How can it be that pregnancy related deaths have doubled in the United States since 1990? I would point directly to the reduced access to affordable health care -- particularly in the lower income strata of the US population. [Recall that the US is the most expensive place on Earth to give birth. That itself is a crime, given the plainly sub-standard job we are doing of keeping moms and babies alive.]
But, no, all I'll now suggest -- is that Mr. Frazier is to be applauded for having the courage to talk openly about a national disgrace. And -- more importantly -- to do something about it. Something that is already working in Uganda and India. That alone should be a sobering call -- to those who still oppose health care reform. From Reuters, then, a bit:
. . . ."As Americans, we simply should not accept that 46 countries have lower rates" of reported maternal mortality, said Merck Chief Executive Ken Frazier. The fact that U.S. pregnancy-related deaths have nearly doubled since 1990 is "appalling" and "something we ought to be ashamed of," he said.
"Given how sophisticated medical care is in this country, I think most Americans would be astonished" that almost 900 women die each year as a result of pregnancy or childbirth and 50,000 have close calls, Frazier said. . . .
The U.S. drugmaker launched the $500 million global program in 2011 to reduce pregnancy-related deaths, focusing on India, Uganda and other poor countries with only rudimentary healthcare systems. . . .
However, pregnancy-related deaths in the United States have risen from 7.2 per 100,000 live births in 1987 to 17.8 per 100,000 in 2009 (the latest year with reliable data), according to the U.S. Centers for Disease Control and Prevention. The rate among African-American women is more than triple that of white women: 35.6 versus 11.7 deaths per 100,000 live births. . . .
I applaud the US roll-out of a great initiative; I cringe that we need it so desperately, here.
But, "No!" say the GOP. Meanwhile, take a look at this editorial in the NYTimes:
ReplyDeletehttp://economix.blogs.nytimes.com/2013/11/19/medicare-part-d-republican-budget-busting/?partner=yahoofinance&_r=1&
Written by a former policy person from the Bush/Reagan years.
"The record also shows that such “deficit hawks” as the current House speaker, John Boehner of Ohio; the current House majority leader, Eric Cantor of Virginia; and the current House Budget Committee chairman, Paul Ryan of Wisconsin, voted for Medicare Part D all the way."
We can't get healthcare for the poor but we can pad the pockets of big pharma.
Sad.
I agree with every word.
ReplyDeleteP E R F E C T.
And sad.
Namaste, do stop back!
While I completely agree with the spirit of this post, one very important fact is that Americans are in pretty poor health overall. How many of the 900 deaths and 50k close calls can be directly attributed to obesity and other preexisting health concerns?
ReplyDeleteI agree that we can do better and it's great to see Ken (Merck) step up on the issue but until Americans start making behavioral changes to support their own basic good health, we'll never have a cheaper (or affordable) health care system. Smoking, drinking to excess, casual drug use, obesity, sedentary lifestyles and poor nutrition are the root causes to why people generally need health care services.
I wish a doctor could fix so many social ills but I don't think that's realistic.
I do hear you Anon. No. 2 --
ReplyDeleteAnd to be sure, some of the deaths are related to obesity, and other entirely avoidable causes.
Even so, basic PREVENTATIVE health care is sorely needed, too. It addresses the root causes you point to. And it is very inexpensive (compared to bariatric, or open heart/bypass surgeries). And the ACA of 2010 provides it.
Finally, there are an awful lot of these events that basic prenatal services (again ACA of 2010-provided) would spot, triage and remedy -- if the mom had been eligible (2009 data).
I hear you, I just don't see it as any real answer to the fact that we -- as a patchwork of US health care delivery systems -- can, and should be able to do as well as (say) Romania, since we spend 10 times as much per child, on average, right?
The math is too large to ignore -- these are not 20 percent differences -- these are factors of ten; exponentials. . .
I would love to see Michelle Obama's youth fitness ("Let's Move!") get a whole lot more traction with young people -- lean and healthy, earlier, is part of the trick here.
Do stop back!
Namaste
Ah! And you've hit on another excellent point, Condor! America SPENDS more so we must have better outcomes! This parallels our conundrum in the education space as well - high per pupil cost/spend, mediocre results.
ReplyDeleteIn the case of the ACA - I absolutely agree health care should be a basic right - similar, again, to education. However, I feel like the ACA took on the wrong end of the equation or only half of the problem. All the included minimum coverage, removal of lifetime max cap and abolishing preexisting conditions were a good start. However, the largest driver of premiums after deductible amd some actuarial calculations are the actual costs of care - costs providers set. Insurance companies negotiate for in - network rates but, ultimately physicians and institutions set the pricing bar.
The consumerization of health care is putting the onus on patients to consider costs of providers but when you have, say, a cancer diagnosis, are you going to bargain hunt? Not likely. Even an ER visit out of network for a household fall could mean financial hardship.
There was an entire Time Magazine devoted to the runaway charge masters of institutions and providers that are still real threats to anyone who falls ill. Search it out if you haven't already it's quite eye opening.
I read this today, Condor, and thought you might find it interesting as well. http://www.nytimes.com/2013/12/03/health/as-hospital-costs-soar-single-stitch-tops-500.html?_r=0
ReplyDeleteThanks -- I too read that NYT article yesterday, Anon.
ReplyDeleteWith 60 per cent of all US hospitals still losing money, it is hard to explain just how broken our health care delivery model still is, from an economic point of view.
I continue to believe that Obamacare will in time reduce the cost of health care, system wide.
I continue to believe that young healthy Americans will pay a little more, and something like 29 million to 40 million Americans will have basic health care benefits for the first time in their lives.
These -- among others -- are my abiding hopes.
Do stop back!
Namaste