Rich Americans Live Up To 15 Years Longer Than Poor Peers, Studies Find

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Above Photo: Wealthy Americans can expect to live 15 years longer than poor peers, studies in the Lancet find. Photograph: Ariel Skelley

Health insurance system – the most expensive in the world – is worsening situation, researchers find, arguing healthcare should be treated as human right

You can’t buy time – except, it seems, in America.

Increasing inequality means wealthy Americans can now expect to live up to 15 years longer than their poor counterparts, reports in the British medical journal the Lancet have found.

Researchers said these disparities appear to be worsened by the American health system itself, which relies on for-profit insurance companies, and is the most expensive in the world.

Their conclusion? Treat healthcare as a human right.

“Healthcare is not a commodity,” wrote US Senator Bernie Sanders in an opinion article introducing the issue of the journal, which is devoted to inequality in American healthcare. “The goal of a healthcare system should be to keep people well, not to make stockholders rich. The USA has the most expensive, bureaucratic, wasteful, and ineffective healthcare system in the world.”

Sanders, like authors of the lead report, called for single-payer health insurance or what Americans might know as “Medicare for all”, a reference to an existing public health program for older Americans.

“Making sure that every citizen has the right to childcare, healthcare, a college education, and secure retirement is not a radical idea. It is as American as apple pie,” he said.

The Lancet studies looked at how the American health system affects inequality and structural racism, and how mass incarceration and the Affordable Care Act (ACA), also known as Obamacare, have changed public health.

Among the studies’ key findings: the richest 1% live up to 15 years longer than the poorest 1%; the same gap in life expectancy widened in recent decades, making poverty a powerful indicator for death; more than one-third of low-income Americans avoid medical care because of costs (compared to 7% in Canada and 1% in the UK); the poorest fifth of Americans pay twice as much for healthcare as a share of income (6% for the poor, versus 3.2% for the rich); and life expectancy would have grown 51.1% more from 1983 to 2005 had mass incarceration not accelerated in the mid-1980s.

The poorest Americans have suffered in particular, with life expectancies falling in some groups even while medicine has advanced. For example, researchers reported that the poorest fifth of women born between 1930 and 1960 statistically lived four years less than Americans in the top fifth of the socioeconomic spectrum.

All of these health outcomes arrive in the context of widening general inequality. The share of total income going to the top 1% of earners has more than doubled since 1970, making the US more unequal than all but three developed countries: Chile, Mexico and Turkey.

At the same time, the ACA brought relief to many. The number of Americans without insurance dropped from 48.6 million in 2010 to 28.6 million in 2015. The number of Americans who struggle with medical bills dropped from 41% to 35% in 2014.

Further, accounting for current public health insurance programs, military healthcare, the portion of local and state budgets used to purchase private health insurance for workers, and subsidies to employers to buy workers health insurance, researchers believe as much as 65% of health insurance nationally is already paid for by taxpayers.

The conclusions come at a tumultuous time for American healthcare.

Donald Trump’s election threw his predecessor’s market-based health laws into question. Trump promised multiple times on the campaign trail to repeal the ACA and replace it with “something terrific”.

Though Barack Obama’s signature health law insured more Americans than ever before, problems remain.

Insurance companies have increasingly passed costs on to consumers through “cost-sharing”, or asking Americans to pay more for doctor’s visits, prescription drugs and procedures before insurance kicks in. Sky-high prescription drug prices have prompted public outrage. And a requirement that Americans purchase insurance, even with government subsidies, was politically toxic.

Though Republicans promised for more than seven years to repeal the ACA – if they could only gain control of the federal government – once Trump took office, they offered a plan not conservative enough for conservatives, and not moderate enough for moderates. With an abysmal public approval rating of just 17%, the plan combusted weeks after it was introduced. Failure to pass the bill became a major loss for the Trump administration.

That has left a vacuum of ideas. Republicans tried and failed to resurrect a version of the hated plan this week. Progressives have expressed hope that single-payer reform could move into the forefront.

“I, like many others, was deeply concerned with Republican proposals that went down in flames,” said Dr David Himmelstein, a New York City doctor and co-founder of Physicians for a National Health Program, a group that lobbies for single-payer health reform. Himmelstein was also the author of one Lancet report, America: Equity and Equality in Health.

“It would have been tremendously damaging to large numbers of people in our country. So the defeat of that proposal was encouraging,” he said.

“It’s opened up much more room for debate about what there should be, so in that way, I think it’s an encouraging time that has perils but also opportunities.”

However, single-payer healthcare remains unpopular with American conservatives, who still control the government.

Robert Moffit, a researcher at the conservative thinktank the Heritage Foundation, argued that Americans would use healthcare willy-nilly if it were provided by the government.

“I mean look – you can save money with a single-payer system, don’t misunderstand me, but the quality and supply of medical services is going to be determined by government officials,” he said.

“You’re going to have inequalities in any state,” he said, calling it it “naive” to believe a “government-run system that is going to ultimately be highly politicized” would be better than a private one.

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  • DHFabian

    The public discussion for years has excluded America’s truly poor, making efforts to discuss this issue today particularly difficult. The mainstream see an inequality problem, yet remain unaware of our poverty crisis.

    It really isn’t so difficult to understand. The US shipped out a huge number of jobs since the 1980s, and ended actual welfare aid in the 1990s. Not everyone can work (health, etc.) and there aren’t jobs for all. The last I heard (some years ago), there are 7 jobs for every 10 jobless people who still have the means to pursue one (home address, phone, etc.). People can read these statistics, yet insist that “there is no excuse” for being jobless. The number of people who have lost everything, with no way back up, has only grown. Meanwhile, the overall life expectancy of the US poor has fallen below that of every developed nation.

    People say that the only solution is to continue to call for jobs, as we’ve been doing for decades. This translates into corporate tax cuts every year, hoping they will use some of that money for job creation, with some of those jobs eventually trickling down to the poor. This strategy has been a grotesque failure. People need food and shelter today, not promises of eventual jobs. This would require moving a fraction of our current war and prisons budgets into aid for our jobless poor. This would require a public discussion that Americans are unwilling to have.

  • chetdude

    “Robert Moffit, a researcher at the conservative ‘think’ tank the Heritage Foundation”

    Has a set of deeply warped defects:

    A) Is biased toward Big Business to keep his job
    B) Knows NOTHING about how Health Care works better and cheaper in civilized countries.
    C) Knows NOTHING about human psychology — “overusing” Health Care, being poked, prodded, impaled, cut up and drugged are not exactly sh*t that people line up for…

    HR676 – Health Care is a Right…

  • tsyganka

    Moffit is a reich-winger with no regard for human life if it isn’t the life of an obscenely rich person. He’s also another one of those idiots who recommend “bootstraps” to people who have to Eat their boots to survive.

    Medicare is one of our most efficiently run and cost-effective programs. Most people who have it are Satisfied with it. I know I am. The “quality and supply of medical services” from Medicare are superior to the ones I had before I became old enough to get Medicare.

    As to Moffitt’s whining about the “quality and supply” being “determined by government officials,” the main problems with Medicare are 1) the medical establishment itself sets biased codes for particular services, thus making lucre for the AMA, Big Pharma, and the insurance sharks; and 2) the restriction on negotiating medicine prices.

    Moffitt is full of it. Privatization – for-profit BizNiss – ALWAYS raises prices and lowers quality, no matter whether the privatization is in healthcare, education, utilities, prisons, or whatever.

  • tsyganka

    Something omitted from the article is that poor people (not rich people) live next to disease-causing coal slurries, pet coke, fracking, pipelines, chemical plants, etc. and pollution and contaminated water in general. This is because immoral capitalists lie and harass impoverished people, buy right-of-ways through hereditary property at below market price, or use eminent domain or civil forfeiture to simply steal it, whereas the obscenely wealthy aren’t subjected to such harassment and theft. The rich can always move to better pastures; the poor can”t.

  • chetdude

    I have Medicare.

    It’s better than the nothing that I had during half of the years I worked before age 65.

    It’s NOT better than the Cadillac plan I had at a couple of employers back in the 60s through early 80s before the sick care industry went full-on corporate and became wholly owned subsidiaries of the lawyers and bean counters of massive corporate “medical centers”, the AMA and the drug pushers of Big PhRMA. Back when most “health insurance” was from non-profits…

    Thanks to a loophole in the system, my Medicare provider was able to terminate my “plan”, re-label the same coverage and jump my premium by SIXTY PERCENT this year.

    Thanks to the corporate-funded duopoly that writes the laws, USAmerican Medicare is the worst, most punitive implementation of single-payer on the Planet…

    We need Medicare for All but we need SUBSTANTIALLY improved Medicare for All with the power to reform the corporate delivery system into a Health Care system as well…

  • tsyganka

    YES. – And Medicare for All bills have been introduced in both chambers of Congress. I hope an ultimate resolution will have the Appropriate way of funding it – which is to remove the contribution cap and tax the SNOT out of the rich. Tax them and their corporations; and most of all, put a transaction fee on every share of stock that’s traded. As far as I’m concerned, no other funding method is appropriate. Negotiation of drug prices is also a must, as is the inclusion of alternative/complementary care and treatments. The AMA (coding procedures especially), Big Pharma, and the insurance sharks must be curbed. Privatized for-profit entities interfere with good healthcare.