Healthcare

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PARADIGM

BLOOD PRESSURE

Hypertension (or high blood pressure) is a recipe for premature death.[1]

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  1. In the randomized controlled intervention studies, conducted in obese hypertensive patients [56 years and older] and reviewed in the present meta-analysis, a decrease in body weight by 1 kg resulted in a reduction of systolic and diastolic pressure by 1.2 and 1.0 mmHg, respectively.[2]
    • In previous studies, a decrease in weight by 1kg resulted in a reduction in blood pressure by 3.4/1.3 mm Hg in hypertensive patients and in normotensive subjects the corresponding reductions averaged 1.4 mm Hg and 0.6 mm Hg for systolic and diastolic pressure, respectively.[3]

DIABETES

Diabetes is no fun.[4]

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DATA

Life expectancy across a selection of 'first-world' industrialized mixed economy countries.

Country Male Female Infant Mortality Child Mortality
United States of America 76.6 81.7 5.8 7.3
Great Britain 80.3 83.3 3.8 4.3
France 80.9 85.3 2.7 3.2
Italy 81.9 86.0 2.2 2.6
Sweden 81.7 85.0 1.7 2.1
  • Infant mortality means death of baby during childbirth, per 1000 births.
  • Child mortality means deaths of children between birth and 5 years of age, per 1000.

FOR-PROFIT AND PUBLIC HEALTHCARE

American innovation versus European public service?

Healthcare in the United States, leaving aside issues like insurance companies refusing cover (many patients get treated anyway), is an objectively higher cost per capita than any other developed country. Part of that is big pharma and other providers of medical goods/service charging high, for maximum profit. Partly it’s because gov’t provision needs to level the elderly playing field so they get the same quality of care as younger Americans using regular insurance; and this is expensive, for the reason prior.

American doctor and hospital standards are mostly very good, on a par or better equipped than other developed countries with nationalized healthcare.

America’s enormous healthcare system and the billions of dollars annually passing from taxpayer to IRS to public spending (social security, Medicare, Medicaid) generate vast, largely stable profits for companies doing business in the industry. This is an incentive for competitive high standards as well as pharmaceutical research, biotech startups, drug development (expensive trials, patient safety testing, winning FDA approval).

Profit attracts innovation. Demand and liquidity is underwritten by gov’t money. The end result is a dynamic, creative healthcare service. For most Americans.

“For most Americans” is the key point of ideological divergence, if you boil away all the white noise of political rhetoric. “For most Americans” means the healthcare system doesn’t cover everyone. It means the excellent median quality of care deteriorates closer to the bottom (poor) demographics. It means ‘can we profit?’ is part of the decision-making process on the provision of care, made by insurance companies trying to do the best possible job for their shareholders. Insurance has a systemic resistance to paying out; and this is entirely legitimate given its business model.

Most of the cost of healthcare across a country’s population comes from providing medical treatment for chronic conditions, terminal (or major life-threatening) illness, the working poor, and the growing elderly demographic. Millions slip through gaps in the system and live uninsured, praying for good health rather than visiting a doctor when sick.

In a nationalized healthcare system, the government foots the bill for these unprofitable sections of society, spreading the burden across the entire population.

American government picks up much of this slack, Medicare and Medicaid covering most of the old and much of the poor patient demand. It pays hundreds of billions of dollars a year, of taxpayer money, to maintain these programs.

By having government – or nobody – bearing the cost of the unprofitable sections of society, insurance, and medical providers exist in the majority space of “most Americans” from whom it’s possible to make their profit. The American healthcare system’s hard-edged government-corporate partnership is an effective way to manage a nation’s medical system while also allowing profit and removing risk to business by public spending to cover the unprofitable demographics. It’s a complex picture.

Whether or not this big capital cabal is better – in America – than a more socialized healthcare system, is open to debate. What is objectively true, however, is the United States has an excellent doctor, hospital, research, and medical services network, for the top half of society. Quality drops but remains good for much of the lower half. The rest – some 20-30 million Americans – have little or no coverage and bad healthcare.

To date the corporate-government model has been the choice of the American establishment and, for the most part, it’s a choice supported by the majority of its citizens. The ethical question of universal healthcare – to each according to need – is quite rightly an ongoing debate. It won’t help Democratic Party progressive ambitions to simply dismiss the current pro-capitalist big capital system. Evidence of the latter’s effectiveness, for most Americans, is as plain as a Bulgarian centerfold.