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The Field Guide to the U.S. Economy (Revised and Updated)A Compact and Irreverent Guide to Economic Life in AmericaJonathan Teller-Elsberg, Nancy Folbre, James Heintzin conjunction with the Center for Popular EconomicsThe New Press, New York 
Chapter 7: Health
The U.S. healthcare system has been sick for years, but political bickering andspecial interests continue to block an effective cure. The problems are chronic; manyAmericans lack health insurance, prices for care keep climbing at a rapid pace, and thequality of care too often depends on a person’s ability to pay.Chart 7.1 compares health spending in the United States and other high-incomecountries. Other countries are able to provide their residents with healthcare for a smaller fraction of gross domestic product. They also get more bang for their healthcare buck:Chart 7.2 reveals that despite higher spending in the U.S., life expectancy is longer inthese other countries. Chart 7.3 demonstrates that leaving most healthcare provision tothe marketplace has contributed to America’s high costs. While government-providedinsurance costs more per person in the U.S. than elsewhere, it covers relatively few people; many Americans must also make large out-of-pocket payments and purchaseexpensive private insurance to cover the gap.Prices for medical goods and services have been rising fast, as seen in Chart 7.4.Since 1980, healthcare prices have grown more than twice as fast as prices in the overallField Guide to the US Economy: Jonathan Teller-Elsberg, Nancy Folbre, James Heintzin conjunction with the Center for Popular Economics
 
economy. The combination of financial stress and more limited access to healthcaremeans that those with lower income don’t feel as healthy as those with higher income, asindicated in Chart 7.5. Finding affordable health insurance is not easy, and Chart 7.6shows that nearly one third of low-income Americans have no coverage at all. Disparitiesin coverage among Americans from different racial and ethnic groups are striking. Chart7.7 points out that Asian Americans and African Americans are almost twice as likely,and Native Americans and Hispanic Americans are roughly three times as likely, to bewithout health insurance as whites are. One result, pictured in Chart 7.8, is that black and Native American infants are much more likely than white infants to die before their first birthday.High prices and limited public support can drain household resources. Chart 7.9shows that the lowest 20% of earners in America spend 18% of their pre-tax income onhealthcare, while the top 20% of earners spend only 3%. Chart 7.10 indicates that a large proportion of women undergo abortions because they feel they cannot afford a child.This is especially true for those below the official poverty line. Struggling with financestakes a toll on mental health. Chart 7.11shows that people who are lower down theincome ladder have higher odds of suffering from an anxiety or depressive disorder thanthose higher up. Stresses are compounded when the high costs of healthcare and thecomplexities of health insurance contribute to financial collapse. Chart 7.12 documentsthe large fraction of all personal bankruptcies that result, in part, from medical expensesthat get out of control.We could avoid many of the fatal diseases that strike down Americans each year.Chart 7.13 points out that many deaths are preventable. But it’s difficult to changeField Guide to the US Economy: Jonathan Teller-Elsberg, Nancy Folbre, James Heintzin conjunction with the Center for Popular Economics
 
unhealthy behaviors, especially when industries promote them through advertising. Drugcompanies set a terrible example. Chart 7.14 shows that they spend more on marketingand administration—and take home more in profits—than they spend developing newand better drugs.These problems are even more pressing in the international arena. Chart 7.15describes the terrible impact that HIV/AIDS is having around the world, emphasizing thehuge global effort necessary to rein in the epidemic. Chart 7.16 makes the impacts of  poverty on health clear, showing that large portions of the world’s people live withoutthe clean water and sanitation needed for a healthy life.
7.1 Hey, Big Spender
Throwing money at a problem doesn’t necessarily make it go away. The U.S.spends a far greater share of its gross domestic product (GDP) on healthcare than other industrialized countries. Even though healthcare expenditures equaled more than 14% of total U.S. GDP in 2001, nearly 40 million people lacked medical insurance.Americans rely on a hodge-podge of private insurance, public assistance, and out-of-pocket payments that finances luxury treatment for some but begrudges basic care toothers. In most other wealthy countries, the government either provides care directly or insures everyone. This can reduce multiple layers of bureaucracy, resulting in moreefficient and egalitarian provision of healthcare.Field Guide to the US Economy: Jonathan Teller-Elsberg, Nancy Folbre, James Heintzin conjunction with the Center for Popular Economics
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