"Treatable Mortality" -- i.e. deaths potentially preventable via medical care -- is much higher in the US than 4 "peer" nations. Moreover, we've stopped making progress in the past 10 years, widening the divide.
Meanwhile, blood pressure control — a big way modern medicine saves lives — has been deteriorating over this same period for the general US population.
Similarly, among adults with diabetes, both glycemic control and blood pressure control are worsening.
Meanwhile, while a feared and predicted 2020 surge in uninsurance did not come to fruition (for a number of reasons, including aggressive policy), the number of insured has gradually risen since 2016 according to three benchmark federal surveys:
Uninsurance and underinsurance among children rose from 2016-2019:
To be clear, I'm emphasizing the worsening trends in blood pressure and glycemic control as a failure of the healthcare system — we're doing something wrong.
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Life expectancy now approaching (but still below) pre-pandemic level
78.4 in 2023 77.5 in 2022 78.8 in 2019
A few observations.
(1) This is exactly as expected because, fortunately, cases of severe COVID fell sharply after 2022 — very evident from death certificate data (and certainly observable for those of us in the ICU).
This doesn't mean all is well with US health however — far from it
(2) The years before the pandemic were grim, with plateauing, sometimes dropping life expectancy — a departure from 50 years of progress (progress that is the norm in modernity outside of epidemics & war).
There's growing convergence of opinion that "moral hazard"-based healthcare policies (i.e. skin-in-the game copays & deductibles) are harmful or at least unnecessary, including from some of the nation's leading health economists.
This is good, but also begs a question:
Why did it take so long? Many nations built healthcare systems premised on providing care free (or nearly so) at point of use generations ago. Ted Kennedy's first single-payer bill from early 1970s eschewed cost-sharing, as did PNHP's single-payer proposal dating from late 1980s
From his experience nearly losing his leg as a child, Tommy Douglas said: "I came to believe that health services ought not to have a price-tag on them, and that people should be able to get whatever health services they required irrespective of their individual capacity to pay."
In wake of last week's dustup over Anthem's pullback from its proposed anesthesia policy, I have a piece today at @MSNBC that responds to articles by @EricLevitz & @Noahpinion, & comments by @mattyglesias & @dylanmatt, & the question: who is to blame for our healthcare mess?
The above have argued that private insurance is not the real problem — the problem is those who provide healthcare. They contend the primary savings from Medicare for All-type system is not via reduced insurer waste, but lower hospital funding & clinician reimbursement.
They are factually wrong. Many studies have been done on this which they ignore. Most robust is from CBO (our detailed analysis of it is below), which found that major savings IS from reduced insurer administrative overhead — $400 billion+ a year!
This often goes unstated, I believe, because it undercuts the idea that "supply side" solutions would bring US healthcare costs in line with other nations, which is not true. We do need a PCP:specialist physician rebalancing. But the interesting thing is that increasing supply...
... in healthcare will tend to increase society-wide costs, not reduce them. That is not necessarily a bad thing if you are trying to meet unmeet needs! But building and staffing more hospitals and beds is unlikely to reduce total resources spent on hospitals.
This is incorrect -- the Congressional Budget Office's Medicare for All cost study projected **$400 billion** in savings annually from reduced insurance overhead.
It projected total provider payments falling by much less, or going up by much more, depending on assumptions.
And that doesn't account for provider-side administrative savings: Canadian hospitals spend half what US hospitals do on administrative **as a share of total revenue**
I'm not suggesting that this is the intent of the OP, but in US context it really often feels like these claims are designed to turn healthcare workers against Medicare for All (& deflect attention from the primary dysfunction of a broken, fragmented private insurance system).
Even if you ignore his crank beliefs about WiFi & vaccines & ivermectin etc etc (not that you should), he’s also not going to do anything useful about “chronic diseases”.
Take the environment, which RFK Jr. purports to care about …
… and which can drive morbidity from chronic disease (e.g. air pollution > asthma).
Well, last time around Trump shredded a 100 environmental regulations, and worsened air quality. He’s going to do the same thing again.
Take nutrition among kids. Yes, we should have more nutritious (and free) school lunches. Do you really think Trump is going to bolster federal spending to improve access to high quality school lunches? Then I have a bridge to sell you.