Our Life Expectancy Falls: Lack of Medicare for All a Factor ignored in mainstream press, California goes big

Although the U.S. health care system is among the best in the world, Americans suffer from what experts have called “the U.S. health disadvantage,” an amalgam of influences that erode well-being... These include a fragmented, profit-driven health care system; poor diet and a lack of physical activity; and pervasive risk factors such as smoking, widespread access to guns, poverty and pollution. The problems are compounded for marginalized groups by racism and segregation... The result is a high disease burden among Americans, and shorter life expectancy compared with that in comparable high-income nations over the last two decades, NYT

Saturday, Sept. 3, 2022

Norm's Key Takeaways:

• Our lowered longevity rate is due to our mostly privatized healthcare system.
• Medicare recipients who take advantage of it are probably the best cared for population and a reason for rising life expectancy in the over 65 - the drop is connected to the younger population.. especially due to drugs. Regular visits to a doctor are crucial and not everyone makes it a habit.
• A medicare for all system with control of drug prices would reverse things and lead to a rise in overall health and life expectancy. In areas with sparse medical coverage, privatized Medicare Advantage plans are often the only option - and some report decent care - if you don't get real sick.
• In the current political climate only a state by state approach will bring us a universal system. The blue states are the most likely. California was close to passing a bill and so has NYS - but the unions are an obstacle. They shouldn't be.
• The UFT and other unions should stop opposing the NY Health Act which would bring such a system to our state. Our union claims to support the concept but says only in a national system, which the chances of happening are nil.
• Medicare for all costs too much both parties say but billions for Ukraine, useless visits to the moon and defense -- no one says a peep except those on the left.

See: Labor Campaign for Single payer

California and Newsome is embracing a muscular role for government, contrasting the Clinton/Obama neoliberalism - a new left alternative to neoliberalism in the Dem party.

Even Biden in some ways has moved away from neolib. More like tiptoed. 

UPDATED BELOW

I've been on Medicare for almost 13 years and attribute my relatively good health to my ability to engage in preventive medicine. The article below points to the drastic drop in life expectancy in this country for the first time in a 100 years - since the 1919 Spanish flu. Yes, Covid has been a factor -- but also the number of deaths due to Covid is related to poor medical care, its high costs - for non-insured and even insured -- and yes the fact healthcare is privatized and profit making, leading to high salaries, advertising costs (Joe Namath ads), high admin costs, a less competent work force, etc. is a major reason we pay double than any other nation in the industrialized world - most of which has some form of a universal system.

But once you reach 65, you have access to Medicare, a government managed system that is better run with less expenses than any of the privatized systems. (I know due to my wife working for a major hospital with all the insurance companies and became a medicare for all supporter 40 years ago due to that work where she found Medicare the most competent and efficient.) It covers 80% of the costs and we need some system to cover the other 20%. UFT retirees get that 20% coverage through SeniorCare at a minimal cost. We all do pay monthly medicare costs out of social security - and through our working life we put money into Medicare. Medicare sets the prices it pays to hospitals and doctors and 98% accept it though they submit outrageous bills. Ie. I had pic lines put in at NYU for a bad infection - it was serious work - 3 people working on it for about an hour - so I can see it is not cheap. NUY submitted a bill to Medicare for $15,000. Medicare paid $650.

I feel reasonably healthy and believe in preventative medicine. 

I've had reason to use the medical system a lot over the past dozen years. Achilles, Broken wrist, a few bad infections, a few short bouts in the hospital, a turp on the prostate -- I know, too much information -- but I feel confident in the system. Which was why so many of us reacted so strongly emotionally at the threat of Mulgrewcare -- even if he was right -- he ignored the threat we felt. 

And by the way, we are still under threat of being forced into a MedAdv plan as Adams and Mulgrew partner up.

Of course the key is finding good docs you trust. Many of our friends use the primary doc we've been using for 30 years - we love him but it looks like he's heading for retirement. Talk about insecurity we all feel. He practices practical medicine - he has told me I sent all my commie friends to him - and he loves it.

I can see where there is waste in Medicare and the inability to negotiate for drugs leads to much higher costs -- even the new bill signed will not do as much as they claim. But fundamentally, both political parties have been trying to kill Medicare and move to the privatized MedAdv system for 30 years. A government controlled system has the capability and potential to set prices - though the lobbyists get to influence decisions and they are winning the battle to put a dagger into Medicare as 50% are in MedAdv and its growing -- with the Biden admin helping the privatizers. They are happy to force costs for medicare up so they can argue it's too expensive and then once it's gone it's Katy Bar the door -- the same with the charter argument -- let's kill public ed and then once unions are gone, drive down teacher salaries where they can - make us all like red states.

This month and next I have an ENT, dermatologist, podiatrist, cardiologist, urologist and my regular checkup. I do teeth every 6 months even though not covered. I do a hearing test every few years. Eyes every year for sure -  my dad had wet macular so I monitor things. Medicare covers my visits. GHI picks up the rest. Mulgrewcare would have taken me out of traditional medicare and put me in a 100% system of coverage. I and others just don't feel safe going there -- even though I know UFT retirees who chose a managed system on retiring and are happy - so far.

I did the gastro thing last year - both colonoscopy and endoscopy - they go in both ways at the same time. Most people I speak to never consider the latter. Years ago I was told by my doc that chronic heartburn can lead to cancer and the gastro guy explained to me how that can happen, so I've done a few. I was told by some I was going overboard.  Then two years ago a close friend with chronic heart burn found out he had stage 4 esophageal cancer. He died a few months later. I raced to get a test but I wasn't eligible for another year but the doc looked at the photos of my last one and assured me there were no signs. That cancer can be spotted early on with a regular endoscopy. Should everyone get one? If tums works ok on your heartburn maybe not. Who knows - but my friend's 4 months of hell cost the system a million bucks. Better safe than sorry.

I do not have a heart condition, though my dad had one and died of a heart attack - at 94. I'll take it. In a few weeks I will be seeing my cardiologist, who I see every 6 months. My primary care doc, who I see once a year for a regular checkup - unless I am sick or injured -  doesn't feel I need a cardiologist and is somewhat skeptical of the tests he does to monitor my heart. He feels just taking a statin every day helps keep my arteries clear. I wasn't taking statins when a simple carotid artery check showed signs of "schmutz" as my doctor terms it - and I immediately began to take the statin. I still have schmutz in my neck but it's under control. The cardiologist told me that the simple test is 88% predictive of a blockage in the heart. I also think it worth doing a stress test every few years at my age. Is the doc gaming the system with these tests? Maybe. I may only go once a year.

I love my docs - even though my great ENT guy is retiring and I'm seeing him for the last time this week. I especially love the old docs in my generation. 

My wife who was in the medical field doesn't do as much preventive medicine as I do. After working with them for most of her life, she may be allergic to doctors. 

Here's the NYT article: 

U.S. Life Expectancy Falls Again in ‘Historic’ Setback

The decline during the pandemic is the sharpest in nearly 100 years, hitting Native American and Alaska Native communities particularly hard.

https://www.nytimes.com/2022/08/31/health/life-expectancy-covid-pandemic.html

While other high-income countries were also hard hit in 2020, the first year of the pandemic, most had begun to recover by last year, he said.

“None of them experienced a continuing fall in life expectancy like the U.S. did, and a good number of them saw life expectancy start inching back to normal,” Dr. Woolf said.

Those countries had more successful vaccination campaigns and populations that were more willing to take behavioral measures to prevent infections, such as wearing masks, he said, adding: “The U.S. is clearly an outlier.”

It was the largest reduction in life expectancy in the United States over the course of a two-year period since the early 1920s, when life expectancy fell to 57.2 in 1923. That drop-off may have been related to high unemployment and suicide rates during an earlier recession, as well as a steep increase in mortality among nonwhite men and women.

Although the U.S. health care system is among the best in the world, Americans suffer from what experts have called “the U.S. health disadvantage,” an amalgam of influences that erode well-being, Dr. Woolf said.

These include a fragmented, profit-driven health care system; poor diet and a lack of physical activity; and pervasive risk factors such as smoking, widespread access to guns, poverty and pollution. The problems are compounded for marginalized groups by racism and segregation, he added.

The result is a high disease burden among Americans, and shorter life expectancy compared with that in comparable high-income nations over the last two decades, Dr. Woolf said.