Via STAT: Republicans' health care plan will worsen inequality in America. Excerpt:
The Republican Party clarified its vision for post-Obamacare health coverage Monday afternoon as Speaker Paul Ryan released a draft bill. Hidden in plain sight among the details is the reality that this plan would further widen the fissures that exist not only in our health system but in our society at large.
The United States spends more money on health care than any other country in the world yet it doesn’t achieve anywhere near the best possible outcomes for its citizens. It’s true that some Americans live long healthy lives, much like those residing in the healthiest countries in the world, such as Japan and Sweden. The average lifespan of women in Fairfax, Va., right outside Washington D.C., is 85 years — three years longer than the average for women in the United States. But just 350 miles away, in McDowell County, W.Va., the average woman lives just 72 years. The gap is even wider for men.
And there are many Americans whose life expectancies are even lower than people living in developing countries such as Algeria and Bangladesh. In fact, a recent report in the Lancet showed that the overall life expectancy of Americans might soon be on par with people living in Mexico and the Czech Republic.
The reason for such large differences is that even though America appears to be one country, from an epidemiological point of view it is in fact two: the America that poor people live in is very different from the America the rich live in. Affluent Americans tend to live longer, healthier lives than poor Americans.
Take heart attacks as an example of this disparity. In research that several colleagues and I recently published, poor Americans are less likely to be prescribed lifesaving drugs such as cholesterol-lowering statins to prevent heart attacks. Such stark disparities also occur at the end of life. Despite a widespread desire to be able to take one’s last breath at home, Americans who are poor are much less likely to die at home than people who are affluent.
The American health system has not alleviated these stark differences in the health of the rich and the poor. Instead, it has exacerbated them over the past few decades. Inequities in income have such a stark effect on health in the US that they alone are the reason more than 80 percent of US counties have fallen behind in life expectancy compared to international standards.