Opinion | The American Health Care Industry Is Killing People – The New York Times

These costs are significantly higher than in most other wealthy countries. One study on health care data from 1999 showed that each American paid about $1,059 per year just in overhead costs for health care; in Canada, the per capita cost was $307. Those figures are likely much higher today.

Wouldn’t lowering overhead costs be an obviously positive outcome?

Ah, but there’s the rub: All this overspending creates a lot of employment — and moving toward a more efficient and equitable health care system will inevitably mean getting rid of many administrative jobs. One study suggests that about 1.8 million jobs would be rendered unnecessary if America adopted a public health care financing system.

So what if some of these jobs involve debt collection, claims denial, aggressive legal action or are otherwise punitive, cruel or simply morally indefensible in a society that can clearly afford to provide high-quality health care to everyone? Jobs are jobs, folks, as Joe Biden might say.

Indeed, that’s exactly what Biden’s presidential campaign is saying about the Medicare for all plans that Senators Elizabeth Warren and Bernie Sanders are proposing: They “will not only cost 160 million Americans their private health coverage and force tax increases on the middle class, but it would also kill almost two million jobs,” a Biden campaign official warned recently.

Note the word “kill” in the statement. That word might better describe not what could happen to jobs under Medicare for all but what the health care industry is doing to many Americans today.

Last week, the medical journal JAMA published a comprehensive study examining the cause of a remarkably grim statistic about our national well-being. From 1959 to 2010, life expectancy in the United States and in other wealthy countries around the world climbed. Then, in 2014, American life expectancy began to fall, while it continued to rise elsewhere.

What caused the American decline? Researchers identified a number of potential factors, including tobacco use, obesity and psychological stress, but two of the leading causes can be pinned directly on the peculiarities and dysfunctions of American health care.

The first is the opioid epidemic, whose rise can be traced to the release, in 1996, of the prescription pain drug OxyContin. In the public narrative, much of the blame for the epidemic has been cast on the Sackler family, whose firm, Purdue Pharma, created OxyContin and pushed for its widespread use. But research has shown that the Sacklers exploited aberrant incentives in American health care.

Purdue courted doctors, patient groups and insurers to convince the medical establishment that OxyContin was a novel type of opioid that was less addictive and less prone to abuse. The company had little scientific evidence to make that claim, but much of the health care industry bought into it, and OxyContin prescriptions soared. The rush to prescribe opioids was fueled by business incentives created by the health care industry — for Purdue, for many doctors and for insurance companies, treating widespread conditions like back pain with pills rather than physical therapy was simply better for the bottom line.

Opioid addiction isn’t the only factor contributing to rising American mortality rates. The problem is more pervasive, having to do with an overall lack of quality health care. The JAMA report points out that death rates have climbed most for middle-age adults, who — unlike retirees and many children — are not usually covered by government-run health care services and thus have less access to affordable health care.

The researchers write that “countries with higher life expectancy outperform the United States in providing universal access to health care” and in “removing costs as a barrier to care.” In America, by contrast, cost is a key barrier. A study published last year in The American Journal of Medicine found that of the nearly 10 million Americans given diagnoses of cancer between 2000 and 2012, 42 percent were forced to drain all of their assets in order to pay for care.

The politics of Medicare for all are perilous. Understandably so: If you’re one of the millions of Americans who loves your doctor and your insurance company, or who works in the health care field, I can see why you would be fearful of wholesale change.

But it’s wise to remember that it’s not just your own health and happiness that counts. The health care industry is failing much of the country. Many of your fellow citizens are literally dying early because of its failures. “I got mine!” is not a good enough argument to maintain the dismal status quo.

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