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With the many examples of Single Healthcare being successful, would it be reasonable to at least have a few states volunteer to try the Health Care system?Contrary to opinion -As is - several states tried, and failed to get past the talking point, including VT, CA, NY, COand states also have further challenges, in that they can not print MONEY-Also contrary to opinion - our costs will never be at other nation’s costs for any comparable programThe U S is not made up of the same genetic mix as other nations, andis not made up of the same medical issue ratios,and does not have the same ratio of illness occurances,What follows is data showing exactly thatalsoThe US government structure is in no way the same as other nationsSo to expect the same cost on a completely different structure is a very misplaced expectationPlease be awareeven after pointing out the differences - many people, including established writers here, continue to deny the basic core differencesmany people flat out deny these have any affect at all -what’s worse - even when pointed out - there is a denial that it is realI wish to thank Steve Harrison for giving me insight in how religious and all ruling the denial isSo - this post actually includes some very specific data and this post is not intended to bellitle or discriminate against anyone or any peopleIt is intended to show what is - so that people can start to actually figure out how to get a workable solution on more than a foundation of “if they can we can too”-assumption - the United States has a population that is genetically very similar to other developed nations,They are not -here is an exampleand here is data on populations MOST prevalent in the US vs other nationsAfrican Americans or blacksBlack or African American refers to people having origins in any of the black racial groups of Africa, including those of Caribbean identity.Chronic health conditionsThirteen percent of African Americans of all ages report they are in fair or poor health.Adult obesity rates for African Americans are higher than those for whites in nearly every state of the nation—37 percent of men and nearly 50 percent of women are obese.African Americans have higher rates of diabetes, hypertension, and heart disease than other groups. Nearly 15 percent of African Americans have diabetes compared with 8 percent of whites.Asthma prevalence is also highest among blacks. Black children have a 260 percent higher emergency department visit rate, a 250 percent higher hospitalization rate, and a 500 percent higher death rate from asthma compared to white children.African Americans experience higher incidence and mortality rates from many cancers that are amenable to early diagnosis and treatment. African-American adults with cancer are woefully underrepresented in cancer trials and are much less likely to survive prostate cancer, breast cancer, and lung cancer than their white counterparts.Leading causes of deathLeading causes of death among this group are heart disease, cancer, and stroke.There are 13.24 infant deaths per 1,000 live births in this population.HispanicsThe federal government defines Hispanic or Latino as a person of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin regardless of race. Hispanics are thus a heterogeneous group and may be any race.Chronic health conditionsTen percent of Hispanics of all ages report they are in fair or poor health.A total of 37.9 percent of Latinos age 20 and over were obese in 2008. Obesity rates were higher in women (43 percent) than men (34.3 percent).Fourteen percent of Hispanics have been diagnosed with diabetes compared with 8 percent of whites. They have higher rates of end-stage renal disease, caused by diabetes, and they are 50 percent more likely to die from diabetes as non-Hispanic whites.Hispanic women contract cervical cancer at twice the rate of white women.One in five Latinos report not seeking medical care due to language barriers.Leading causes of deathLeading causes of death among this group are heart disease, cancer, and accidents.For reasons that are not understood Hispanics live longer than other Americans and have lower rates of infant mortality (5.52 infant deaths per 1,000 live births).Native Hawaiian or other Pacific IslanderNative Hawaiian or Pacific Islander refers to people having origins in any of the original peoples of the Pacific Islands including Polynesian, Micronesian, and Melanesian ancestry.Chronic health conditionsEight percent of this population reports it is in poor or fair health.In comparison to other racial and ethnic groups, Native Hawaiians and Pacific Islanders have higher rates of smoking, alcohol consumption, and obesity. This group also has little access to cancer prevention and control programs.The state of Hawaii found that the diabetes rate for Native Hawaiians was twice that of the white population. Native Hawaiians are also more than 5.7 times as likely as whites living in Hawaii to die from diabetes.Native Hawaiians and Pacific Islanders are 30 percent more likely to be diagnosed with cancer compared to non-Hispanic whites.Leading causes of deathThe leading causes of death among this group are cancer, heart disease, accidents, stroke, and diabetes.The infant mortality rate for Native Hawaiians is 9.6 per 1000 live births, which is 1.7 times greater than non-Hispanic whites.American Indians and Alaskan NativesAmerican Indian or Alaska Native refers to people having origins in any of the original peoples of North and South America (including Central America) who maintain tribal affiliation or community attachment.Health coverageAbout 68 percent of American Indians and Alaskan Natives under 65 years of age had health insurance in the 2005 to 2007 period.Chronic health conditionsThe prevalence of overweight and obesity in American Indian and Alaska Native preschoolers, school-aged children, and adults is higher than that for any other population group.Thirty-one percent of men and 26 percent of women aged 18 years and over in this population smoke.American Indian and Alaska Native adults were 2.1 times as likely as white adults to be diagnosed with diabetes. They were almost twice as likely as non-Hispanic whites to die from diabetes in 2006.In general, American Indian and Alaska Native adults are 60 percent more likely to have a stroke than their white adult counterparts and American Indian and Alaska Native women have twice the rate of stroke than white women.Leading causes of deathLeading causes of death among this group are heart disease, cancer, and accidents.Suicide is the eighth leading cause of death for American Indians and Alaska Natives. It is the second leading cause of death for those age 10 to 34 years. When compared to other racial and ethnic groups, American Indian and Alaska Native youth have more serious mental health problems such as depression, anxiety, and substance abuse.There are 8.28 infant deaths per 1,000 live births in this population group. American Indian and Alaska Native infants are 3.7 times as likely as white infants to have mothers who began prenatal care in the third trimester or did not receive prenatal care at all.Asian AmericanThis racial group is defined as people having origins in any of the original peoples of eastern Eurasia, Southeast Asia, or the Indian subcontinent. Asian Americans represent both extremes of socioeconomic and health indices.Health coverageAbout 82 percent of Asian Americans had health insurance coverage in 2009 compared to 88 percent of white Americans.Chronic health conditionsEight percent of this population reports it is in poor or fair health.Obesity is not generally a problem in this group. In fact, about 1 in 10 Vietnamese and Korean adults are underweight.Asian Americans suffer disproportionately from certain types of cancer, tuberculosis, and Hepatitis B. Vietnamese-American women, for example, have cervical cancer rates five times those of white women.Southeast Asian refugees are at significant risk for posttraumatic stress disorder associated with trauma experienced before and after immigration to the United States.Leading causes of deathLeading causes of death in this group are cancer, heart disease, and stroke.There are significant variations in infant mortality among subgroups of Asian Americans that are not readily explained by known risk factors.Older Asian-American women have the highest suicide rate of all women over age 65 in the United States.https://cdn.americanprogress.org...-Next - genetic disposition to being DIABETIC-why else would Americans have any higher “medical need” than in any other similarly developed countries?As anyone versed in international medicine knows there is ALSO more than just genetics at playTroy Duster points out that genetics is often not the predominant determinant of disease susceptibilities, even though they might correlate with specific socially defined categories. This is because this research oftentimes lacks control for a multiplicity of socio-economic factors. He cites data collected by King and Rewers that indicates how dietary differences play a significant role in explaining variations of diabetes prevalence between populations.Duster elaborates by putting forward the example of the Pima of Arizona, a population suffering from disproportionately high rates of diabetes. The reason for such, he argues, was not necessarily a result of the prevalence of the FABP2 gene, which is associated with insulin resistance. Rather he argues that scientists often discount the lifestyle implications under specific socio-historical contexts. For instance, near the end of the 19th century, the Pima economy was predominantly agriculture-based. However, as the European American population settles into traditionally Pima territory, the Pima lifestyles became heavily Westernised. Within three decades, the incidence of diabetes increased multiple folds. Governmental provision of free food to alleviate the prevalence of poverty in the population, which had comparatively high-fat contents, is noted as an explanation of this phenomenon.-and then there is the Government of the US - with its built-in imposed costsConsider the U S can not logically get to an NHS style systemTo get the prices they have in the US - you have to scrap US government - good luck with that.I don’t care what they do - if you want the prices they pay you have to GO THERE. That is because the laws they have and the systems they have will NEVER be in the US. The US has Local, State and Federal governance on the healthcare system and a Constitution.I care what it takes to do it in the US, under US laws, US regulations with US medical systems and conditions.-now if you want to make changes in the US - take the existing system and its imposed costs apartLet me point out to anyone from elsewhere many people from outside the US chime in and prattle about how “insert country name” has such a utopia.most have no concept of how big the US is - the UK in size and population fits into CA - so the scale of the US escapes them. That is a big issue in transportation and supply chain of anything manufactured or imported, until we can teleport thingsthey have a blind eye to how the nation of choice rations carethey have a blind eye to how limited that nation’s formulary is compared to the “free” worldthe concept that healthcare is taxed by government is unconceivable - yet in the US just at the state level, insurers pay 50 Billion a year in state taxesAt state and federal level taxing medical care is a common revenue sourceplus - they have no clue how protected the US population isHaving pointed that outMy view is that almost all of the problems in American healthcare are caused by the overlapping government, and its desired job, which is to regulate in quality and safety, by using reporting and regulation, as well as stick, but no carrot.So healthcare regulation by clipboard / PC and by hammerIn the U S:Having 3 layers of government to comply with adds needless costs - keep in mind EVERY provider, EVERY insurer, EVERY controlled substance supplier, and every Bio Waste disposal service has to meet Local, State and Federal regulations,To make it worse - usually on the Fed side there are multiple agencies with overlapping data requests, but unique forms. Just in hospital care cost - the federal reporting by itself adds 40 Billion per year to the patient’s bill in compliance costs. And I have not even touched on EPA, waste handling and bulding operations regulations unique to healthcare providers.My personal point of view isif the local government followed the State Constitution, and US Government followed the US Constitutions - then Local and Fed duplication of state regulations would not be needed. If each wanted something - put it in the regs for States to mandate it and then STFU.if the State and Federal Government needs money so badly - stop hiding in other sources, and taxing them to “hide” the tax - and just tax us directly.Taxing medical needs, such asHealthCAREshipping of medical supplies and drugs,import of medical supplies and drugs,warehousing of medical supplies and drugs,Drug and Device makers on profitDrug and Device makers on GROSS salesMedical Waste DisposalHealth Insurance policiesHealth Insurance providersMedical Providers with special feesPharmacies with special feesFacilities with special feesadding EPA fees on top of thatis a downright sneaky way of getting revenueAnd those are 2 reasons why we see higher costs in the US - that most people step right overFor the nitpick group - no, they are not the only reasons - but when was the last time you even bothered to think about these 2, much less mention them? -50 Billion in state taxes is big money,40 billion just in hospital compliance to the fed is big money15%% tax on medical services in just one state adds up to big moneyThat is 0.1 trllion extra cost found on a national spend of 3.5 T

Why is life expectancy decreasing in the United States?The life expectancy in the U S is what it is due to several factorslifestylegenetic makeup of the population - we have a greater population by % of people’s who are prone to specific illnesses ( detailed below )lack of focus on being healthy (assumption that a pill will fix it)drug use and accidental death rate (see first chart )a general lack of focus on medical issues until they are a crisisa shifting of blame to other issues-Many factors affect life expectancy, other than just medical careWhen factors like work place deaths (think high steel, deep water fishing, timber work, etc that are not done in other nations) accidental deaths, fatal injuries, drug overdoses, violence related deaths and lifestyle induced deaths and similar non- medical care related numbers are added in - life expectancy is reduced.What would change those factors?Look at the chart below1 and 2 are mostly a factor of lifestyle4, 5 and 7 are being tied to lifestyle more and more6 is currently being investigated and appears in early results as being a diet induced / affected3 is inclusive of motor vehicle accidents, sports, etc10 is no suprise, when lost keys and lost chargers are the new sources of major stess in the next generation - the ability to deal with life is on a declineFor further reading on the topic of life expectancy, here are some recommendations. Harvard economist Greg Mankiw discusses some of the confounding factors with life expectancy statistics, citing this NBER study by June and Dave O'Neill comparing the U.S. and Canada. (Mankiw calls the misuse of U.S. life expectancy stats "schlocky.") Chicago economist Gary Becker makes note of the CONCORD study in this blog post. In 2009, Sam Preston and Jessica Ho of the University of Pennsylvania published a lengthy analysis of life expectancy statistics, concluding that "the low longevity ranking of the United States is not likely to be a result of a poorly functioning health care system.”-The genetics and biology of a woman and a man are drastically different, and affect leading causes of deathand so affect treatment health care costsFrom the CDC-Leading Causes of Death by Race/Ethnicity, Females-USFrom the CDC-Leading Causes of Death by Race/Ethnicity All Males 2015The disease prevalence in Race is another well known factor, and since all nations are not as evenly allocated by race, adds to the cost & medical issue variationAnd the U S is still has more of multiple hereditary diseases populationsand so Race differences affect health care costsGenetic Factors in Ethnic Disparities in HealthWhy are some genetic conditions more common in particular ethnic groups?From the CDC-Leading Causes of Death by Race/Ethnicity All Males 2015Prevalence of Single and Multiple Leading Causes of Death by Race/Ethnicity Among US Adults Aged 60 to 79 Years.Why 7 Deadly Diseases Strike Blacks MostRace and health - WikipediaFastStats National Center for Health Statistics Race and Ethnicity Fact Sheet: Health Disparities by Race and EthnicityNumber of Deaths per 100,000 Population by Race/Ethnicity-If genetics is a factor, any variation in population to more disease prone would also affect occurrence ratesand so affect health care costsEthnicity and Race by Countriesthe United States has a population that is genetically very DIS-similar to other developed nationshere is an exampleand here is data on populations MOST prevolent in the U SAfrican Americans or blacksBlack or African American refers to people having origins in any of the black racial groups of Africa, including those of Caribbean identity.Chronic health conditionsThirteen percent of African Americans of all ages report they are in fair or poor health.Adult obesity rates for African Americans are higher than those for whites in nearly every state of the nation—37 percent of men and nearly 50 percent of women are obese.African Americans have higher rates of diabetes, hypertension, and heart disease than other groups. Nearly 15 percent of African Americans have diabetes compared with 8 percent of whites.Asthma prevalence is also highest among blacks. Black children have a 260 percent higher emergency department visit rate, a 250 percent higher hospitalization rate, and a 500 percent higher death rate from asthma compared to white children.African Americans experience higher incidence and mortality rates from many cancers that are amenable to early diagnosis and treatment. African-American adults with cancer are woefully underrepresented in cancer trials and are much less likely to survive prostate cancer, breast cancer, and lung cancer than their white counterparts.Leading causes of deathLeading causes of death among this group are heart disease, cancer, and stroke.There are 13.24 infant deaths per 1,000 live births in this population.HispanicsThe federal government defines Hispanic or Latino as a person of Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin regardless of race. Hispanics are thus a heterogeneous group and may be any race.Chronic health conditionsTen percent of Hispanics of all ages report they are in fair or poor health.A total of 37.9 percent of Latinos age 20 and over were obese in 2008. Obesity rates were higher in women (43 percent) than men (34.3 percent).Fourteen percent of Hispanics have been diagnosed with diabetes compared with 8 percent of whites. They have higher rates of end-stage renal disease, caused by diabetes, and they are 50 percent more likely to die from diabetes as non-Hispanic whites.Hispanic women contract cervical cancer at twice the rate of white women.One in five Latinos report not seeking medical care due to language barriers.Leading causes of deathLeading causes of death among this group are heart disease, cancer, and accidents.For reasons that are not understood Hispanics live longer than other Americans and have lower rates of infant mortality (5.52 infant deaths per 1,000 live births).Native Hawaiian or other Pacific IslanderNative Hawaiian or Pacific Islander refers to people having origins in any of the original peoples of the Pacific Islands including Polynesian, Micronesian, and Melanesian ancestry.Chronic health conditionsEight percent of this population reports it is in poor or fair health.In comparison to other racial and ethnic groups, Native Hawaiians and Pacific Islanders have higher rates of smoking, alcohol consumption, and obesity. This group also has little access to cancer prevention and control programs.The state of Hawaii found that the diabetes rate for Native Hawaiians was twice that of the white population. Native Hawaiians are also more than 5.7 times as likely as whites living in Hawaii to die from diabetes.Native Hawaiians and Pacific Islanders are 30 percent more likely to be diagnosed with cancer compared to non-Hispanic whites.Leading causes of deathThe leading causes of death among this group are cancer, heart disease, accidents, stroke, and diabetes.The infant mortality rate for Native Hawaiians is 9.6 per 1000 live births, which is 1.7 times greater than non-Hispanic whites.American Indians and Alaskan NativesAmerican Indian or Alaska Native refers to people having origins in any of the original peoples of North and South America (including Central America) who maintain tribal affiliation or community attachment.Health coverageAbout 68 percent of American Indians and Alaskan Natives under 65 years of age had health insurance in the 2005 to 2007 period.Chronic health conditionsThe prevalence of overweight and obesity in American Indian and Alaska Native preschoolers, school-aged children, and adults is higher than that for any other population group.Thirty-one percent of men and 26 percent of women aged 18 years and over in this population smoke.American Indian and Alaska Native adults were 2.1 times as likely as white adults to be diagnosed with diabetes. They were almost twice as likely as non-Hispanic whites to die from diabetes in 2006.In general, American Indian and Alaska Native adults are 60 percent more likely to have a stroke than their white adult counterparts and American Indian and Alaska Native women have twice the rate of stroke than white women.Leading causes of deathLeading causes of death among this group are heart disease, cancer, and accidents.Suicide is the eighth leading cause of death for American Indians and Alaska Natives. It is the second leading cause of death for those age 10 to 34 years. When compared to other racial and ethnic groups, American Indian and Alaska Native youth have more serious mental health problems such as depression, anxiety, and substance abuse.There are 8.28 infant deaths per 1,000 live births in this population group. American Indian and Alaska Native infants are 3.7 times as likely as white infants to have mothers who began prenatal care in the third trimester or did not receive prenatal care at all.Asian AmericanThis racial group is defined as people having origins in any of the original peoples of eastern Eurasia, Southeast Asia, or the Indian subcontinent. Asian Americans represent both extremes of socioeconomic and health indices.Health coverageAbout 82 percent of Asian Americans had health insurance coverage in 2009 compared to 88 percent of white Americans.Chronic health conditionsEight percent of this population reports it is in poor or fair health.Obesity is not generally a problem in this group. In fact, about 1 in 10 Vietnamese and Korean adults are underweight.Asian Americans suffer disproportionately from certain types of cancer, tuberculosis, and Hepatitis B. Vietnamese-American women, for example, have cervical cancer rates five times those of white women.Southeast Asian refugees are at significant risk for post traumatic stress disorder associated with trauma experienced before and after immigration to the United States.Leading causes of deathLeading causes of death in this group are cancer, heart disease, and stroke.There are significant variations in infant mortality among subgroups of Asian Americans that are not readily explained by known risk factors.Older Asian-American women have the highest suicide rate of all women over age 65 in the United States.https://cdn.americanprogress.org...-Next - genetic disposition to being DIABETIC-would Americans have any higher “medical need” than in any other similarly developed countries?As anyone versed in international medicine knows there is ALSO more than just genetics at playTroy Duster points out that genetics is often not the predominant determinant of disease susceptibilities, even though they might correlate with specific socially defined categories. This is because this research oftentimes lacks control for a multiplicity of socio-economic factors. He cites data collected by King and Rewers that indicates how dietary differences play a significant role in explaining variations of diabetes prevalence between populations.Duster elaborates by putting forward the example of the Pima of Arizona, a population suffering from disproportionately high rates of diabetes. The reason for such, he argues, was not necessarily a result of the prevalence of the FABP2 gene, which is associated with insulin resistance. Rather he argues that scientists often discount the lifestyle implications under specific socio-historical contexts. For instance, near the end of the 19th century, the Pima economy was predominantly agriculture-based. However, as the European American population settles into traditionally Pima territory, the Pima lifestyles became heavily Westernised. Within three decades, the incidence of diabetes increased multiple folds. Governmental provision of free food to alleviate the prevalence of poverty in the population, which had comparatively high-fat contents, is noted as an explanation of this phenomenon.-suppose American companies that are advertising heavily to consumers and doctors to use their products could be related to a higher rate of drug use than in other developed nations?I see no one advertising Meth - the # 1 opioid abusedI see no one advertising Heroin - the # 3 opioid usedI see no one advertising mixing opioids and other illegal drugs - the # 4 and 5 most common opioids usedAnd the number 2 is prescription based opioids - used by people with NO prescription - and using it to transition to less expensive heroinNONE of that is advertising related-Let me close with this last example - and see where we go from there on thisConsider the U S can not logically get to an NHS style system, or similarTo get the prices they have in the U S - you have to scrap U S government - good luck with that.I don’t care what they do - if you want the prices they pay you have to GO THERE. That is because the laws they have and the systems they have will NEVER be in the U S. The U S has Local, State and Federal governance on the health system and a Constitution.I care what it takes to do it in the U S, under U S laws, U S regulations with U S medical systems and conditions.-now if you want to make changes in the U S - take the existig system and it’s imposed costs apartLet’s start with the existing taxMy view is that almost all of the problems in American health care are caused by the overlapping government.Let me point out to anyone elseMost people from outside the U S have no concept of how big the U S is - and prattle about how the country of the choice has such a utopia.the U K in size and population fits into CA - so the scale of the U S escapes them. That is a big issue in transportation and supply chain of anything manufactured or imported, until we can teleport thingsthey have a blind eye to how the nation of choice rations carethey have a blind eye to how limited that nation’s formulary is compared to the “free” worldthe concept that health care is taxed by government is inconceivable - yet in the U S just at the state level, insurers pay 50 Billion a year in state taxesplus - they have no clue how protected the U S population isHaving pointed that outIn the U S:Having 3 layers of government to comply with adds needless costs - keep in mind EVERY provider, EVERY insurer, EVERY controlled substance supplier, and every Bio Waste disposal service has to meet Local, State and Federal regulations,To make it worse - usually in the Fed side there are multiple agencies with overlapping data requests, but unique forms. Just in hospital care cost - the federal reporting by it’s self adds 40 Billion per year to the patient’s bill in compliance costs. And I have not even touched on EPA, waste handling and bulding operations regulations unique to health care providers.-My personal point of view isif the local government followed the State Constitution, and U S Government followed the U S Constitutions - then Local and Fed duplication of state regulations would not be needed. If each wanted something - put it in the regs for States to mandate it and then STFU.if the State and Federal Government needs money so badly - stop hiding in other sources, and taxing them to “hide” the tax - and just tax us directly.Taxing medical needs, such asHealth CAREshipping of medical supplies and drugs,importation of medical supplies and drugs,warehousing of medical supplies and drugs,Drug and Device makers on profitDrug and Device makers on GROSS salesMedical Waste DisposalHealth Insurance policiesHealth Insurance providersMedical Providers with special feesPharmacies with special feesFacilities with special feesadding EPA fees on top of thatis a downright sneaky way of getting revenue