The troubling state of America’s health
The Washington Post, 1/16/13
By Katrina vanden Heuvel
Editor and publisher of the Nation magazine,
vanden Heuvel writes a weekly column for The Post.
America is dangerous to your health. A recent international commission reported that U.S. men rank last in life expectancy for the 17 industrial nations in the study; U.S. women rank next to last. When it comes to health, the United States is exceptional — exceptionally bad.
The stunning report on “America’s health disadvantage” received virtually no attention in Washington and far too little in the media. Washington is fixated on “fixing the debt.” Americans are dying sooner than citizens in other industrial nations. We rank at or near the bottom in nearly every category — deaths from heart and lung disease, diabetes, infant mortality, violence, alcohol and drug abuse, car crashes. Yet Washington focuses on bookkeeping.
This deficit obsession not only saps attention from our shameful health failures, but also contributes directly to them. Our sorry life expectancy is a classic example. “Something fundamental is going wrong,” said the panel’s leader, Dr. Steven Woolf, chairman of Virginia Commonwealth University’s Center on Human Needs. “This is not the product of a particular administration or political party. Something at the core is causing the U.S. to slip behind these other high-income countries. And it’s getting worse.”
The panel identified many culprits. We don’t offer universal health insurance, so primary care resources are limited and many go without insurance. We have the highest poverty rates, and one of the worst high school graduation rates. Our safety net is less generous at protecting the poor. Millions are “food insecure.” We’re number one in sexually transmitted diseases, in deaths from gun violence and car crashes.
This is literally a question of life and death. So you would think Washington would be focused on what should be done. The first steps would include implementing health-care reform — challenging the obstructionist Republican governors who are elevating ideology over public health — both to bolster public-health programs and to get costs under control. That would require taking on the entrenched interests that drive up costs — the drug companies, the insurance companies and the private hospital complexes.
Instead, Washington is debating not how to fix our broken health-care system, but how to cut what government spends on health care — largely through Medicare, Medicaid and the Veterans Administration system. The goal is cuts that can be “scored” for budget purposes, not reforms that will lower costs and strengthen care, and certainly not steps that might be taken to help Americans survive longer.
Thus, the last round of negotiations featured the idiotic notion of raising the eligibility age of Medicare — essentially stripping 65- and 66-year-olds of guaranteed coverage. That would save the government some money, but would actually add billions to what we spend on health care as a country, while depriving millions of Americans of adequate health care. The president and House Speaker John Boehner also nearly agreed to a new inflation measure for Social Security and other changes that would lower benefits in relation to rising costs. That, ironically, might serve only to erase the one life expectancy advantage the U.S. enjoys — that for those who survive to 75.
Next week, the president offers his second Inaugural Address on the federal holiday celebrating Dr. Martin Luther King Jr.’s birthday. It’s reported that he will remind Americans of our strength as a nation of diverse immigrants, and set up the fight for immigration reform. To that necessary reform, he might well add the founders’ vision of a nation dedicated to “life, liberty and the pursuit of happiness.” And that it is time to rededicate our efforts, beginning with the question of life and death.
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