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The High Cost of Health Care Is Stealing Years of Life From Poor Americans

Mother Jones

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According to a new series of studies in The Lancet, the United States risks a “21st century health-poverty trap” if it does not address low-income Americans’ growing inability to access or afford quality health care. The five papers published today in the British medical journal describe how the high cost of health care is intensifying the widening gap between the rich and poor and issue a call for a single-payer health care system.

The studies highlight several alarming trends: America’s richest 1 percent live more than a decade longer on average than the poorest Americans; 40 percent of poor Americans skip going to the doctor because they can’t afford to; the neediest 20 percent of Americans spend almost twice what the richest 20 percent Americans spend on private health insurance; and 1 out of every 10 households facing high medical costs declares bankruptcy, even after the implementation of Obamacare.

“We are witnessing a slow-moving disaster unfolding for the health of lower-income Americans who have spent their working lives in a period of rising income inequalities,” says Dr. Jacob Bor, an assistant professor at the Boston University School of Public Health.

Some of the health effects of poverty documented in the studies are staggering. The average life expectancy rates of the poorest 5 percent Americans have not budged since 2001, despite gains by middle and high-income Americans, who can now expect to live an extra two years on average. Instead, entrenched poverty is elevating mortality rates: The wealthiest 1 percent now can expect to live 10 to 15 years longer than the poorest 1 percent of Americans.

The Lancet series kicks off with an introduction by Vermont Sen. Bernie Sanders calling for a single-payer health care system. “Health care is not a commodity. It is a human right,” he writes. “The goal of a health-care system should be to keep people well, not to make stockholders rich. The USA has the most expensive, bureaucratic, wasteful, and ineffective health-care system in the world.”

The studies also conclude that America would benefit from a single-payer health care system. Authors Dr. Adam Gaffney of the Cambridge Health Alliance and Dr. Danny McCormick of Harvard Medical School argue that offering comprehensive health coverage to all Americans would close the current gaps in access to health care: “A single-payer, Medicare-for-all reform—championed by Senator Bernie Sanders during his upstart presidential campaign, as well as by many physicians and the nation’s largest nurses union—would, in our view, best address health-care inequalities.”

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The High Cost of Health Care Is Stealing Years of Life From Poor Americans

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Here Are Your Chances of Getting an Antibiotic-Resistant Infection After Surgery

Mother Jones

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An eye-opening study published today in The Lancet Infectious Diseases medical journal shows just how many people acquire antibiotic-resistant infections after common procedures: Up to half of infections after surgery and a quarter of infections after chemotherapy are caused by resistant bacteria—meaning that they are significantly more difficult, if not impossible, to treat.

“A lot of common surgical procedures and cancer chemotherapy will be virtually impossible if antibiotic resistance is not tackled urgently,” said Dr. Ramanan Laxminarayan, a study co-author and director of the Center for Disease Dynamics, Economics, and Policy. “All of us at some point have to get a surgery or a root canal or a transplant, or perhaps go through chemo at some point in our lives. But how well these turn out depends on how well the antibiotics used to keep infections away during surgery work.”

Infections during and after surgeries and chemotherapy are common, so it is standard practice to give these patients antibiotics. But as the drugs are overused or misused, antibiotic resistance rates have risen. The Lancet authors conducted a meta-analysis of literature reviews on the efficacy of antibiotics after 10 of the most common surgeries in the United States. They found antibiotic-resistant bacteria to be causing 39 percent of infections after cesarean sections, 51 percent of infections after pacemaker implants, and 27 percent of infections after blood cancer chemotherapy.

If the efficacy of antibiotics drops 30 percent—a rate that the authors see as realistic given the current overuse of antibiotics—then infections from surgeries and chemotherapies could result in 120,000 more infections and 6,300 more infection-related deaths each year in the United States.

Dr. Laxminarayan suggests a multipronged solution to the problem: Doctors need to be trained on when (and when not) to prescribe antibiotics and how to minimize infections after common surgeries. Americans need to stay up to date on vaccines in order to reduce the need for antibiotics in the first place. If you’re getting surgery, he says, choose hospitals and surgeons with low infection rates—hospitals are required to publicly report these numbers in many states. (More from the Centers for Disease Control and Prevention, here).

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Here Are Your Chances of Getting an Antibiotic-Resistant Infection After Surgery

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Tell women about birth control that works — and they’ll choose birth control that works

Tell women about birth control that works — and they’ll choose birth control that works

By on 17 Jun 2015commentsShare

Straight from the “no shit” department: Counseling clients at family planning clinics about the proven effectiveness of contraceptive methods results in more clients choosing more effective methods, and in turn, reducing unintended pregnancy. Fancy that!

A study published today in The Lancet shows what happens when you provide training on effectiveness-based contraception counseling — which includes discussion of long-acting reversible contraceptives such as the IUD and hormonal implant, the most effective forms of birth control — to 20 Planned Parenthood clinics. After monitoring these clinics (and another 20 that did not receive the training), the study authors found a significant difference in contraception choices made.

From The Atlantic:

The results were striking: 71 percent of the providers who received the training discussed IUDs and implants with their patients, but just 39 percent of those in the control group did so.

In the intervention group, 28 percent of women ended up choosing IUDs or implants, compared with 17 percent in the control group. Among women who had gone to the Planned Parenthood for family-planning services, the effectiveness counseling reduced the rate of unintended pregnancies by half over the course of a year.

So — talk to women about birth control based on what actually, really, truly works, and they will choose birth control that actually, really, truly keeps them from getting pregnant when they don’t want to be.

The next step, obviously, is making said birth control more accessible. Baby steps — or should we say, no-baby steps.

Source:
An IUD in Every Uterus

, The Atlantic.

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Tell women about birth control that works — and they’ll choose birth control that works

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