health

Tony Edwards

Tony Edwards2 — Wed, 08 Dec 2010 12:05:39 -0500

Inequality's Death Toll: A New Calculation

Sam Pizzigati — Wed, 18 Nov 2009 15:05:33 -0500

What has the potential to save more lives, the insurance reforms in the House health care bill or the higher taxes on the rich the bill imposes to pay for those reforms? This rather odd question, suggests a new study on inequality and health, really does merit asking.

Over the past year, Americans have been heatedly debating how best to help people who get sick. But why do people get sick in the first place? Why do some developed nations seem to have much healthier populations than others? Why do people in Japan live much longer, on average, than people in the United States?

Epidemiologists — the scientists who study the health of populations — have been busily exploring these questions for decades now, and they’ve fixed upon a reality that has stimulated an enormous scholarly debate within the public health community. Equal societies, the researchers have found, consistently exhibit better health than unequal societies.

Why should this be so? Last week, in the British medical journal BMJ, an editorial by epidemiologists Kate Pickett and Richard Wilkinson neatly identified the two competing explanations.

The first explanation suggests “that more unequal societies have worse health simply because they have more poor people.” If poor people had more money, they would likely spend more on “things that benefit health” — better food, for instance, or warmer housing.

But the problems inequality creates, other epidemiologists contend, go far beyond poverty. Income gaps, these scientists argue, corrode social bonds and create a chronic stress that wears away at the health of all people who live in deeply unequal societies, not just the poor.

This second explanation has just gained significant new support — from a new “meta-analysis,” also published last week in BMJ, of previously conducted inequality and health studies.

The new paper’s authors, epidemiologists from Japan’s University of Yamanashi and the Harvard School of Public Health, subjected these studies to a series of complex statistical analyses. Their goal: to offer “quantitative evaluations on the association between income inequality and health.”

Their principal finding: Individuals “living in regions with high income inequality have an excess risk for premature mortality independent of their socioeconomic status, age, and sex.”

In other words, if you’re a middle-income person in an unequal society, you’re going to have shorter life than a similarly situated middle-income person in a more equal society.

How powerful an impact does inequality have on health? In the world’s top 30 industrial nations, the Japanese and American research team concludes, “upwards of 1.5 million deaths” — nearly 10 percent of total mortality in the age 15-to-60 age group — could be prevented by reducing income inequality.

The impact of inequality on the United States turns out to be even more stunning, not surprisingly since no developed nation sports wider gaps in income and wealth. Of the deaths the new BMJ study ties to inequality, almost 900,000 came in the United States.

That total, University of Washington epidemiologist Stephen Bezruchka pointed out last week, amounts to a sizeable share of America's annual death toll.

“We can say,” he calculates, “that one in four deaths can be attributed to our high rates of income inequality.”

Such numbers have, of course, enormous political implications. An unequal society, as last week’s BMJ editorial noted, amounts to a “broken society.” Political leaders, the editorial continued, ought now endeavor to repair that break — “by undoing the widening of inequalities that has taken place since the 1970s.”

Sam Pizzigati edits Too Much, the online weekly on excess and inequality.

jerdan fantilano

jerdan fantilano — Wed, 17 Jun 2009 07:30:04 -0400

NAME: JERDAN C FANTILANO
ADDRESS: 0402 MAGSAYSAY STREET
CITY: DIGOS
AREA CODE: 8002
COUNTRY: PHILIPPINES
SCHOOL: UNIVERSITY OF MINDANAO
COURSE: B.S.I.T

Health Insurance Nightmares Shared By Our Readers

Bernie Horn — Wed, 10 Jun 2009 10:53:28 -0400

In my blog “Why Not Single-Payer,” I asked readers for their thoughts. I received arguments, which I’ll share in a later post. But first I thought I should reprint some of the awful-but-true stories of smart, hardworking people who have been unjustly treated by our nation’s Rube Goldberg-style health insurance system.

One reader explained:

We are self-employed, have been for nearly 30 years. In a family of four, we have three different health insurance policies, due to pre-existing conditions which are mostly benign, and cost little to treat. No surgeries needed, rarely medications, yet when we tried to change companies, due to cost, my husband and son were both turned down….

For my family, this means that we have deductibles which add up to about $20,000 total. God forbid we have any catastrophic events. If I could combine policies, I could keep that deductible to a much lower figure—not easy, but better. The monthly cost of all these policies (and it goes up every few months) at this time is running nearly $900.00. I try to put a bit aside for the HSA, but for the past 8 months, due to the recession, it has been nearly impossible.

I am afraid to get regular checkups myself (needed, because my mother was recently diagnosed with colon cancer), because I am afraid of being dropped by [my insurance company]—I don’t want to trigger any red flags. What a mess.

Here’s another about unreasonable cost:

I'm a progressive Democrat and I'm one of those scared people you wrote about. I've worked for 42 years consecutively and consult part-time. My husband who passed away three years ago worked 43 years consecutively. He received 3 social security checks before he died. I worked and have my own social security. Are you getting the picture? My husband and I did most things right. We lived frugally, but we've always gotten the raw end. Unless we transform to the French medical system, I think millions of people like me will be hurt. I should say further harmed. It's not been fun. I have Medicare now and it's the best medical coverage I've ever had. However I can't pay one penny more for additional coverage or prescriptions.

This is about the frustration of battling insurance companies:

The HMO police are far worse than any government health police in my opinion! I've already dealt with them many times. When my child had had 5 bouts of strep throat in 6 months, and could no longer swallow solid food, the doctor recommended an urgent tonsillectomy. The HMO police said it wasn't medically indicated. I had to pay for the surgery myself. Luckily the doctor’s insurance staffer kept fighting and I eventually got a partial refund. For my own surgery and other more recent health problems, I had to fight for every line item on every hospital bill. The HMO game plan is to wear you out until you give up on the claims.

And this one’s about medical bills:

My sister died at 37 from a metastatic sarcoma (the same thing that got Ted Kennedy, Jr.’s leg). I watched her die, went to her funeral and, in mourning, went back to pack up her apartment and sift through stacks of medical bills, trying to figure out what she owed to whom and how we would get them paid. This doesn’t happen in most industrialized countries and shouldn’t happen here. It's a disgrace.

I guess I should add my own story here:

I changed jobs last year, going from an employee to a consultant. I went to the insurance company that previously covered my family and applied to continue with a private non-group policy. To my astonishment, the insurance company that covered us for 8 years accepted me but denied my wife and both of my children, all for different—and exceptionally unremarkable—“preexisting conditions.” Fortunately I was able to scramble around and get group coverage through my wife’s employer. But I was lucky. I have no idea what someone else in my position could have done if they weren’t lucky enough to have a spouse who qualified for employer-sponsored health insurance.

The first writer is correct: the system is a mess. According to the most recent estimate, 52 million Americans are uninsured, and 25 million more are underinsured. Even Americans with insurance are struggling with soaring health care costs and have to battle with insurance companies to receive the coverage that they are due.

We finally have a realistic chance to fix the system. Both the U.S. House and Senate will likely vote on sweeping health care reform legislation during the last two weeks of July. There will be a series of votes on amendments that will determine whether we get real reform—whether the people or the special interests will win. And there will be a relatively small number of lawmakers—mostly “moderate” Democrats in the Senate—who will cast the key votes for or against.

President Obama famously declared that “nothing can stop the power of millions of voices calling for change.” Please add your voice to his. Visit our friends at Health Care for America Now, go to the “get involved” page, and help us win this desperate, crucial battle.

The writer is a Senior Fellow at Campaign for America’s Future and author of the book, “Framing the Future: How Progressive Values Can Win Elections and Influence People”.