A new study of mortality in 16 countries offers reasons why Americans are less healthy and die younger than people in other wealthy countries: We eat more poorly, get fatter and have less access to health care.
The 404-page report, done by the Institute of Medicine and the National Research Council also found that even though we are a so-called wealthy country, we have more people living in poverty.
In too many cases, out health care system contributes to that poverty.
We tallied up lower scores than these other nations on infant mortality, injury and homicide rates, teen pregnancy and sexually transmitted illnesses, HIV/AIDS, drug addiction, obesity and diabetes, heart disease, lung disease and disabilities.
So, what's the problem here?
Well, for one thing, out food supply is contaminated by chemicals and it's less nutritious than it could be because of our industrialized agriculture.
Why is it that many glucose-intolerant people can eat wheat in Europe but not here? It's because they're not reacting to the glucose but to something else -- likely some chemical we're adding that Europeans are not.
We add high fructose corn syrup to everything because it's cheaper than sugar, and our bodies do know the difference, despite what the corn industry's ads say. High fructose corn syrup is metabolized differently, leaving our bodies unable to use insulin the way they should, leading to a higher likelihood of type 2 diabetes. Corn sugar also makes our bodies feel hungrier, leading to overeating and obesity. The "epidemic" of obesity and diabetes began in the 1970s, which is exactly when we started using so much high fructose corn syrup in our food.
Americans spend less on food as a portion of our income than any other wealthy nation, but we get what we pay for -- lousy nutrition. These contaminated, compromised foods are what's making us sick, but we continue to belly up to fast food counters and wolf down the crap they dish out. We continue to eat processed food because it's more "convenient."
The food industry is as powerful as Wall Street when it comes to fending off regulation, so we have to be smarter consumers. We have to buy locally from small farms whenever we can, organic, when we can't get local. Know our farmers. Most places have tailgate markets and farmer's markets now. There's really no reason to eat antibiotic- and hormone-laden meats. Yes, local, humanely raised meat is more expensive, but what is your health worth? Eat less meat.
Our food system is leaving us open to so many illnesses and millions of us are lacking full access to health care. We get sick and fat and we either don't have insurance or our deductibles and co-pays are so high we can't get the care we need for our high blood pressure, high cholesterol and diabetes, so our condition gets worse until we have a heart attack or stroke, go into renal failure or lose a limb. Then we go deep into debt from the cost of crisis care. In right-to-work states, people lose their jobs because of illness, leaving them sick, in debt and uninsured.
Our poverty levels are only partly caused by health care costs, although that is a contributing factor. The real problem is that we are paid less than we were a generation or two ago. There has been a steady erosion of workers' wages and rights since 1980 as the power of unions has eroded. We work harder, make less and are less secure in our jobs than any time since the 1930s. As poorer people, we are less able to afford decent nutrition and we have less access to quality health care. We live in less safe neighborhoods and we are exposed to more dangerous pathogens because of the lack of food regulation.
Our children are at higher risk of STDs and teen pregnancy because rather than teach them about safe sex, we pretend they won't become sexually active until their wedding nights and they wind up pregnant or worse. We pretend that talking to them will make them want to experiment so they begin to experiment anyway with little or no education.
Overall, we're a mess and the causes are easy to identify but difficult to fix with our current political polarization and the control huge corporations have over our government.
We have to make the changes we can and lobby for changes at a higher level. We need real regulation of our food supply and real access to health care.
In 2009, the National Alliance on Mental Illness gave the United States a D in its overall efforts to provide care to people with mental illnesses. Things haven't improved much since then.
Suicide deaths in the military exceed combat deaths, but states continue to cut mental health services. More than half of the people in our jails have mental health issues. And although people with mental illnesses are not likely to harm others, if you give someone who can't reason ready access to guns, he or she is more likely to commit mayhem.
Still, "reform" efforts across the nation have eliminated hospital beds for people in crisis, Medicaid reimbursement rates are so low that most service providers can't afford to take on too many patients.
Starting in 2001, North Carolina began to "reform" its system "to offer consumers more choice." I cringe whenever I hear that phrase because it means privatization, and mental health care should never be left solely to the private sector.
People with severe and persistent mental illnesses need a lot of care, and they're not easy patients. If their illness is not well controlled, they might not even show up for appointments; they might stop taking their medications, in which case the illness will get worse.
Our system in North Carolina imploded. People were dying on the streets -- literally. And the state General Assembly is still looking to make more cuts.
The system is changing from a fee-for-service to block grants, which will total less than what was being spent. The money just isn't adequate, as our local management agency here in Asheville learned from experience.
So now, instead of reviewing cases every year, it is done every three months, which means four times the paperwork and four times the likelihood that a person's care will be reduced or terminated. Fewer care providers are willing to do this increased and unpaid work.
Instead of being an hour, sessions are now 45 minutes. You can still bill for an hour, but you will be reimbursed for only 45 minutes of your time.
More people are falling through the cracks and then turning up in jail or dead.
When NAMI revisited its national report card in 2011, the advocacy nonprofit found more cutbacks in states' systems.
The Affordable Care Act contains some strong advocacy for people with mental illnesses, including a mandate that insurance companies cover psychiatric care at the same level they do every other specialty. You can't charge a $50 copay for an endocrinologist and $75 for a psychiatrist. You can't allow 52 visits to a gastroenterologist but only 12 to a psychiatrist.
That's great for people who have insurance, but people with severe and persistent mental illness aren't likely to be able to hold down a job, and our health insurance in this country is tied to employment. Even after the Affordable Care Act takes full effect in 2014, most of us still will get our health insurance through our employers.
So, people with mental illnesses are left to fend for themselves. Some will have access to disability, but if they have been able to work for any length of time, they will only be eligible for SSD, which means they might lose Medicaid and not have access to Medicare for two years.
Some have sporadic employment and so will not be eligible for Medicaid, especially in states that refuse to expand Medicaid.
None of this makes any sense to me. It's so much more cost effective -- not to mention humane -- to treat this chronic illness properly.
But there still are people who believe we can all control our own brain chemistry and that someone with a mental illness is somehow morally deficient.
Many evangelical Christians believe people can and should pray the illness away, even though they would never say the same thing about asthma.
We as a society are punishing people for an illness over which they have no control, and it's costing us billions in lost productivity, in criminal justice dollars and
According to an article in Sunday's New York Times, health insurance companies are raising their rates by double digits again, despite the promise of some 30 million new customers in the coming year.
It's not big businesses that are getting hit with these 20-percent increases, but individual customers and small businesses; big companies are seeing rate increases of about 4 or 5 percent.
In California, where the request by Anthem Blue Cross Blue Shield to raise rates by 39 percent in 2010 helped put the Affordable Care Act over the top, companies once again are seeking rate increases of up to 26 percent.
Not all states are subject to the whims of Big Insurance, though. New York, for example, has a commission that must approve rate hikes, and insurance companies must prove they need the revenue to get the raise. So far, 37 states allow regulators to reject or reduce increases of 10 percent or more.
Under the Affordable Care Act, regulators are required to review any request for a rate increase of 10 percent or more; the requests are posted on the federal Web site,healthcare.gov, along with regulators’ evaluations.
Historically, Big Insurance has gotten its way almost every time it has wanted something. Its lobbyists were able to gut the plan for a public option in the Affordable Care Act, which would have made the industry face some competition.
Now, the industry has a monopoly with nowhere near enough regulation, and we the consumers have nowhere to turn if we're treated unfairly, overcharged, denied coverage.
Yes, the Affordable Care Act provides for appeals, but the states will set the specific rules for those appeals. In the law passed by the NC House in 2011, the consumer protections were minimal at best and the insurance company protections were strong as steel. Fortunately, that law never made it through the state Senate and North Carolina will partner with the federal government in its insurance marketplace.
The proposed NC law for its marketplace also allowed oversight of the Benefits Exchange by insurance companies and health care business associations, making the chances for successful challenges even tougher. It seems no one understands the meaning -- or the danger -- of conflict of interest anymore.
So, perhaps it's time to change tactics -- maybe we should start making a lot of noise about getting a public option added to the Affordable Care Act so we can have a real choice.
Let me buy into Medicare.
Let me escape the greedy grasp of the insurance companies.
Dear Gov. McCrory,
I didn't vote for you, partly because I didn't believe you were a moderate Republican. You can prove me wrong.
Soon now, you will announce whether North Carolina will expand Medicaid to about a half-million people in the state. The action won't cost the state a dime in the first three years, and then we'll pay just 10 percent of the cost each year after that.
I urge you to stand up to people who for ideological reasons alone would allow 500,000 people to be denied basic health care.
People who make less than 133 percent of the federal poverty level can't afford even the most basic care, so they don't get checkups and they can't manage chronic illnesses.
So, let's look at the logic here. If we deny them care, we will pay a whole lot more down the road as people show up in the emergency room in renal failure or with a massive stroke or heart attack, or with cancer that has progressed beyond the point of any hope for a cure.
People who don't have access to care are much sicker by the time anything is done for them, and by then it may be too late to save their lives.
That's what happened to my son, Governor. He couldn't get insurance because a birth defect was a pre-existing condition, and without it, he couldn't get the screening tests he needed. He got sick and he got sicker and was finally admitted to the hospital weighing just 110 pounds (he was 6 feet tall). He was so sick it took them five days to stabilize him, and his cancer was stage 3. He had to leave his wife to get Medicaid, and his chemo cost about $600,000. That's just the chemo, not the two surgeries, the radiation, the other medications and the loss of his tax revenues. So, by cheaping out on his care, we probably spent more than $1 million.
My son would be an attorney now, making decent money and paying his fair share in taxes.
Multiply that by 500,000 people, and I'm just talking about the financial cost.
How about the emotional cost? How about the cost to our souls as human beings?
Have you ever lost a child, especially one who shouldn't have died? I wished my own heart would stop when his did, and many days I still do.
You have the chance to save thousands of lives of people in this state. I know your buddy, Art Pope, is advising you to let those poor people fend for themselves, but I hold out hope that you have more character and compassion than that.
Make no mistake about it, Governor, we are talking about letting people die just to make a political point.
If that isn't evil, what is?