The Lancet studies looked at how the American health system affects inequality and structural racism, and how mass incarceration and the Affordable Care Act (ACA), also known as Obamacare, have changed public health.
Among the studies’ key findings: the richest 1% live up to 15 years longer than the poorest 1%; the same gap in life expectancy widened in recent decades, making poverty a powerful indicator for death; more than one-third of low-income Americans avoid medical care because of costs (compared to 7% in Canada and 1% in the UK); the poorest fifth of Americans pay twice as much for healthcare as a share of income (6% for the poor, versus 3.2% for the rich); and life expectancy would have grown 51.1% more from 1983 to 2005 had mass incarceration not accelerated in the mid-1980s.
The poorest Americans have suffered in particular, with life expectancies falling in some groups even while medicine has advanced. For example, researchers reported that the poorest fifth of women born between 1930 and 1960 statistically lived four years less than Americans in the top fifth of the socioeconomic spectrum.
All of these health outcomes arrive in the context of widening general inequality. The share of total income going to the top 1% of earners has more than doubled since 1970, making the US more unequal than all but three developed countries: Chile, Mexico and Turkey.
At the same time, the ACA brought relief to many. The number of Americans without insurance dropped from 48.6 million in 2010 to 28.6 million in 2015. The number of Americans who struggle with medical bills dropped from 41% to 35% in 2014.
Further, accounting for current public health insurance programs, military healthcare, the portion of local and state budgets used to purchase private health insurance for workers, and subsidies to employers to buy workers health insurance, researchers believe as much as 65% of health insurance nationally is already paid for by taxpayers.
(From Jessica Glenza, The Guardian, 4/7/17)