Linda de Sosa, Houston TX
A Dissection of the Health Care Reform
First, why do we need it?
Possibilities mentioned are a.
The US Healthcare system is not good b.
The US Healthcare system is good, but not enough people have access c.
The US Healthcare system is good, but healthcare or insurance costs too much
What is the quality of the US health care system?
Look at Infant mortality
(percentage of infants not living to one year of age) The US rate is high, relative to other countries (6.8%) What are the causes? d.
Higher rate of very low birth weight infants in US (12.4%) and rising rapidly i.
Primarily teen mothers and mothers 40+ (Source: CDC study) ii.
For older mothers, directly related to higher multiple births (fertility treatments, not lack of health care) iii.
Younger mother analysis 1.
Mothers younger among American Indian, black, Mexicans, and Puerto Ricans 2.
Mothers younger in Alabama, Arizona, Arkansas, DC, Georgia, Louisiana, Mississippi, Nevada, New Mexico, Oklahoma, South Carolina, Tennessee, Texas. iv.
US infant preterm mortality rate is actually higher than other countries, indicating better health care e.
Decreases significantly if we could reduce low birth weight
suggests improved access to prenatal care for teens and improved teen pregnancy prevention programs f.
Small rate variation due to US increased definition of live birth i.
Several countries do not consider a birth live unless it is over a certain weight or gestation week
Norway, Czech Republic, France, Ireland, Netherlands, Poland ii.
Accounts for some, but not large amount of our lag g.
The top 3 causes of infant mortality (equally 43% of the cases) are congenital malformations, disorders leading to low birth weight and gestation, and sudden infant death syndrome.
Therefore, infant mortality does not indict health care quality itself.