Map of life expectancy at birth from Global Education Project.

Wednesday, December 16, 2009

Health care policy 101 -- cont.

Now I hope that I've demonstrated the simple proposition that we are paying twice as much for medical services as comparable societies, and getting worse health outcomes. To our shame, we aren't bearing the burden of our collective failure equally: disparities in health and life expectancy between rich and poor, black and white, are large and persistent. Here's the simplest possible presentation:

What this shows is that, while women on average live longer than men (a biologically determined fact, once you have reasonably safe child birth), in the U.S., white people live longer than black people. (In case the graph is a bit confusing, white men have about the same life expectancy as black women; white women have the highest and black men the lowest.) As you can see, while life expectancy has generally been increasing, the disparities have remained essentially unaffected.

Former Surgeon General David Satcher and co-authors noted in Health Affairs in 2005 that 83,570 Black Americans die prematurely every year who would not die if that mortality gap were eliminated. That is the equivalent of loading a jumbo jet every day and crashing it into the ground with no survivors – week after week, year after year, forever. This is an excruciating national embarrassment. The corporate media -- not to mention Daily Kos -- are full of stories about influenza and rare events such as deaths from food poisoning or unusual medical conditions, but this is going on all the time and it’s largely ignored. I’ll let you speculate about why that is.

But now we come to the problem that has actually gotten the attention of powerful people.

Health Care Spending as Pct. of GDP, U.S.

This is health care spending in the United States as a percentage of GDP. And yes, it has also tended to increase in other countries: new medical technologies come along all the time, and they are usually expensive. People place a high value on cure, if possible, and failing that palliation. We want to live and function well and if there is hope of that we'll pay for it. The problem is that health care has gotten so expensive in the U.S. that under our present system of financing, a lot of people just can't afford it; and politicians and policy wonks are starting to worry about the affordability of Medicare to the federal government and of Medicaid to both federal and state government. Long term, this relentless cost growth is driving more and more people out of the system and threatening public solvency.

Next up: Economics 101

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