U.S. Life Expectancy Has Not Yet Recovered From COVID

 

Our Inequality Is Causing A Shorter Life Span For Many

The following is part of a thought-provoking post is by Robert Reich:

I want to examine a root that hasn’t gotten nearly the attention it deserves: the remarkable reversal in life expectancy among those without college degrees, many of whom comprise Trump’s base.

In 1900, U.S. life expectancy was 47 years. Infectious diseases routinely claimed babies. Women died in childbirth or from complications arising from childbirth. Many diseases were incurable.

Then came antibiotics, insulin, vaccines, the surgeon general’s report on smoking and cancer — followed by a sharp drop in smoking, the introduction of CT scans and MRIs, and steady improvements in sanitation and water supplies. Poverty and sickness in the elderly were eased by Social Security and Medicare.

Life expectancy in America soared. By 2010, it was approaching 80 years. 

But then something happened — and it happened even before COVID. Life expectancy for most Americans reversed course. 

Why?

Research by economists Anne Case and Angus Deaton shows that life expectancy did not reverse course for the 30 percent of Americans with four-year college degrees. 

It reversed for people without college degrees. 

Life expectancy for those with four-year college degrees was 84 years on the eve of the pandemic — up from 79 years in 1992. During the pandemic, their life expectancy slipped a year.

But for those without college degrees, life expectancy has been falling since 2010.

 

In 2010, adult life expectancy for non-college graduates was nearly 77 years. By 2021, it had dropped to under 75 years. (And during the pandemic, their life expectancy dropped 3.3 years.)

Why does this widening gap in life expectancy correlate with whether someone has a four-year college education? 

Because Americans with college degrees have become far wealthier, on average, while those without college degrees have become poorer and less economically secure.

 

In 1990, America’s total wealth was equally split between those with and without college degrees. Today, three-quarters of wealth is owned by college graduates.

Meanwhile, the wages of people without college degrees have stagnated or declined. Average weekly nonsupervisory wages — a measure of blue-collar, non-college earnings — were higher in 1969 (adjusted for inflation) than they are now.

Most Americans without college degrees are now working harder and longer hours than they worked decades ago and taking fewer sick days or vacations. They also have less economic security. Nearly one out of every five American workers is in a part-time job. Two-thirds are living paycheck to paycheck.

 

Income and wealth have direct impacts on health and longevity. They determine access to life-supporting services like high-quality preventive health care, nutritious food, and housing. 

And they have a lot to do with whether someone is subject to life-threatening things like handguns, opioids, and economic stress.

Other developed countries — Japan, Canada, most European countries — have not experienced declining life expectancies among non-college graduates or a widening gap in lifespans between those with four-year college degrees and those without them. 

Why this discrepancy among developed nations?

 

Because other developed nations have stronger and more generous social safety nets. They finance their much less costly health care through government support rather than through what is essentially a flat tax on employment (employer payments for health insurance are effectively taken out of a worker’s salary).

 

And because a far higher percentage of non-college workers in other developed nations are organized into unions that have successfully pushed for higher wages and have enough political clout to resist efforts to erode the safety nets they count on.

Social and economic trends in the United States have fostered an increasingly angry and frustrated working class, highly susceptible to the resentments and grievances of Trumpism.

 

Americans who for decades have been on a downward economic escalator have become easy prey for demagogues peddling the politics of hate.

Life Is Tenuous

Sometimes we forget just how tenuous life can be. Most of us expect to live to a ripe old age and don't really consider the possibility that it might not happen. But life is not fair and is no respecter of persons. It can end in a heartbeat. This odd story brings that fact home.

Taylor Mitchell was a young Canadian folk singer with a bright future ahead of her. Although she had just turned nineteen, she had already been nominated for a Canadian folk music award and her career seemed to be taking off. All of that ended with a walk through a national park.

Mitchell was taking a solitary walk through the Cape Breton Highlands National Park in Nova Scotia when she was attacked by a pair of coyotes. Other visitors heard her screams and notified park rangers. Rangers said the coyotes were "extremely agressive" and they shot and killed one of them. They are still hunting for the other.

It is extremely rare for coyotes to attack a human. I grew up in the country listening to the night howling of coyotes, but it was rare to even see one. They are afraid of humans and will usually run away before a human can even get close to them. They live by killing small animals like rabbits or scavenging on the leftovers from other animals' kills (or roadkill).

But in spite of the extreme rarity, the attack happened. The young singer was airlifted to a hospital in Halifax where she died on Wednesday. In an instant, a young life and possibly brilliant career were over.

This should serve as an example to us all. Maybe we will live to be cranky old men and women. And maybe it will end tomorrow. No one knows.

U.S. Is 50th In Life Expectancy

Republicans are quick to claim that the United States has the best health care system in the world. It should be the best, because it is the most expensive. The United States spends more for health care than any other country in the world. But "most expensive" and "best" are two different things.

While the U.S. system is undoubtedly the most expensive, there is one little statistic that shows it is far from the best. The fact is that the United States ranks a very poor 50th in life expectancy for its citizens. Let me repeat that. While life expectancy is 78.1 years for U.S. citizens, there are 49 countries where the life expectancy is longer.

How can it be that 49 countries have a longer life expectancy, if we supposedly have the "best" health care system in the world? It is because our system is the best only for the rich. If you have the money to purchase the best insurance possible, and the money to pay for the medical bills that insurance won't cover, then the U.S. health care system is great. But what about the other 95% of the population?

The other 95% of the population is in trouble (although many of them don't know it yet, because they are healthy right now). We know that around 41 million people don't have any health insurance at all. Their problem is obvious to everyone.

But there is a much larger group of working and middle class families who have insurance through their work. These people are one layoff away from having no insurance themselves. They are also in for a shock when they need to use that private insurance and they find out how much it does NOT cover (62% of bankruptcies in the U.S. are dues to medical bills and 75% of those people had insurance). They can also find their insurance has been cancelled once the medical bills start climbing.

That's because health insurance companies are in business to make money -- not to pay medical bills. The more medical bills they can avoid paying, the larger their profits. In fact, the insurance company employees who deny the most claims (medical bills) are the ones who get the biggest bonuses. The reason our country is 50th in life expectancy is because the private insurance companies are more concerned with maximizing profits than with patient health.

But there is an interesting fact about the 49 countries with a longer life expectancy. They have a public (government-run) health insurance system. In most of those systems (like France or Canada), every citizen can choose their own doctor and hospital, and no one has to declare bankruptcy because of unpaid medical bills -- because those public insurance systems pay for whatever treatment the doctor says is needed.

Harvey Brenner, professor of public health at the University of North Texas Health Science Center and Johns Hopkins University, says, "What we are able to find in the industrialized world is that life expectancy will be influenced in a beneficial manner to the extent that health care expenditure is publicly financed."

That's because in countries where patients must pay a large part of their own medical bills, they tend to wait until their medical problems are serious before consulting a doctor. These countries (including the U.S.) also put less emphasis on preventative care.

The conservative American Enterprise Institute disagrees that public insurance is the reason for the longer life expectancy. They say the life expectancy is determined by having high economic growth and per capita income levels. That's a silly argument. Are they saying there are 49 countries with a higher economic growth and per capita income than the United States? No one, even a conservative, could really believe that!

The truth is that economic growth and high per capita income are spurred upwards by a healthy workforce. So while the American economic engine is among the best in the world, it could be even better with a public health insurance system producing healthier workers. It would also be helped by the fact that American companies would be able to compete with foreign companies easier, because they wouldn't have to pay the high private insurance costs of their workers (even if they paid for part of a public insurance system, it would be much cheaper than current rates).

There are only two groups that would not benefit from a public (government-run single-payer) health insurance system -- the richest 1-5% of U.S. citizens and the insurance companies. For everyone else public insurance would be better. It would:

* cover the 41 million Americans currently without insurance.

* protect the middle class from bankruptcy because of huge medical bills.

* Give workers continuing insurance coverage even when switching jobs or being laid off.

* save small businesses and corporations money in covering their employees and provide them with healthier workers.

* save money by cutting out the huge profits and high overhead (see chart above) of insurance companies.

* allow every citizen to choose their own doctor and hospital.

* let doctors determine medical treatment instead of insurance companies.

* put more emphasis on preventative medical care.

* increase the life expectancy of all citizens.

Do you really want an insurance company restricting your choice of doctor or hospital, or determining what kind of medical treatment you can receive? Do you want your insurance to disappear if you lose your job or your medical bills get too high? Do you want an insurance company employee to get a huge bonus for denying your medical claim?

If not, then make sure your senator and representative know that health care reform must include a public insurance option? If it doesn't, it will be little more than a huge payday for private insurance companies, and it won't solve the problems in our health care system.