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American Social and Medical Disorder: The 'Pre-Existing Condition That Doomed the U.S. Covid Response

Originally published at http://www.commondreams.org/views/2021/02/19/american-social-and-medical-disorder-pre-existing-condition-doomed-us-covid

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“The ACA left “nearly 30 million uninsured” and funneled new public dollars “through private insurers whose exorbitant overhead and profits drain funds before they reach the clinic.””

“Mortality numbers like these helped move the White House to Donald Trump in 2016. His county-level vote share in 2016 closely correlates, the Lancet commission points out, “with mortality trends.” Counties where over 60 percent of locals voted for Trump had higher life expectancy in 1980 than those counties where over 60 percent went for Hillary Clinton. But by 2014 these same Trump counties lagged more than two years “behind counties that had voted for Clinton.””

We have the world’s stupidest health don’t-care system in the world. Thank the DLC for keeping us this way.

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Trump was just too incompetent to be the President. The president of the USA should always have at least 1 brain cell Trump has none. In fact the whole republican cartel are incompetent. Their blatant in your face wanton stupidity and uncommon ignorance is always grounds for failure especially in government. Name one red state that is prospering other than the 1%. A republican government means a poor state with crumbling infrastructure of roads and bridges and low end education, coupled with low wage jobs creates a cesspool of poor ignorant voters all dipped in Jesus oil and vote republican because they dont know any better…

So does a democrat administration.

If you had read the article you would have seen the explanation of how Obama’s failure with health care helped to make people desperate enough to give Trump a try.

Biden is well on his way to guaranteeing us a worse-than-Trump, while we still don’t have universal health care in the middle of a pandemic.

At least the republicans admit that they want me to die.

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The US Government has had commissions after commissions struck over the past decades to investigate the state of health care in the USA. They have invited foreign Doctors to the same to describe how systems worked in other Countries. They have brought forward Doctors from the USA to describe why the system in the US is superior and how “socialized medicine” would ruin “The health care system”.

Democrats and Republicans both sat on these Commissions and lauded the US Model even as they denigrated those in other Countries. Democrats and Republicans both were paid by the health Care industry to do this.

This lancet study is just another that Biden will ignore as he colludes with the health insurance industry to enact “reforms” that will simply increase the profits of that industry.

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“The suffering and dislocation inflicted by Covid-19,” the Lancet commission sums up, “has exposed the frailty of the U.S. social and medical order.”

How do you measure inequality, if you want to be methodical about it? It’s not the same as extreme poverty. You need ridiculous, obscene wealth cheek-by-jowl with abject privation in order to get to the real pinnacle, but that’s tricky to actually hang a number on. Along comes the inequality virus to settle the question internationally, definitively. The worst inequality on Earth is here in USA, and we have that straight from the microbe’s oracular spike proteins to Johns Hopkins’ ear.

STATE COVID-19 OUTBREAKS

Ranking is momentum-based on Johns Hopkins’ test-positivity factored with “per-capita newcases” (daily cases per 100K) & “immediate mortality” (the ratio of death to case tallies, analogous to case-fatality).

>                       JH     per-capita   immed
>                   positivity  newcases  mortality
>                       %          %%         %
> --- --------------------- ---------- ----------
>  1. South Carolina    9.9       62.7       1.85
>  2. Alabama          23.7       35.6       5.73
>  3. Kentucky         17.5       42.1       1.93
>  4. Kansas           23.5       30.6       3.59
>  5. Oklahoma         13.6       44.5       1.90
>  6. Georgia          13.0       43.2       2.78
> --- --------------------- ---------- ----------
>  7. Arkansas         12.2       39.6       2.40
>  8. Virginia         11.7       39.2       1.15
>  9. South Dakota     21.6       18.6       3.25
> 10. Mississippi      15.4       35.7       2.80
> 11. New Jersey        7.7       44.1       1.80
> 12. Iowa             18.6       24.2       3.94
> 13. North Carolina    7.7       44.3       1.80
> 14. Idaho            23.2       20.6       1.67
> 15. Tennessee        10.7       31.9       3.51
> 16. Arizona           7.2       47.4       3.62
> 17. Florida           7.6       38.2       2.02
> 18. Utah             11.2       37.1       0.78
> 19. Texas             9.5       42.5       2.13
> 20. Pennsylvania      7.9       31.1       3.05
> 21. New York          4.1       49.2       1.71
> 22. Delaware          5.4       40.3       1.69
> 23. Rhode Island      2.4       46.6       2.27
> 24. New Hampshire     5.6       31.1       1.57
> 25. Nevada            7.1       25.8       4.02
> 26. Ohio              8.4       29.4       0.88
> 27. Missouri          7.2       17.7       4.42
> 28. Louisiana         5.7       31.5       2.30
> 29. Connecticut       3.1       34.2       2.12
> 30. Massachusetts     2.5       38.9       2.35
> 31. Montana           4.9       24.0       2.76
> 32. California        4.4       33.1       3.32
> --- --------------------- ---------- ----------
> 33. West Virginia     4.6       30.6       2.32
> 34. New Mexico        3.6       24.7       3.68
> 35. Nebraska          4.2       26.4       1.16
> 36. Colorado          4.4       22.2       1.18
> 37. D.C.              2.8       22.2       2.58
> 38. Maryland          3.5       22.3       2.42
> 39. Illinois          3.2       22.4       2.34
> 40. Wyoming           2.9       19.4       3.05
> 41. North Dakota      5.1       13.0       1.70
> 42. Indiana           4.0       25.7       2.84
> 43. Michigan          4.0       14.8       3.25
> 44. Wisconsin         3.7       20.5       2.12
> 45. Alaska            2.1       21.8       1.12
> 46. Washington        4.2       16.3       2.26
> 47. Minnesota         3.4       16.1       1.55
> 48. Oregon            3.4       12.7       2.18
> 49. Vermont           1.6       20.5       0.74
> 50. Maine             2.6       19.8       1.52
> 51. Hawaii            1.4        5.2       3.94

This is the best this digest has looked since I started it last November. Except for the third column: comparable to case-fatality. USA’s national case-fatality recently bounced from 1.67 to 1.77%. The “immediate mortality” of most states going markedly higher than that could be an indication of trouble brewing from (mostly undetected) new variants here.

A parallel way of viewing the case/death mismatch, via CDC’s graphs:

~https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendsdeaths

Here we see deaths finally declining a bit over the past week, but still not proportionately with USA’s recent caseload decline. We’re watching a race between the vaccines and the variants, to see whether the former can catch up soon enough to block out the worst from the latter. South Carolina, hanging on tenuously to first place, happens to be the state where they first found that “South African” variant in USA.

Alabama’s got me so upset
Tennessee made me lose my rest
And everybody knows about Mississippi Goddam

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Though it’s already very bad, I’m expecting AL. mortality % and per-capita newcases % to increase, possibly dramatically. Their vaccine roll out has been dismal, and Mobile announced they had identified their first variant case from the UK. And if their mask wearing % has dropped as much as it has here (I live about 20 mi. west), it doesn’t look good.

Don’t know if you caught this in one of my comments last week, but I took a 81 yr. old relative to get her second vaccine, the cops were trying to walk their drug dog around the cars as they entered the parking lot where the health dept. was set up to administer the vaccine shots. Incredibly ignorant when your trying to get the public vaccinated to slow down a pandemic imo.

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Thank you for the Johns Hopkins COVID-19 data, @Aleph_Null.
There’s old Iowa, among the worst, with the nation’s #2 mortality rate.
Like @ReconFire’s Alabama, our “vaccine roll out has been dismal.”
Some eastern Iowans travel to Illinois and Wisconsin for their vaccines, as local news outlets have reported.

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By the way since Biden took office the price of insulin in the USA has jumped 550 percent.

A Diabetic with type 1 diabetes can expect to pay 1200$ a month for insulin. A person with type 2 diabetes can expect to pay 2300$$ per month.

Here in Canada a person with type 1 would pay around 90$$ per month and type 2 180$$ per month.

I think it too high here in Canada and these costs should be supported by a National drug program but that said I have no idea how Diabetics in the USA can afford this. Many are out of work or on part time jobs , many are months behind on rent and now they have a must have expense that is actually more then they would pay in rent.

I do not know how anyone can support that “system”.

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"…a decades-old trends toward deregulation and market-based reforms” that have helped massive investor-run health-care systems buy up independent hospitals and physician practices and use “their monopoly power to leverage higher fees.”

Boy, is that the truth! I’ve just moved back to the county that my husband was born/raised in & that we lived in for many years, until 11yrs ago. We have recently returned & found that 1 hospital & its “physicians network” now own everything! I mean everything but the County hospital & private Kaiser medical. The 1 hospital, in addition to a major renovation, has bought up the other 2 hospitals & virtually all doctors are part of their physicians network. The few doctors who aren’t part of it have NO “hospital privileges”. A definite detriment to their medical practice.
Needless to say, the price for all kinds of medical care has skyrocketed above & beyond the big rise in medical costs elsewhere, including where we were living before this. But, patients have no choice, unless they can go to another county for all their care. Not so easy.
I’ve needed medical care since returning & hospitalized 3x. The bills for doctor visits & hospital are astronomical & I am forced to fight my health insurance on everything, since they don’t want to pay those high bills. Leaves me between a rock & a hard spot, since I am still having same health probs, but don’t dare go back to the Dr’s, since I am held responsible for everything my insurance doesn’t wanna’ pay & owe (am making payments) many $1,000’s already & more is still being argued about between hospital, insurance & me.
2 large, powerful entities & 1 still not well patient…guess who is inevitably winning the battle of who ends up paying. And, as I said, there is no longer a 2nd choice in this entire county!

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I’m gratified, in turn, to hear your accounts (and those of @BillinDubuque). My grandfather lived all his life, and my mother was born, in Mobile (as a high-school girl in CA, her nickname was “you-all”). Moving out here so young, her adult accent was the slightest vestigial hint – sometimes popping out with surprising strength on particular words, like “dinosaw.”

Today Alabama boasts a proud workforce of mainly black, mainly female Amazon warehouse workers. Keeping the whole country afloat, and seeing if Bezos will follow through on his threat to shut the whole thing down if they vote yes for unionization. (Speaking of gross inequality…)

This hospitalizations summary from OWID is a handy bookmark. Overall, beds look to be simmering down to 60K nationwide – equaling the height of our previous two hospitalization peaks. ICU occupancy is now between the previous two peaks, which differed.

~https://ourworldindata.org/covid-hospitalizations

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The financial-healthcare complex puts profit over people – it is an oxymoron. As profit grows – general health declines.
It may be concerning that both Joe Biden and the one who anointed him on behalf of the DNC, Jim Clyburn, are both beneficiaries of healthcare insurance corporate support.

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If it is possible to change insurance, a different insurance company might help.

I once lived in a place (Mobile, AL) that essentially had single payer healthcare. Thanks to immoral business practices, if you had Blue Cross you were covered. If you had any other insurance, you had problems.

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Husband’s employer provides it. But, having seen the bills & lots of extra bloodwork they did daily in hospital, I understand insurance questioning it. But, that should be worked out between the 2 large entities, not shoved off onto patient’s shoulders to be paid. I had no control over what they did, nor what the Drs who saw me 5 mins a day, charged for that. As long as medical providers get paid their money no matter what, where’s the incentive to negotiate lower prices with the Ins. Co.? They sure don’t negotiate anything with me! Just demand payment. Ins. Co. just says “no” to paying for things ~ did same with Urgent Care (who sent me to hospital when they saw how bad it was).
Meanwhile, am only getting worse & they really don’t know what’s wrong? Would take more tests Ins. wouldn’t pay for, to figure it out. What a racket!
Maybe, if they don’t find & fix, patient shouldn’t have to pay…?! LOL

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I’ve been there. Doctor billing tells you to talk to insurance. Insurance tells you to talk to doctor. And sick you gets to figure it out. You might get some help from your husband’s human resources dept. They have a little pull.

I ended up diagnosing my own mystery illness. The internet literally saved my life.

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I doubt that here in this country that we have any choice other than to not being treated. I’ve been part of the medical conglomerate system on both sides and I believe that for profit so called medical care is seriously nasty.

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Hey there, Dubuque

Something really weird happened to Iowa’s stats yesterday: The whole state’s monthly caseload more than doubled in a single day. We see counter-physical adjustments to the numbers like this from time to time (usually from Mississippi) – this is a very large one. However it happened, Iowa’s caseload propels it to the top of our digest, in a class by itself (just one day’s difference from the digest above).

STATE COVID-19 OUTBREAKS

Ranking is momentum-based on Johns Hopkins’ test-positivity factored with “per-capita newcases” (daily cases per 100K) & “immediate mortality” (the ratio of death to case tallies, analogous to case-fatality).

>                       JH     per-capita   immed
>                   positivity  newcases  mortality
>                       %          %%         %
>  1. Iowa             18.4       68.8       1.31
> --- --------------------- ---------- ----------
>  2. South Carolina    9.9       60.8       1.90
>  3. Kansas           23.5       30.1       3.86
>  4. Kentucky         17.1       41.6       1.90
>  5. Alabama          23.3       34.2       5.93
>  6. Oklahoma         13.3       43.4       1.92
>  7. Georgia          12.8       42.0       2.87
> --- --------------------- ---------- ----------
>  8. South Dakota     21.1       18.0       3.52
>  9. Virginia         11.3       38.0       1.14
> 10. Arkansas         12.0       37.3       2.44
> 11. Mississippi      15.0       33.9       2.68
> 12. New Jersey        7.7       43.1       1.77
> 13. Tennessee        10.9       30.4       3.49
> 14. North Carolina    7.7       43.2       1.83
> 15. Idaho            22.9       19.8       1.70
> 16. Florida           7.5       37.4       2.10
> 17. Arizona           7.0       46.1       3.61
> 18. Utah             11.1       35.8       0.86
> 19. New York          4.0       48.9       1.71
> 20. Pennsylvania      7.8       30.4       2.90
> 21. Texas             8.9       40.5       2.13
> 22. Delaware          5.3       39.8       1.86
> 23. Rhode Island      2.4       44.9       2.30
> 24. New Hampshire     5.5       30.5       1.49
> 25. Nevada            7.2       24.9       4.00
> 26. Ohio              8.3       28.3       1.02
> 27. Louisiana         5.6       29.9       2.38
> 28. Montana           4.9       23.9       2.77
> 29. Connecticut       3.1       33.9       2.10
> 30. California        4.3       32.4       3.41
> --- --------------------- ---------- ----------
> 31. Massachusetts     2.4       37.6       2.34
> 32. Missouri          7.1       17.1       4.23
> 33. West Virginia     4.6       29.5       2.35
> 34. New Mexico        3.5       23.9       3.71
> 35. D.C.              2.8       22.4       2.51
> 36. Colorado          4.4       21.8       1.17
> 37. Nebraska          4.2       23.6       1.32
> 38. Wyoming           2.8       19.4       3.06
> 39. North Dakota      5.0       12.9       1.65
> 40. Maryland          3.4       21.7       2.39
> 41. Illinois          3.1       21.8       2.38
> 42. Michigan          3.9       14.3       3.30
> 43. Indiana           4.0       24.8       2.83
> 44. Wisconsin         3.6       20.0       2.17
> 45. Washington        4.2       15.8       2.31
> 46. Minnesota         3.4       15.9       1.45
> 47. Alaska            2.1       22.1       0.72
> 48. Oregon            3.4       12.6       1.89
> 49. Vermont           1.6       20.0       0.69
> 50. Maine             2.6       18.6       1.51
> 51. Hawaii            1.4        5.2       4.07
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It doesn’t surprise me, @Aleph_Null, that we are in a class with the state of Mississippi. The governor ( R ) and majority ( R ) legislators are in charge, and have mishandled this pandemic from the first days. Like Trump, who the governor adores.
Iowa is a state top heavy with senior citizens, and our COVID mortality rate is usually among the highest, although the mortality number in this chart is lower. Perhaps it’s wrong, “counter-physical adjustments.”
Thanks for the data.

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With its death-rate holding fairly steady as the case-count (inexplicably) shoots up 50K, Iowa’s ratio thereof – case-fatality – has to plummet. Iowa’s all-time case fatality, at 1.48%, is now lower than the national figure. But their relative caseload (at least as reported, for now) leads the states.

~https://coronavirus.jhu.edu/region/us/iowa

The article notes that for three years (before Trump) life longevity in the USA has declined, and among other things blames this on inequality. Some part of that sounds “non sequitur” to me.

If prosperity of the masses has gone up, then life longevity should too, regardless of how much income share the top 1% earned. And much the same in the other direction. The claim really amounts to the usual charge that “the rich have gotten richer and the poor have gotten poorer.” But it is equally possible that most of the income lost by American 99% masses went instead to Chinese laborers. In which case the poor have gotten poorer, and the Chinese very poor have gotten less very poor.
- We have to consider that Americans, as a mass, are far richer than most everyone else in the world, and we don’t deserve to be.

That leaves us with some policy choices, among them:
* Hanging our 1% from the nearest lamp-posts. This likely won’t make us materially better off, but it will feel good.
* Figure out how to live better healthier lives at a lower income. I am told it can be done, starting with not smoking and eating less and healthier, plus regular exercise.