. . . but makes mistakes in it article.
"Mortality has fallen for almost everyone. You would expect this: health care and lifestyles (most notably, smoking rates) have improved. Less predictably, age affects how those gains are divvied out between rich and poor (see chart). Those over 50 have done best in rich counties, reinforcing the notion that the link between income and health is strengthening for the middle-aged. Yet among the young—and particularly among young men—the biggest gains have been in the poorest places.
There are three likely explanations. First, crime has fallen, benefiting poor areas more. In 1990 there were 37 homicides per 100,000 men aged 18-24. By 2014 there were 20. This has particularly affected black men, who more frequently fall victim to murder. In 1990 twice as many young black men died from any cause as young white men. That has fallen to 50% more, with the lower murder rate accounting for four-fifths of the improvement."
Mortality fell dramatically between 1900 and the present. Between 1900 and perhaps 1980, the primary cause of this drop was electrification, clean water, reliable sewage systems, sanitary waste disposal, refrigeration, better food handling, and food sanitation. Medicine, and healthcare played a tiny role. After 1980 the role of medicine and healthcare increased substantively but remains fairly low overall. With the historic killers now conquered, healthcare will become ever more important in extending longevity.
The article gets this mostly correct. But it also contains some serious misinformation.
"In 1997 the federal government also began helping states provide health insurance to children in families that were poor, but not poor enough to qualify for Medicaid. This has probably reduced infant deaths that happen after mothers and babies leave hospital. A study in 2014 found that such deaths are largely responsible for America’s persistently high infant-mortality rate compared with Europe’s."
The actual cause of "America's persistently high infant-mortality rate compared to Europe" is Europe cheats (this is not just restricted to Europe). In America we believe the data is king, and all births should be tallied. In Europe they do not. How each nation in Europe "cheats" is different, but they generally follow a few patterns. Many simply do not count as a "live birth" where the infant is below a particular weight. So, very small babies are never even considered, yes, these are the infants most likely to die prematurely. Some countries do not consider infants born before a specific number of gestational weeks to be live births. Again, these are the births most likely to result in premature deaths. These countries improve the statistics by simply removing from the calculation the most likely to die.
European data is at best poor, and more commonly very poor, and is almost never comparable to US data.This is one of the primary reasons that US SEER data is considered such high quality, it is as complete and accurate as possible. European data, on the other hand, must commonly be corrected for these politically demanded outcomes, and so is, accordingly, inferior. It is shocking that the Economist, which must know all of this, is still hide bound in its inaccurate taring of the US medical system.
But back to the subject at hand.
If we wish to further increase longevity in poor areas, we can do so at a negative cost. Yes, I mean negative. To do that we need to follow the Portugal, and legalize recreational drugs. As the article indicated murder rates in the US dropped dramatically between the early 1990s and today. Currently, 60% of our murder, and violent crimes are attributable to the lawless recreational drug market. Drug dealers cannot rely on police and, so, are required to resort to incredibly violent self help. This is the very reason we created government to eliminate this need. We have proven we cannot illegalize drugs, maintain civil order, and safety, the only rational recourse we have now, is to allow liberty to control this market, legalize the sale and use of these commodities, subject them to the rule of law, and then only use the police power to control the actually harmful outcomes.
By legalizing drugs we would likely be able to reduce homicide, and violent crimes by more than half. Nearly the entirety of this change would accrue to poor areas. The cost savings leading to a negative cost would come from the huge decline in necessary police, judicial, criminal justice, and corrections employment, as well as the tax monies from the sales, income taxes, etc.
The other low cost mechanism we could use is to rationally modify Obamacare to move it from a failed policy to a functional policy by allowing insurers to sell all types of medical insurance policies (including low cost higher deductible policies) on the Obamacare web sites, eliminating the complicated and frequently financially damaging Obamacare subsidy system, eliminating medicaid, and then providing a direct subsidy through an expanded tax credit (payable immediately when necessary) similar to (or an expansion of) the Earned Income Tax Credit. These healthcare funds should be paid into an Healthcare Savings Account which would earn interest tax free and be forever free of creditors, or bankruptcy, provided the funds are used for actual medical expenses.
These changes would allow all people to access low cost health insurance, and health care and not be forced into the incompetent, and occasionally deadly Medicaid system.
There is little doubt that by doing this, the cost of health insurance would begin to come down, and the long term cost of medical services would also begin to decline.
Oregon Study: Medicaid 'Had No Significant Effect' On Health Outcomes vs. Being Uninsured
Medicaid Is Worse Than No Coverage at All
We place people into these incompetent systems because politicians want control and power, and they like the graft and corruption which these systems create.
We could systematically improve the health of the poor, increase their autonomy, liberty, and still allow them access to the best medical system in the world for less cost than we pay today. To do otherwise is a moral wrong.