fresh voices from the front lines of change







Harold Myerson, over at the Washington Post, points out a new report by the National Research Council and the Institute of Medicine contains some bad news about about the America's health. The title pretty much says it all: "U.S. Health in International Perspective: Shorter Lives, Poorer Health."  The summary of the report goes into more detail. 

The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. A growing body of research is call- ing attention to this problem, with a 2011 report by the National Research Council confirming a large and rising international “mortality gap” among adults age 50 and older. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people, since recent studies suggest that even highly advantaged Americans may be in worse health than their counterparts in other countries.

Either Billy Joel was onto something when he sang "Only the good die young," or America's health care system still has some serious problems. 

Compared to 16 other high-income "peer" countries America is almost always dead last (no pun intended). Every single one of these countries —  Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, the Netherlands, and the United Kingdom — get more bang for their health care bucks than we do. We're only tops in how much we spend on health care. (Well, that and violent deaths. We're number one in that category too.)

What gives? Meyerson hones in on a likely factor.

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? Have seniors discovered the Fountain of Youth? Do U.S. geriatricians outpace all our other physicians?

Part of the answer is Darwinian: Those Americans who have been less able to access reliable medical care, maintain good diets and live in neighborhoods that are not prey to gun violence have disproportionately died off before age 80. That isn’t natural selection but social selection — the survival of the economically fittest in a nation that rations longevity by wealth.

But 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.

 That, as Meyerson points out, puts the defenders of private health insurance in a bit of a bind. That bind may get even tighter. Thanks to a bill introduced by Reps. Jan Schakowsky (D-Ill.) and Henry Waxman (D-Calif.), the "public option" is back in the mix.

 A group of House Democrats are surfacing the health care public option as a way of reducing the deficit, revisiting an approach suggested by President Obama's debt commission in 2010.

According to a Tuesday statement from Rep. Jan Schakowsky's (D-Ill.) office, Schakowsky, Rep. Henry Waxman (D-Calif.), and 43 other House members have introduced the Public Option Deficit Reduction Act, which would "would offer the choice of a publicly-run health insurance plan, an option that would save more than $100 billion over 10 years."

"As Congress looks to reduce the deficit, it is important to remember the one policy that could save billions of dollars is the public option. I hope that my colleagues will take a fresh look at this in the months ahead,” Waxman said in the statement.

The public option, hotly debated during negotiations over Obama's health care reform law, was left out of the legislation after it repeatedly failed to gain enough traction in Congress.

The statement from Shakowsky's office points out that a public option would cut the country's health care spending by more than $100 million, and lower health care costs for families by putting pressure on private insurers to lower their rates in order to compete. Not only would it save money, but according to this report, it would also save lives.

Let's face it, we weren't really done with health care after the Affordable Care Act, and this report tells us that we've still got a long way to go. 

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