The US Health System Was Already Falling Short. Then COVID-19 Happened.
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It starts with life expectancy, the bluntest measure of how well people are served by their health system. Life expectancy in the developed world has steadily improved over the past few decades, driven primarily by major breakthroughs in the treatment of heart disease and other cardiovascular problems, which rank near the top among causes of deaths in wealthy nations. But not as much in the United States as in other countries. According to a KFF analysis of health care trends from 1991 to 2016, Americans saw their life expectancy rise by 3.1 years during that period — a meaningful improvement, to be sure, but substantially less than the 5.2 years gained in comparable countries.
And in the US specifically, that progress has stagnated in recent years. With tens of thousands of people dying of opioid overdoses every year and a sustained increase in the number of suicides, American life expectancy actually started tailing off in 2014, according to a 2019 analysis published in JAMA. The gap between the US and other wealthy countries was already growing before Covid-19 struck.
Likewise, disease burden had steadily improved until a recent downturn separated the US from other countries. The reasons for the improvement were the same: better medical treatment for chronic diseases. But once again, America did not improve to the degree that comparable countries did, seeing a 12 percent improvement versus an average of 22 percent elsewhere. In the United States, the burdens from disease of the heart, lung, kidney, and liver — as well as from diabetes — remain stubbornly high compared with the rest of the developed world. And the reasons for America’s recent stagnation are the same, too: Suicides and drug overdoses, plus a rise in the number of young people with chronic health conditions, are robbing people of years of healthy living.
The same pattern holds for medical errors. They have been declining in the US over the last 25 years but are still more common in America than in comparable countries. Avoidable hospitalizations and adverse drug events are down, but not as much as in wealthy European or Asian nations. Americans are roughly twice as likely to experience an error in their medical care as their counterparts the world over.
Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction
July 8, 2021 at 11:43 AM #433943David the GnomeParticipant
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Whether its health insurance premiums, co-pays, or the cost of services in general. In general, the average for an ER visit is around 1400 dollars. For an overnight hospital stay, it is over ten thousand. An MRI is typically a couple thousand (at least) as is a CT scan. Even the average cost of a regular scheduled visit is around 200 bucks. Three hundred – five hundred for an initial consultation with a psychiatrist. Dental work, if you need it, is also in the thousands.
Say you have a deductible of 5K (not uncommon) and a yearly salary of roughly 30K before taxes. That’s one sixth of your total yearly income. So of course people can’t pay it at once – they’re going to be on monthly payment plans that are typically (At least) 200 dollars a month. Throw that in with the rest of the expenses… and, surprise! Average life expectancy goes down.
It is not that our technology or overall medicine has declined – it is that it costs too much for the average person. If you are very poor, you might get medicaid. If you are old enough to qualify for medicare – that covers a good bit – but if you are in between, like tens of millions are, you’re going to get screwed hard. Of course, medicaid is also somewhat infamous for not being the best with paying the full amount, or paying on time. It is also routinely subject to cuts, usually when a Governor decides they need to balance a budget.
As for the ACA…. it is a lot like medicaid. If you are poor enough, you might get some help via subsidy. If you aren’t, well…
Then there are all of those people who have no health insurance. The ER has legal obligations to at least stabilize them, but for anything beyond that they are looking at debt and/or charity care, if the hospital in question has such.
A for profit system overseen and typically regulated by sociopaths.
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