Since 1990, the average life expectancy of a white woman without a HS diploma has fallen by 5 years. This nearly matches the catastrophic decline of 7 years' life expectancy in Russia since the fall of communism. The corresponding decline among white men without the HS diploma has been 3 years.
These are the core of the people that Obama's Medicaid expansion was designed to save. These are the people that Republican governors wish to cast adrift without a lifeboat. These are also likely among those upon whom entitlement reform would fall most heavily.
In his blog of November 15, Krugman brought attention to an eye-opening article from September about the death toll extracted from uneducated whites by the health care mess and income inequality over the past 3 decades.
Researchers have long documented that the most educated Americans were making the biggest gains in life expectancy, but now they say mortality data show that life spans for some of the least educated Americans are actually contracting.Among the salient facts are that the life expectancy of a white woman without a HS diploma has fallen 5 years - the equivalent of returning to the life expectancies of 1960. The life expectancy for a white male w/o a HS diploma has dropped 3 years since 1990.
The latest estimate shows life expectancy for white women without a high school diploma was 73.5 years, compared with 83.9 years for white women with a college degree or more. For white men, the gap was even bigger: 67.5 years for the least educated white men compared with 80.4 for those with a college degree or better.The abstract for the underlying study ("Differences In Life Expectancy Due To Race And Educational Differences Are Widening") showed that racial disparities in life expectancy between whites and blacks have also generally widened, but not for one group. White women without a high school diploma now have a lower life expectancy than black (or Hispanic) women of the same educational level.
The dropping life expectancies have helped weigh down the United States in international life expectancy rankings, particularly for women. In 2010, American women fell to 41st place, down from 14th place in 1985, in the United Nations rankings. Among developed countries, American women sank from the middle of the pack in 1970 to last place in 2010, according to the Human Mortality Database.
One factor: 43% of whites with no diploma have no health insurance, compared to 35% in 1993. Another factor for women, incidence of smoking has increased in this group, for men it has declined. For both men and women obesity has risen - one of many reasons Obamacare stresses preventative medicine.
When race and college education interact, the differences in health can be dramatic:
In 2008 white US men and women with 16 years or more of schooling had life expectancies far greater than black Americans with fewer than 12 years of education—14.2 years more for white men than black men, and 10.3 years more for white women than black women. These gaps have widened over time and have led to at least two “Americas,” if not multiple others, in terms of life expectancy, demarcated by level of education and racial-group membership. (from abstract)(A new slogan? Get a college education to save your life.)
So now a large group of Republican Governors wish to block implementation of Medicaid for person up to 133% of the poverty level. With American health care imitating the Russians for the uneducated, this is like stopping a Good Samaritan from throwing a life preserver to a woman overboard.
CALL TO ACTION
Democrats and health professionals in the red states need to bring this outrage and scandal to the public's attention. Letters to the editor, social media, distribution of the NYTimes article, and more creative ways.
It's not only a matter of humanity, it's a matter of math. After all citizens in these states will be paying all the same federal taxes as citizens where health care is provided. They just won't get their share of the money. Initially all and years down the road, 90% of the cost will be borne by the Feds. Economic studies show that the eventual 10% that the states will contribute will save more than those sums from state budgets in reducing their other health care costs.
Unhealthy workers are unproductive workers. Given that you're already paying the taxes for this benefit, it supports the business community.
It's needed to support the general health care community. Reimbursement schedules have been revised on the assumption that the number of unpaid services performed by hospitals will dramatically decline. If Medicaid is not paying for these patients many hospitals may hit a wall.
Because of these financial issues for hospitals, there is also an appreciable chance that the Republican Governor's stance could have disastrous impact for those now on Medicare and Medicaid, as well as the health system generally. Many hospitals who serve patients through emergencies skate on thin ice as it is. This could very well be the tipping point to crash the system.
(This is almost certainly why Gov. Scott of Florida is belatedly "trying to get to yes." He may be an ass, many of you think he is a crook, but he understands the basics of the economics of the health care system.)
As Obamacare comes to the states and meets Republican obstruction on Medicaid expansion, I truly believe it has the potential as a wedge issue for Democrats. Although Democrats do better with whites without a diploma than whites with just a HS diploma, they lose lots of these votes and almost all of them (outside of Union members) in the South. Don't let them do this horrible deed in the dark, without paying a political price for it - particularly if it all blows up.
In the afterglow of November 6th, it is easy to forget that we are heavy underdogs in 2014 and we have trojan's work to do to start recouping the losses of 2010. It's time to get started.
ON THE BUDGET FRONT
This article dramatically illustrates why age adjustment of Medicare and Social Security payments is the absolute worst way to trim spending. It's like a means test in reverse. The well-educated, who have prospered in life continue to get the great bulk of their benefits, and those who need the benefits the most lose a big chunk of theirs. Rob from the poor and uneducated to secure the benefits of the well-educated.