With the acrimonious debate over healthcare reform poised to return to the US Congress as its members return from their summer break, two new studies bear a sobering message: don't expect an expansion of health insurance coverage alone to improve Americans' health.
Politicians are trying to revamp a system that spends around twice as much per person on healthcare
as most European countries, while getting worse results overall, lagging on measures such as life expectancy at birth and infant mortality.
Two teams, one led by Pierre-Carl Michaud of the Rand Corporation in Santa Monica, California, the other by Samuel Preston of the University of Pennsylvania in Philadelphia, have dug into international health statistics to ask why US citizens can expect to die earlier than their counterparts in the richest European nations.
Michaud concludes that the blame lies largely with high rates of chronic disease caused by poor diet, lack of exercise and the lingering effects of tobacco use from a time when smoking was more prevalent in the US than in Europe.
Preston agrees, and also finds that in some respects – screening and treatment of cancer and cardiovascular disease, for example – the US healthcare system is actually performing well.
Sicker
This means that eliminating profligate spending on ineffective medical interventions by US doctors is only part of the solution to US health woes. Changing citizens' behaviour so that they eat less and exercise more will be vital, both to improve health and reduce costs. "One of the main reasons that US healthcare is so expensive is that we are sicker than other people," says Preston.
The Rand team has put a number on it, suggesting that gradually moving US citizens towards the health enjoyed by Europeans could save up to $1.1 trillion in healthcare costs by 2050.
Politicians leading the US healthcare reform effort stress the gains to be made by expanding preventive medicine. "If we can use cost-effective screenings and other up-front interventions to prevent tens of millions of occurrences of cancer, diabetes and cardiovascular disease, then we are going to slash healthcare costs significantly," says Tom Harkin, Democratic senator for Iowa, in a statement posted on his blog.
But specialists in health policy warn that improved screening and encouragement to adopt healthy habits can only go so far. "It's not going to fix the underlying problems of poverty, poor diet, lack of exercise and smoking, which are the biggest determinants of health," says Shannon Brownlee of the New America Foundation in Washington DC.
Making US citizens as healthy as Europeans may require widespread changes, from providing more sidewalks in car-dominated neighbourhoods where it's hard to walk around, to improving conditions for impoverished communities so that healthy food becomes a viable alternative to cheap, high-calorie junk.
"You can find a role for the healthcare system, but there are other very strong forces at play," says Michaud.
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Great Article
Fri Aug 28 18:45:41 BST 2009 by Alex
http://zerodev.tumblr.com
I'm happy to see research like this come to light. It is going to take much more than healthcare reform to actually get people to live healthier.
there will have to be a major change in the attitude of young people in the US for there to be better health.
As long as children and teenagers are allowed to turn there noses up and refuse to eat vegetables by their parents no amount of money spent by the government will make its citizens healthy.
When all the kid wants is soda pop and fast food and the parents let him have it we will see an ever increasing obesity and cancer problem. It is even predicted that the life expectancy of the children in the US is actually lower than their parents now enjoy. You can trace this back to the parents not properly training the children to eat properly.
Insufficient money exists if U.S. health care is to be reformed by greater amounts of government spending.
Within 5 to 7 years the U.S. federal deficit will breach the $20 trillion mark, and the Failed American state will be printing significant quanties of cash in order to pay for it's day to day operations.
Investors in bonds and other government backed securities will demand higher interest rates on those investments as a result.
It is not unreasonable to expect that they will be receiving somewhere around 5% interest at that time, and over the following 5 years most of the Federal Debt will be converted to that rate.
5% of $20 Trillion = 1 Trillion = 1,000,000,000,000.
Interest on that debt will then translate to about $3,000 per year per person in the U.S, or $12,000 per family per year.
A 10 precent interest rate would double that tax burden to $24,000 per year per American family.
A very optimistic 3% interest rate would produce a per family burden of only $7,272 per year.
And this is only the interest on the National Debt.
Currently the U.S. federal budget is around 3 trillion dollars, with about 1 trillion borrowed, producing a tax burden of about $24,000 per American family.
Presuming there are no net increases in existing federal spending, the net burden on the American consumer will therefore increase to $36,000 per year within the next 7 years, and then to $48,000 per year over the next 6 years due to compounding, and then $60,000 over the following 4.5 years, etc.
The extent of the budget imbalance in the U.S. is such that even if you shut down the entire federal government, leaving only Medicare/Medicade, Social Security and the U.S. military (all about the same size), the U.S. federal deficit would still not be reduced to zero.
We can conclude from this several things.
1. The U.S. is bankrupt.
2. The U.S. must take steps to reduce it's health care costs by limiting the amount of wasteful Free Market spending in the marketplace.
3. The U.S. economy is exquisitly sensitive to changes in the interest rate. If an entity can force interest rates to rise - either through the printing of money, through the undermining of the U.S. currancy, by driving fear into the econoomy, or through other means, the U.S. financial situation will rapidly grow excpetionally worse.
4. For this reason the U.S. will use every power it has to keep interest rates as low as possible - lower than 3% if possible.
5. The U.S. government has no choice but to cut government spending in the area of defense to offset the growing demand for social services by it's ageing population.
6. If the U.S. state is to survive the coming decade taxes will have to rise significantly.
7. No amount of tweaking will save the U.S. from oblivion. Neither can "free market" principles save the state as they are the principle cause of the current fiscal disaster.
Only revolutionary change will save the American state, and with American Conservatives blocking the required change, and demanding more of the same poison that has brought the failed American state to it's current plight, there is not much chance for substantive change over the next 7 years, and hence no chance that America will be able to survive as a nation through the next decade.
Medical reform in the U.S. is necessary, but it is a cut finger compared to the severed artery that is bleeding America dry.
At this point, no amount of medial reform is going to improve the health of the Ameican people, since they are destined for decades of poverty even if they do manage to scrape enough guts together to save their vile nation.
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There's still some ways out. We could corner the market on green manufacturing and use our national clout to bully through severe green laws on the rest of the world, leading to a huge trade surplus. This could be politically acceptable (since it involves rich people making money).
Personally, I am hoping for a bird flu outbreak to cleaning out the excess elderly population, combined with a massive-demilitarization of our nation, slashing the military budget 90%, pulling the troops home from our hundreds of bases, and ending our wars.
The Empire days are over (thanks Clinton and Bush 43!), we can go down hard or go down easy.
Do the math, genius. He's right. Althought I am betting on hyper-inflation since right now to just keep up with the debt the Fed is printing money to buy treasuries. Hyper-inflation would wipe out the national debt (and the standard of living in the USA). But I know, bad things NEVER happen to the USA (because GAWD loves us so), so trying to fix serious structural flaws in our government and economy, or even speaking the truth about them is just EVIL and counter to God's plan for 'Merka. Heretic Vendicar!
He's also wrong in pointing the blame at conservatives alone, since the Democrats seem almost equally devoted to riding the corporatist ship into the inky abyss.
Do you guys ever get the feeling you're living in the last days of Krypton?
You should have quit early on. Since the US is already financially bankrupt, no amount of continued theft from its citizens is going to fix it, and you should know better. More mismanaged government programs (e.g., 'health scare') that add to the deficit won't improve things either, and to suggest otherwise is simply dishonest.
Consider: Current regulations in many US states prevent or severly discourage many doctors from offering low-cost comprehensive care programs to their patients for routine checkups, etc. Doctors that try are harassed by state regulators. Do a little research before condemning 'free-market' principles. The ignorance on this thread is astounding.
"More mismanaged government programs (e.g., 'health scare') that add to the deficit won't improve things either" - Hick
The American Hick forgets thta U.S. health care costs are almost twice as high as in the socialist states as a result of free market inefficiencies in the U.S.
The Hick demands more of the same because he fears that the Americans he elects to manage his nation don't appear to be smart enough to do so.
Maybe the U.S. should import some smart Europeans to manage their nation for them.
The reform of American health care is as much a step to reforming the U.S. budget as it is reforming the U.S. health care system.
Given the Conservative opposiion to budget reforms, it should now be readily apparent to even common stones, that the goal of American Conservatives is the fiscal Eradication of the Failed American State.
"The American Hick forgets that U.S. health care costs are almost twice as high as in the socialist states as a result of free market inefficiencies in the U.S."
And yet, the amazingly smart Vendicar is ignorant of the many varieties of nearly bankrupt public health care programs in the US (Medicare, Medicaid, SSI, a wide variety of near-bankrupt state programs, etc.) that are so "efficient".
I'm also sure because of his amazing smarts that he's aware that we don't have long waiting lists for people who need gall bladder surgery, prostate surgery, etc., like so many idyllic public health care countries.
"The Hick demands more of the same because he fears that the Americans he elects to manage his nation don't appear to be smart enough to do so."
It's amazing that someone as "smart" as Vendicar cannot even handle basic reading comprehension, history or US constitutional law. In America, we don't elect people to "manage" us, thank you very much. That tendency of people to want to "manage" others has been shown repeatedly to bring trouble. The goal was to keep government out of people's lives as much as possible, you know? Sheesh! Grow a brain.
"The reform of American health care is as much a step to reforming the U.S. budget as it is reforming the U.S. health care system."
Boy, you're just batting 0 for whatever today, aren't you? If you actually read HR3200, you would know that what you spouted is just BS. (And yes, I have an sister who is an attorney that also reads the bill, and we discuss this frequently.) So, I conclude that you are merely testifying from complete ignorance on this, which is just another way of saying that you are bearing false witness, one of the Ten Commandments we like to use for a rule of thumb in deciding between competing arguments. Go ahead, show me where HR3200 does this! Then, explain why the very pharmaceutical companies that are supposedly responsible for so much of the increases in health care costs are contributing $150 MILLION in advertising to try to persuade the American people about this piece of trash bill.
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