Some links about the health care system and being healthy.
Atul Gawande in The New Yorker
It's a question that divides Americans, including those from my home town. But it's possible to find common ground.
A right doesn't distinguish between the deserving and the undeserving,
and, for many in my Ohio home town, that rankled.
...
As he saw it, government existed to provide basic services like trash pickup, a sewer system, roadways, police and fire protection, schools, and health care. Do people have a right to trash pickup? It seemed odd to say so, and largely irrelevant. The key point was that these necessities can be provided only through collective effort and shared costs. When people get very different deals on these things, the pact breaks down. And that's what has happened with American health care.
The reason goes back to a seemingly innocuous decision made during the Second World War, when a huge part of the workforce was sent off to fight. To keep labor costs from skyrocketing, the Roosevelt Administration imposed a wage freeze. Employers and unions wanted some flexibility, in order to attract desired employees, so the Administration permitted increases in health-insurance benefits, and made them tax-exempt. It didn't seem a big thing. But, ever since, we've been trying to figure out how to cover the vast portion of the country that doesn't have employer-provided health insurance: low-wage workers, children, retirees, the unemployed, small-business owners, the self-employed, the disabled. We've had to stitch together different rules and systems for each of these categories, and the result is an unholy, expensive mess that leaves millions unprotected.
There are several routes to universal coverage -- some more politically feasible than others.
As we consider the most effective strategy for achieving universal
coverage, progressives should keep two admonitions in mind.
First, we must not conflate our foremost health care goal
(universal coverage) with competing pathways toward achieving that goal
...
America's unique history and politics make the successful promotion
of a single-payer system an unlikely pathway to universal health coverage.
There are three reasons. The first involves the inevitable strong and
well-funded opposition of special-interest groups.
...
The second political impediment is the potential backlash to the cost
of single-payer, and how it will be financed.
...
Finally, as both Democrats and Republicans have now learned, once
people have health care coverage, they are sensitive about efforts
that might take it away or potentially diminish its quality. Today,
approximately half of the US population receives health coverage
through the workplace. If that coverage is replaced with a
single-payer system, workers will be vigilant about making sure
the new coverage is at least as good as what they had before.
Over time, there's no reason incrementalism can't get us all the way
to 100 percent coverage. Single-payer isn't the only route to that goal.
In the foreseeable future, the step-by-step approach is the strategy
progressives should pursue.
And it spends far, far less than the United States does. Yet
it achieves some outcomes Americans would find remarkable. Life
expectancy at birth is two to three years longer than in Britain or
the United States. Its infant mortality rate is among the lowest in
the world, about half that of the United States, and just over half
that of Britain, Australia, Canada and France. General mortality
rates are impressive compared with pretty much all other countries
as well.
...
Americans tend to think that they have a highly privatized health
system, but Singapore is arguably much more so. There, about
two-thirds of health care spending is private, and about one-third
is public. It's just about the opposite in the United States.
...
In other words, Singapore discovered that, as we've seen many
times before, the market sometimes fails in health care. When that
happened in Singapore, government officials got more involved. They
established the proportion of each type of ward hospitals had to
provide, they kept them from focusing too much on profits, and they
required approval to buy new, expensive technology.
Americans spend at least $3.2 trillion on health care each year.
That's well beyond any other country in total and per capita.
A great many factors feed the glut, but a primary contributor is
overtreatment. Unnecessary tests and procedures account for at least
$200 billion in spending every year.
...
The most cited reason for overtreatment was "fear of malpractice."
An astounding 84.7% of the responding physicians feared a lawsuit
if they didn't exercise every treatment precaution.
"Patient pressure/request" and "difficulty accessing prior medical records"
were the next most common reasons, at 59% and 38.2% respectively.
...
"Only 2-3% of patients harmed by negligence pursue litigation,
of whom about half receive compensation. Paid claims have declined
by nearly 50% in the last decade..." they wrote.
Also see How drug companies make you buy more medicine than you need.
Study compiling data from every country finds people are living longer but millions are eating wrong foods for their health.
Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes.
For men who are weighing the pros and cons of prostate cancer screening, a new study strengthens the evidence that testing can reduce deaths from this cancer, something two earlier large landmark clinical trials appeared to reach different conclusions about.
...
"I personally believe that results from models are less convincing
than data from actual clinical trials, so I doubt there's anything
here that would move the needle on PSA screening," said Dr. Kenneth Lin,
an associate professor of family medicine at Georgetown University
Medical Center.