the average life expectancy between Mississippi, in the Deep South, and Connecticut, in prosperous New England. Huge disparities have also opened up in income, health and education depending on where people live in the US, according to a report published yesterday. The American Human Development Index has applied to the US an aid agency approach to measuring well-being – more familiar to observers of the Third World – with shocking results.

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Despite an almost cult-like devotion to the belief that unfettered free enterprise is the best way to lift Americans out of poverty, the report points to a rigged system that does little to lessen inequalities. "The report shows that although America is one of the richest nations in the world, it is woefully behind when it comes to providing opportunity and choices to all Americans to build a better life," the authors said. Some of its more shocking findings reveal that, in parts of Texas, the percentage of adults who pass through high school has not improved since the 1970s. Asian-American males have the best quality of life and black Americans the lowest, with a staggering 50-year life expectancy gap between the two groups.

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Despite the fact that the US spends roughly $5.2bn (£2.6bn) every day on health care, more per capita than any other nation in the world, Americans live shorter lives than citizens of every western European and Nordic country, bar Denmark.

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"Some Americans are living anywhere from 30 to 50 years behind others when it comes to issues we all care about: health, education and standard of living," said Sarah Burd-Sharps co-author of the report.

Southwest Virgina's Mortality Mystery

I noticed a story earlier in the week that looked at the declining life expectacy in various parts of the USA, including Southwest Virginia, but I did not find time to do a post on it. Now, today, the Washington Post has a story that focuses on Southwest Virginia's declining life expectancies, particularly for women. The article looks at a number of factors, but never adequately focuses on what I suspect is a major factor: lack of health insurance coverage that allows preventative treatment and diognostic tests. It is mentioned briefly, but fails to point out that emergency room care in non-profit hospitals does NOT include such medical treatment. Therefore, I believe much of the population lacks decent medical insurance coverage and as a result lacks minimal quality care. In fact, years ago my sister who is a nurse practioner worked in a clinic in that area of the state under a UVA grant and was horrified at the conditions and lack of medical care.

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As backward as the greater Norfolk area seems at times, it is down right cosmopolitan and progressive compared to the southwest part of the Virginia which is the poorest area in the state and also the most backward in terms of social views and education. Other than coal mine operations, there are not many large employers in that area of the state - not anymore that is. Furniture manufacturers, textile mills and other former large manufacturing and industrial employers that once paid a living wage and provided health insurance coverage have largely closed down as jobs have been exported overseas. As the article notes, even Wal-Mart closed a store in that region. The state is making efforts to induce new employers to relocate to that part of the state, but few progressive firms would want to be based in that area. While the area is physically beautiful and has gorgeous mountains (the Appalachian Trail runs throught the area), socially it is like a 1950's time warp in the worse sense and no liberal or gay in their right mind would move there if they had a choice in the matter. In fact, those with brains and ambition leave the area for more progressive parts of the state or country. Thus, the area is in a downward spiral - the more backward and reactionary it becomes, the fewer would be employers want to relocate there. Bigotry, reactionary politics (Southwest Virginia is the GOP's most secure bastion in Virginia) and fundamentalist Christianity which predominate the area have a very high price in terms of driving development and progress away. Here are some story highlights:

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In this corner of southwest Virginia, cow-speckled fields and empty downtown streets tell of a slower, calmer life. It's a place where older men can be found around a table every morning drinking 25-cent coffee with the nearest Starbucks miles away. Residents will tell you little distinguishes the city of Radford and neighboring Pulaski County from elsewhere in rural America. That is what troubles health-care workers here most about a new study that found a sharp drop in life expectancy for women in the two communities.

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According to the study, life expectancy for women dropped in nearly 1,000 counties but fell most in Radford and Pulaski. In 1983, life expectancy for women in the two jurisdictions was about 84 years. By 1999, it had dropped 5.8 years, to 78. No other jurisdiction in the nation had a decrease of more than 3.3 years.

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But in an area struggling economically, where the day's gas prices might determine whether it's worth a drive to the doctor's office, it's not always easy to push preventive measures, he said. "If you are struggling to put food on the table, you don't have time to think about prevention," Hershey said, adding that lack of health insurance is a significant problem in southwest Virginia.

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On Main Street in the town of Pulaski, economic distress is clear. "For Sale" signs hang on several storefronts, and even at lunchtime, few people stroll the streets. It wasn't always like this, business owner David Allen said. That was before popular stores left and major manufacturers, such as Pulaski Furniture, where many residents worked, closed. Now everyone talks about expected layoffs at Volvo, a major employer. "It's going downhill," John Stevens said. "We even lost a Wal-Mart here. Who loses a Wal-Mart?"