C'mon, Bob. The Lancet is about as unbiased as you can get. Eric
________________________________
From: uupretirees-bounce@xxxxxxxxxxxxx <uupretirees-bounce@xxxxxxxxxxxxx> on
behalf of hils. <dmarc-noreply@xxxxxxxxxxxxx>
Sent: Sunday, February 21, 2021 10:19 AM
To: uupretirees@xxxxxxxxxxxxx <uupretirees@xxxxxxxxxxxxx>
Subject: [uupretirees] Re: A study of life trends and medical care in America
and the world
A nice partisan piece(for one side) ,thats all and of course my opinion.
Bob Kasprak
============================================.
-----Original Message-----
From: Eric Russell <ericprussell@xxxxxxxxxxx>
To: uupretirees@xxxxxxxxxxxxx <uupretirees@xxxxxxxxxxxxx>
Sent: Sat, Feb 20, 2021 8:53 pm
Subject: [uupretirees] A study of life trends and medical care in America and
the world
It's long but worth your time. It covers a lot more than COVID and is damning
of both parties. Eric
A commission set out to study Trump’s abysmal COVID policies. Their report is
an indictment of the entire US system
[A commission set out to study Trump’s abysmal COVID policies. Their report is
an indictment of the entire US system]
Donald Trump is greeted by President Ronald Reagan at a 1987 White House
reception, White House photographer.
<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.alternet.org%2Fauthor%2Figor-derysh&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821095479%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=dosZHWE2wZOdpGn%2FmGnjaa4jtAPD1MGLUTaYv6I8T98%3D&reserved=0>
Igor
Derysh<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.alternet.org%2Fauthor%2Figor-derysh&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821105493%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=6u21FqlnRRGU3m2fnJqLmaAWgqqPjSkoM2HukcXl8zU%3D&reserved=0>
and
<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.alternet.org%2Fauthor%2Fsalon&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821105493%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=KwGVKlhXSpfxquMdQDlXjULqygyXg9JV05w7l%2BcfPR0%3D&reserved=0>
Salon<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.alternet.org%2Fauthor%2Fsalon&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821115476%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=hW1R9ygBLhnVTkaaXfH5IWd1CWU408gUS1hUfwkZpsM%3D&reserved=0>
February 14, 2021
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<mailto:?subject=A%20commission%20set%20out%20to%20study%20Trump%E2%80%99s%20abysmal%20COVID%20policies.%20Their%20report%20is%20an%20indictment%20of%20the%20entire%20US%20system&body=https://www.alternet.org/2021/02/trump-reagan/>
About 40% of coronavirus deaths under President Donald Trump were avoidable —
but even the total number of U.S. pandemic deaths last year is dwarfed by the
annual number of preventable deaths caused by four decades of racist and
pro-corporate policies, according to a new Lancet Commission
report<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.thelancet.com%2Fjournals%2Flancet%2Farticle%2FPIIS0140-6736(20)32545-9%2Ffulltext&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821135463%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=Bnhx2w9f%2BvxVlxpbzx4MHw69CWMAN7b9OUUvFXIHqL4%3D&reserved=0>.
Months into Trump's presidency, dozens of medical experts formed a commission
to study the health impacts of his policies for The Lancet, a highly-respected
British medical journal. The Lancet Commission on Public Policy and Health in
the Trump Era found that roughly 40% of coronavirus deaths in the United States
could have been prevented if the average death rate matched that of other
wealthy nations.
ADVERTISING
"We became concerned that even within a few weeks of him coming into office he
had started to implement policies which we thought would be deadly," Dr.
Steffie Woolhandler, a health policy expert at the CUNY School of Public Health
at Hunter College and co-chair of the commission, said in an interview with
Salon. "And now that we're in 2021, we have actual data and, in fact, his
policy has been very deadly."
Instead of galvanizing the public to fight the pandemic, the report said, Trump
"publicly dismissed its threat (despite privately acknowledging it),
discouraged action as infection spread, and eschewed international cooperation."
"His refusal to develop a national strategy worsened shortages of personal
protective equipment and diagnostic tests," the researchers added. "President
Trump politicized mask-wearing and school re-openings and convened indoor
events attended by thousands, where masks were discouraged and physical
distancing was impossible."
00:5601:44[https://img.connatix.com/7a26d19b-92dd-42ba-a811-373e855f4e43/2.png]
[https://img.connatix.com/583543fe-e5a9-43d8-b755-9d53d3df0aea/1_th.jpg?crop=655:369,smart&width=655&height=369&format=jpeg&quality=60&fit=crop]
But the commission went further, finding that life expectancy in the U.S. has
diverged from other major industrial nations since the 1980s, despite
continuous economic growth. As a result, the country sees more unnecessary
deaths each year than all the 2020 coronavirus deaths combined.
"In 2018, 461,000 Americans died who would still be alive if our life
expectancy were as long as in other wealthy nations," Woolhandler said. "So
COVID killed about 400,000 people in 2020, which was horrible. But every single
year, the United States was losing that many people relative to other developed
nations, because our policymakers had failed to create the conditions for
health."
There's little doubt that the coronavirus pandemic and Trump's mismanagement
has significantly worsened that trend, particularly in communities of color.
The pandemic has increased the life expectancy gap between Black and white
people by more than 50%, the report said. The average Latino life expectancy in
the U.S. has fallen by 3.5 years since the start of the pandemic.
"Overall, in the USA, Black and Latinx people have incurred more total years of
potential life lost than white people because of COVID-19, although the white
population is three to four times larger," the researchers wrote.
"The strong focus on racism in all its forms and its impact on almost every
area of public policy is very important," Richard Gottfried, chair of the New
York State Assembly's health committee and a member of the commission, said in
an interview with Salon, adding that many Americans "may not fully understand
the all-pervasive nature of the impact of racism."
Even before the pandemic hit America, Trump's policies were linked to an
increase in preventable deaths. Despite repeatedly failing to repeal Obamacare,
Trump undermined the
program<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2017%2F10%2F13%2Fdonald-trump-unwittingly-admits-hes-sabotaging-health-care%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821135463%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=0Ck%2F%2B15AIJV%2B7eFjHm3wUHiSSFmY7sP8zlxPt%2FsO0QU%3D&reserved=0>
in various ways and the number of uninsured Americans increased by 2.3
million<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2021%2F02%2F11%2Four-failing-healthcare-system-costs-us-countless-lives-its-time-to-adopt-medicare-for-all%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821145454%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=b4SULrhRrTOSacn4d9PGe5Fp%2F3QD46pI8%2Fzz0zuA%2FBk%3D&reserved=0>
before the pandemic, a number that rose further amid rampant job losses during
the health crisis. He used the deficit caused by the 2017 tax cut that
primarily benefited the wealthy and
corporations<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fitep.org%2Fupdated-estimates-from-itep-trump-tax-law-still-benefits-the-rich-no-matter-how-you-look-at-it%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821145454%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=QC%2BxgYCZxsOvsQx%2BqCnr9cCXI8AfsAs8zDFBhcSOo6M%3D&reserved=0>
to "justify cutting food subsidies and health care," the report said. His
deregulation agenda worsened
pollution<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2020%2F07%2F15%2Fderegulations-deadly-consequences-how-trumps-assault-on-government-exacerbated-the-pandemic_partner%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821155450%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=KADFdvLu%2BWbTyVompbXrFkPLdabs%2BK6umrflZBkfp10%3D&reserved=0>,
"resulting in more than 22,000 extra deaths in 2019 alone."
Trump's "disdain for science" and cuts to global health
programs<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2020%2F05%2F29%2Ftrump-terminates-us-relationship-with-world-health-organization%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821155450%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=%2FUDwGwmiCrrlWdyc22mfL8jxq3csbrtVMD5%2FE4mx2M4%3D&reserved=0>
and public health
agencies<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2020%2F03%2F23%2Ftrump-administration-cut-cdc-expert-monitoring-outbreaks-in-china-months-before-coronavirus-report%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821155450%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=xIIk%2FZ%2FKkKZi2SQ2rIdSWPT%2Fh5gbGnqNIqbGRq7geYw%3D&reserved=0>
hampered the coronavirus response, "causing tens of thousands of unnecessary
deaths," according to the report, and those cuts "imperil advances against HIV
and other diseases."
But the researchers warned that "focusing narrowly on Trump's policies and
rhetoric, while ignoring the failings that precipitated his election, risks
obscuring the causes and remedies for the longterm downward trajectory of
health" in the United States.
"The disturbing truth is that many of President Trump's policies do not
represent a radical break with the past but merely accelerated the decades-long
trend of lagging life expectancy that reflects deep and long-standing flaws in
US economic, health, and social policy," the report said.
In fact, Trump's county-level vote share was closely correlated with worsening
life expectancy trends. Counties where more than 60% of voters backed Trump had
higher life expectancy in 1980 than counties where Clinton won more than 60% of
the vote, according to a 2017
study<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5607673%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821165446%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=5J6haiJjcwnJchjXxjpDftW9aFT9nr9nnbPxKcqdzys%3D&reserved=0>.
But in 2014, the Trump counties had an average life expectancy two years lower
than the average Clinton county.
"People's deteriorating life prospects appeared to be feeding unhappiness and
dissatisfaction that Trump was able to adequately cynically mobilize for his
own purposes," Woolhandler said.
Many lower-income white people with "deteriorating life prospects" have
gravitated toward Republican policies because they believe people of color
disproportionately benefit from expansions of public health and social safety
nets, even though they themselves would greatly benefit from policies that
improve public health.
"Ironically, the ascendance of right-wing populism and Trump's weakening of the
US Government's role in protecting health are likely to exacerbate the income
and place-based health disparities that harm many of his voters," the report
said. "A negative feedback loop — with low-income white people helping to
stifle demands for vital public investments — risks inflicting additional and
long-lasting damage to their health and wellbeing."
Trump, the researchers argued, used this racial animus to "deflect attention
from policies that abet billionaires' accretion of wealth and power," arguing
that his America First narrative "camouflaged policies that enriched people who
were already very
wealthy<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2017%2F12%2F24%2Ftrump-brags-at-mar-a-lago-that-he-just-made-his-rich-friends-a-lot-richer%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821165446%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=IyoLI%2BF6gOo19m%2BgjiLWbm8pgWuOQ4cTfxxbkHOD7f4%3D&reserved=0>
and gave corporations license to degrade the environment for financial
gain<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2019%2F05%2F20%2Fexperts-call-out-trumps-epa-for-redefining-environmental-standards-to-allow-for-more-air-pollution%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821175440%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=VEQ0XlPC9HWd4iC%2Bw04Rsiiov%2FSqZLSiDSaBPNktkj8%3D&reserved=0>."
Meanwhile, the report said, Trump "halted progress in almost every domain,
undermined care for low-income people and the middle class, weakened pandemic
preparedness; withheld food and shelter from those in need, and persecuted
those who were vulnerable and oppressed."
But Trump is obviously not the first president to push the privatization of
public services and deregulation aimed at helping corporations maximize
profits. Arguably every president since at least Jimmy Carter has played a role
in that process.
"Although Trump's actions were singularly damaging, many of them represent an
aggressive acceleration of neoliberal policies that date back 40 years," the
report said. As a result of policies that chipped away at New Deal and Civil
Rights-era progress, the "widening income inequality has widened inequalities
in health."
The deepening inequality began in earnest during the Reagan
era<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2020%2F12%2F27%2F50-year-study-of-tax-cuts-on-wealthy-shows-they-always-fail-to-trickle-down%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821175440%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=xEWZA5k54OEcDgIuiXg1xGAjUK5ZEGo7Exa75eEe%2Baw%3D&reserved=0>
as unions were "stifled," the tax code and government policies increasingly
favored the wealthy, and high-paying manufacturing jobs began to disappear, the
report said. Despite a booming stock market and low unemployment, the report
added, many people have been "forced into precarious jobs that offered low pay
and insufficient benefits."
After Reagan's election, "we saw U.S. life expectancy begin to lag [and] health
care costs begin to soar," Woolhandler said. In 1980, American life expectancy
was around the average for developed nations. By the time the pandemic hit,
U.S. life expectancy was 3.4 years below the G7 average, according to the
commission.
The damaging policies were not limited to Republicans. Through Bill Clinton
rejected many Reagan-era policies, he expanded trade
agreements<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2016%2F03%2F14%2Fbill_clintons_odious_presidency_thomas_frank_on_the_real_history_of_the_90s%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821185434%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=5WmDGhbhkORTXm9PP2qPgDPKyS%2Bu%2BK46SJo5mjndQkM%3D&reserved=0>
that weakened protections and unions and imposed
restrictions<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2016%2F03%2F14%2Fbill_clintons_odious_presidency_thomas_frank_on_the_real_history_of_the_90s%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821185434%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=5WmDGhbhkORTXm9PP2qPgDPKyS%2Bu%2BK46SJo5mjndQkM%3D&reserved=0>
on welfare and food benefits. He also signed
bills<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2016%2F03%2F14%2Fbill_clintons_odious_presidency_thomas_frank_on_the_real_history_of_the_90s%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821195427%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=H3SGAsQ1uf3r5hxRhB9jnprZofRiYs4kCZwCHHo6ySc%3D&reserved=0>
that expanded mass incarceration and worsened wealth and income inequality.
"A major problem with trade policies has been that they made drugs too
expensive," Woolhandler said.
Though Barack Obama expanded health coverage, his signature health program
funneled money through private profit-seeking
companies<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2020%2F11%2F27%2Fconservatives-backed-the-ideas-behind-obamacare-so-how-did-they-come-to-hate-it_partner%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821195427%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=M60AeGl0RD%2FyC0aKDu%2Fk5xgUelBJVLGvym0U1aIvu3M%3D&reserved=0>
and exploded out-of-pocket
costs<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.rollcall.com%2F2020%2F03%2F10%2Ften-years-into-obamacare-cost-and-access-issues-abound%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821205423%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=N8uFoakZoPJk7BqSqrHF4ZoRAnz4rtcL%2BfTjquF%2BERI%3D&reserved=0>.
Between 2002 and 2019, the share of public health spending in the U.S. fell
from around 3.1% of the GDP to 2.45%, roughly half the proportion in Canada and
the U.K.
"Market-oriented health policies shifted medical resources toward high-income
people, burdened the middle class with unaffordable out-of-pocket costs and
deployed public money to stimulate the corporate takeover of vital health
resources," the report said.
Although the Affordable Care Act expanded health coverage to tens of millions
more people, the program still left between 25 million and 30 million uninsured
before Trump took office. Despite the coverage expansion and a booming economy
since 2010, "there's been essentially no improvement in Americans' life
expectancy, which is all the more shocking," Woolhandler said.
"That is really historically unprecedented, because usually when the economy
grows, life expectancy grows," she said. "It's good for you to have more
resources. But in the United States, we actually have an uncoupling of life
expectancy growth from economic growth."
The decline in life expectancy has been especially stark in communities of
color. Life expectancy for Black Americans is about 3.4 years
shorter<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F66%2Fwr%2Fmm6617e1.htm&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821205423%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=U1VBwWHMFwOQoAiA73hDo5MniaqU4Xe2fTnyagyg6EA%3D&reserved=0>
than for white people. Life expectancy among Native
Americans<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ihs.gov%2Fnewsroom%2Ffactsheets%2Fdisparities%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821205423%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=MhehD9nXeoW2bJxV439HsBI62qTdIXnirWXeey9s5Z8%3D&reserved=0>
is poorest of all, Woolhandler observed, saying these statistics "are related
to structural white supremacy."
The report found that all people of color except Asian Americans receive
significantly less medical care than white Americans despite having worse life
expectancy and seemingly greater need. Mass incarceration, the drug war and
police violence are also major factors in the lagging life expectancy of people
of color. The report cited estimates that roughly one in every 1,000 Black
men<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.pnas.org%2Fcontent%2F116%2F34%2F16793&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821215416%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=KxaWtFcuUMwUFyp9R8LGP6Qf5MJfm1XFAYGRdFKYbDc%3D&reserved=0>
will be killed by police, a rate 250% higher than that of white males. While
discourse around the opioid epidemic has largely focused on drug use among
white people, Black Americans saw the sharpest increase in opioid
deaths<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F30146996%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821215416%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=LtnWvnY8UziR0zmPavHJ3YXOm%2FDO1eUQkX%2F0J9KDOcg%3D&reserved=0>
between 2012 and 2018, a problem that has likely been exacerbated during the
pandemic due to economic stress and social isolation.
"We still have an unequal society based on a history of white supremacy with
discriminatory treatment continuing to this very day," Woolhandler said.
"That's something that needs to be changed. We concluded that racism is
obviously bad for the health of people of color, but also that we think it
threatens everyone.
"Racism has been manipulated by cynical politicians like Trump to encourage
low-income white people to oppose social services. They're opposing social
services in the mistaken belief that they only benefit people of color. So
low-income whites are often mobilized against their own self-interest on
services that would benefit them personally, opposing it just for people of
color. So racism harms health directly for people of color, but also harms
health by poisoning the political climate that we need in order to get our
government to act."
The commission's report included dozens of recommendations for President
Biden's administration and lawmakers, many of them focused on addressing the
racial inequities in public health. But the extent of these policies shows that
Congress and Biden need to "go beyond simply repairing Trump's damage," the
report said.
"Racism has a profound impact on what health care providers are available in
communities of color and their access to it," Gottfried said. "It denies people
full health coverage disproportionately and has an impact on the quality of
care that's available in their neighborhoods. And you see the results in
shocking data on infant and maternal mortality and life expectancy and almost
every measure of health care quality and bad outcomes."
The researchers called on lawmakers to address structural racism, decriminalize
drug use, and reform policing and criminal justice systems that "oppress"
communities of color and "fill prisons." The recommendations also include
addressing policies that suppress voters, particularly voters of color, and
creating a National Center on Anti-Racism and Health within the Centers for
Disease Control and Prevention. The commission also called for reparations to
African Americans, Native Americans and residents of Puerto Rico "for the
wealth and education confiscated from (or denied to) those groups in the past."
"To repair health deficits in the USA, we must redistribute wealth and income
through taxation, fortify social programmes and regulation, remediate the
structural racism that afflicts Black, Latinx, and Indigenous people, and heal
US democracy by eliminating obstructions to voting," the report said.
The report also called on lawmakers to address the worsening pollution caused
by Trump's deregulation of environmental regulations and to mobilize "massive
resources to avert climate catastrophe."
Funding for these major reforms could come from redirecting resources from the
military, raising taxes on the wealthy, and ending corporate subsidies and
programs that funnel public funds through private companies.
At the heart of the report's recommendations is the need for a universal health
care program that does not allow tens of millions of people to be denied
coverage while forcing tens of millions of others to pay skyrocketing
out-of-pocket costs that lead to
bankruptcies<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.thebalance.com%2Fmedical-bankruptcy-statistics-4154729&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821225411%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=C3Yapn4soiEFiLLF%2BaxYsSn0qGw83sjq3Nxekbos69k%3D&reserved=0>
and avoidance of medical
care<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1464118%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821225411%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=z1mGp3NSGSBZd3nCZqvFm%2BPNkG%2F47mry0K5mFr7%2BbNc%3D&reserved=0>.
"Almost every problem we face in health and health care, whether as patients or
providers or employers or taxpayers, is made much worse and much harder to
solve because of the way we pay for health care in America," said Gottfried.
Gottfried has sponsored a single-payer health care bill called the New York
Health
Act<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.nyhcampaign.org%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821235410%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=EV%2FIIKZ1WH%2F1bGFBJfFN3ZrJjnTB0EE606jIPmq7T%2Bs%3D&reserved=0>
in the state legislature for nearly three full decades.
"Really the only solution to the coverage problem that is effective is a
single-payer system," he said. "Everything else leaves us with gaps and a
fragmented system and all the wasted spending that is caused by a fragmented
system dominated by insurance companies. … Getting rid of that waste would
generate enough money to provide complete coverage for everyone, including
long-term care. Until we get rid of that waste, it is virtually impossible to
achieve high-quality and equitable healthcare."
A study by Woolhandler and fellow commission co-chair Dr. David Himmelstein
last year found that eliminating overhead and administration costs from health
care spending by transitioning to a government-run health care program similar
to Canada's would save enough money to pay for the entire cost of the
program<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2020%2F02%2F15%2Famerican-health-care-system-costs-four-times-more-than-canadas-single-payer-system%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821235410%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=TBztp9KI%2B912b4JH%2FedQ7roPG2vexIfrM4JxlChf5Yg%3D&reserved=0>.
Woolhandler and Himmelstein are also the co-founders of Physicians for a
National Health Program, which has long advocated for a single-payer system.
Their findings were echoed in another study published last year in The
Lancet<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2020%2F02%2F22%2Fmultiple-studies-show-medicare-for-all-would-be-cheaper-than-public-option-pushed-by-moderates%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821245400%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=0AjARin%2FwieTKa%2Fp8ChabO3oFsyg2mVCgy5b%2FIo%2FU9g%3D&reserved=0>
and a review of 22 studies published in PLOS
Medicine<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2020%2F02%2F22%2Fmultiple-studies-show-medicare-for-all-would-be-cheaper-than-public-option-pushed-by-moderates%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821245400%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=0AjARin%2FwieTKa%2Fp8ChabO3oFsyg2mVCgy5b%2FIo%2FU9g%3D&reserved=0>.
Biden has made clear that he opposes a Medicare for All-style single-payer
system, although he has vowed to expand Obamacare. Gottfried said that progress
will first likely have to come at the state level if New York and others can
pass bills like his single-payer proposal.
"I think the most we can expect from the Biden administration is cooperation
with states that want to do single-payer systems," he said. "I believe New York
can implement single-payer coverage even without federal cooperation. It would
be more complicated, but we can do it."
In Canada, Gottfried observed, single-payer health insurance "began in one
province and then another province joined in and in just a few years it became
a provincial-based program but funded largely with federal money." He suggested
that the same could happen in the U.S. "After one state enacts it, you'll see
more states doing it. Eventually, either there will be a national program or
there will be federal funding to help support state single-payer programs."
The commission's report included numerous immediate reforms the Biden
administration could use to improve public health en route to an eventual
single-payer system, including providing incentives for states to expand
Medicaid if they have yet to do so — primarily in the South where half of
America's Black population lives. The commission also recommended rolling back
all Trump's efforts to undermine Obamacare and undoing his expansion of the
public charge immigration
rule<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.salon.com%2F2019%2F08%2F22%2Ftrump-administration-revives-public-charge-clause-that-kept-nazi-era-refugees-from-the-us_partner%2F&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821255394%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=sIVnjXiLDD2fGiuaP%2BeZ%2FcvsmBy%2BxCMUyYxQOD6DATU%3D&reserved=0>.
"The public charge rule is a long-standing immigration term that originally
just applied to people who receive cash benefits and who resided in long-term
care institutions paid for at government expense," Woolhandler said. "Trump has
expanded that rule so that it can encompass virtually any use of public
benefits, and that has really frightened many people in immigrant communities.
People are afraid to enroll themselves or their children in Medicaid. They're
afraid to use nutrition benefits. They're afraid to seek housing benefits, and
those things are very important for health."
Biden quickly signed dozens of executive
actions<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.federalregister.gov%2Fpresidential-documents%2Fexecutive-orders%2Fjoe-biden%2F2021&data=04%7C01%7C%7C521401f6ae204f5e961508d8d67c1aec%7C84df9e7fe9f640afb435aaaaaaaaaaaa%7C1%7C0%7C637495175821255394%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=45ffbCbHWTYZkey22ndwTWZin5Xgk3BpCK7SJOWmEoE%3D&reserved=0>
to roll back many of Trump's policies related to health care, immigration,
climate and racial equity, and plans additional executive orders and
legislation to undo Trump's damage. But the commission emphasized that
correcting inequity will require much more than rolling back four years of
Republican policies.
"Policymakers are going to have to create the conditions that allow my patients
to be healthy," said Woolhandler, who is also a practicing primary care
physician. "We need to change the direction of American public policy to make
sure that people's needs are met, and that the conditions for their health are
met.
"If we fail to do that, we're going to continue to see people feeling
desperate, see people feeling angry. Those are the conditions that allow the
rise of autocratic leaders like Trump. So Trump may be gone, but Trumpism will
come back and cause problems for us unless we build a society that actually
takes care of people."