JustCare

Tag: Death

  • Why do Americans die younger than people in other wealthy nations?

    Why do Americans die younger than people in other wealthy nations?

    Americans have shorter life expectancies than people in other wealthy nations, even though we spend more on health care than other nations. The Peterson-KFF Health System Tracker looks at why it is that Americans die younger than people outside the US.

    KFF studied mortality rates in the US as well as Austria, Belgium, Canada, France, Germany, Japan, Netherlands, Sweden, Switzerland and the United Kingdom. Americans have a premature death rate of 408 deaths for 100,000 people under 70. The other countries had 228 premature deaths, close to half as many as people in the US.

    Unlike other wealthy nations, which have seen a reduction in the number of their premature deaths, the US has faced an uptick since 2010. Americans had a similar life expectancy as people in peer nations 45 years ago. We saw some increase in life expectancy with scientific advancements, but other countries saw greater increases in life expectancy by 1990. Moreover, peer countries did not see as great a reduction in life expectancy from COVID-19 as the US.

    Heart disease and cancer are the two leading causes of death in each of the countries studied, particularly for older adults. New medicines have reduced the number of premature deaths from heart disease. But, since 2010, Americans have seen an increase in premature deaths from heart disease, while other countries have seen a decrease.

    Americans suffer more from heart disease, chronic respiratory diseases, and chronic kidney diseases, which are collectively responsible for about 105 of the 408 premature deaths. COVID-19 was responsible for 64 of the 408 premature deaths in the US, and substance abuse was responsible for 29 of the premature deaths.

    Today twice as many Americans die of heart disease before the age of 70 than people in peer countries, likely because of more substance abuse and obesity in the US. Moreover, people with chronic heart conditions need ongoing medical care to remain healthy. But, Americans face much larger barriers to care than people in other countries.

    Cancer death rates declined by 40 percent in the US since 1988 for people under 70. And, the US cancer death rates remain comparable to those in peer countries over the last 40 years. Older Americans are less likely to die of cancer than people in peer nations. Some believe that’s because more Americans have died prematurely of other conditions than people in peer nations.

    Younger Americans suffer more from chronic conditions, substance abuse, injuries and communicable diseases than people in peer nations. Fifteen to 49 year olds in the US suffer two and half times more premature deaths than 15-49 year olds in peer nations. The premature death rate for this population in the US has not changed much in the last 45 years. In peer nations, it has dropped by half!

    The US has also seen higher numbers of childhood deaths than other wealthy nations. Over the last 45 years, the number of deaths of 0 to 14 year olds in the US has declined some, but it’s still higher than peer nations, 20 more deaths per 100,000 American kids. Some attribute this difference to racial disparities leading to worse health of babies at birth, more of whom are born premature or with congenital birth defects. In addition, three to four times more American kids died from killings, travel fatalities (we drive bigger cars and have less public transportation) and choking.

    Thankfully, medical advances have reduced death rates a lot. Many fewer people die of neonatal conditions, birth defects and HIV/AIDS. Deaths resulting from heart conditions also have dropped considerably. And, because fewer people smoke, fewer people are dying of cancer and heart disease. But, we are the richest country in the world, and there’s no excuse for our continuing to have shorter life expectancies than people in ever other wealthy country.

    Here’s more from Just Care:

  • It’s once again time to get your flu shot!

    It’s once again time to get your flu shot!

    It’s important to get the flu shot every year, no matter how old you are. It’s particularly important for older adults. And, it is all the more important with Covid-19 surging. Now that it’s sweater weather, it’s time to get your flu shot!

    Talk to your doctor about getting the flu shot and about whether you should get a special vaccine available for people over 65. The good news: Medicare covers the full cost of a flu shot.

    You do not need to go to the doctor’s office for your flu shot. You can likely get the flu shot at your local pharmacy or your local supermarket. More pharmacies are offering drive-through and curbside flu shots, in addition to in-store vaccines.

    Why get the flu shot now? That’s how you best protect yourself, the people you love and your community. The flu, like Covid-19, can be lethal. It kills thousands of people each year. Because people have been taking precautions against Covid-19 though, in 2021-22, the CDC found a significant drop in hospitalizations and deaths from the flu. Ten thousand people in the US were hospitalized from the flu and 5,000 people died. Older adults are more likely to die from the flu than younger people.

    The flu vaccine takes between two and four weeks to become effective. So, even if you get it now, it might not protect you from the flu until the end of October. It will not protect you from Covid-19, though the symptoms can be quite similar–a cough, a cold, sore throat, fever. You should also talk to your doctor about getting the Covid-19 booster shot, now available; also ask whether you should get the new RSV vaccine.

    Sometimes the flu shot will not keep you from getting the flu. However, even if you get the flu, the flu shot reduces the odds that it will be a severe case. The flu shot may keep you from being hospitalized for the flu or, worse still, from being in the intensive care unit of the hospital. It also reduces your risk of death.

    You shouldn’t wait to get the flu shot. No one knows whether the flu season will begin this month or next. You want to protect yourself as soon as possible.

    You need the flu shot even if you haven’t gotten the flu before. (There is one exception: People who are allergic to the flu vaccine.)  There is only benefit from getting the flu shot. The flu shot cannot give you the flu.

    Here’s some good news: Everything you are doing to protect yourself from Covid-19–social distancing, wearing a mask and regular hand washing–should also minimize your chance of getting the flu!

    A version of this post was originally published on September 9, 2020.

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  • Falls are primary cause of harm and death for people over 65

    Falls are primary cause of harm and death for people over 65

    Unintentional falls are the primary cause of harm and death for people over 65 reports the Centers for Disease Control in a new report. You might have thought it was car accidents or cancer. Fortunately, many falls are preventable.

    Nearly one in four older adults (14 million) reported falling in 2021. Fall rates, or at least reporting of fall rates, are higher in some states than in others.  In Alaska, nearly four in ten older adults reported falling in 2020. In Illinois, just under two in ten reported falling. In 2o21, overall, 100 older adults died each day from falling.

    While women fall more than men, men are more likely to die as a result of a fall than women. Just over 91 men out of 100,000 died of a fall in 2020, while 68 women out of 100,000 died of a fall.

    Death rates from unintentionally falling also varied dramatically from state to state. In Alabama, 31 out of every 100,000 people died as a result of falling. In Wisconsin, 177 out of every 100,000 died as a result of falling.

    Here’s what you can do to minimize your risk of falling:

    • Have your primary care doctor assess you for the risk of falling.
    • If your risk is high, determine whether there are any specific causes that can be treated and ask your doctor to check your medications.
    • Get physical therapy–Medicare should cover it in full with a prescription from your doctor.
    • Modify your home to reduce trip hazards such as loose rugs and bedding.

    The National Council on Aging offers a free check-up that you can do yourself to determine if you are at risk of falling. To take the check-up, click here.

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  • Covid deaths on the rise, particularly among older adults who have not gotten booster shots

    Covid deaths on the rise, particularly among older adults who have not gotten booster shots

    ABC News reports that only one in three older adults have received a Covid 19 booster shot. Not surprisingly, three times more older adults are being hospitalized for Covid 19 than younger adults. And, more than nine in ten deaths from Couid are among older adults.

    Earlier this month, nearly seven in 100,000 older adults were hospitalized with Covid. In sharp contrast, fewer than one percent of people under 18 were hospitalized with Covid. The number of hospitalized older adults is trending upwards.

    Many hospitalized older adults with Covid will be ok. But, some will have long Covid. Today, more than nine in 10 Covid deaths are among Americans 50 and over. Covid deaths are highest among older adults 80 and over.  After then, death rates are highest among those between 60 and 79 who are unvaccinated.

    Older adults who have received booster shots are far less likely to be hospitalized than those who have been vaccinated but not boosted. To be clear, more than nine in 10 older adults have received the Covid vaccine. But, fewer than one in three of them have received the booster shot.

    if you haven’t yet gotten the Covid booster shot, you need it!

    Why haven’t more older adults received the booster shot? Many people do not appreciate how much they need it. They also might not know it’s free. Or, they might have had Covid and mistakenly think they are protected against getting it again.

    Covid 19 is not the only virus older adults need to protect themselves against. Older adults are also being admitted to hospital for the flu and RSV at a rate of 18 and 3.5 per 100,000, respectively.

    Here’s more from Just Care:

  • How prior authorization requirements in Medicare Advantage could threaten your health

    How prior authorization requirements in Medicare Advantage could threaten your health

    If you’re in a Medicare Advantage plan and have needed any costly care, you likely know about prior authorization requirements that save corporate health insurers money but can threaten people’s health and well-being. Doctors say that many of these requirements are not evidence-based but, somehow, they are allowed. In an opinion piece for the AMA News, Gerald Harmon, MD, President of the AMA, describes how prior authorization “administrative hassles” could threaten your health.

    People in traditional Medicare do not have to deal with prior authorization requirements in order to get the care they need. If their doctor recommends a test or a specialty service, Medicare pays. In stark contrast, Medicare Advantage plans impose prior authorization requirements in a variety of situations, often harming patient health. AMA doctors surveyed reported incidents of preventable “hospitalization, disability and permanent bodily damage, or death” for patients they care for as a result of prior authorization requirements.

    Dr. Harmon writes about his attempt to get prior authorization for his 92-year old mother, which kept her from getting important drugs for an unknown period of time. He spent an hour trying to expedite approval of his mom’s prescriptions with no success. After trying to get help from a variety of folks, he turned to his mom’s doctor who took over the effort to get his mom the drugs she needed.

    Even with help from his mom’s doctor, there was no guarantee his mom’s insurer would authorize her drugs for several days. In turn, Dr. Harmon was deeply concerned about the deleterious effects on his mom’s health of not having needed medications. Note: Dr. Harmon was not concerned about drug copays–another enormous barrier to care–that leads to thousands of unnecessary deaths of people with Medicare each year.

    The AMA has an initiative to “fix” prior authorization requirements. For sure, prior authorization should either be eliminated or restricted to specific evidence-based situations when certain treatments might not be warranted. They should never prevent patients from getting timely access to needed care.

    The AMA supports bi-partisan legislation in Congress that would help people in Medicare Advantage plans, the Improving Seniors’ Timely Access to Care Act of 2021 (H.R. 3173/S.3018). It wouldn’t eliminate prior authorization, but it would simplify and standardize it.

    If you have stories about how prior authorization in Medicare Advantage kept you or someone you love from getting needed care, please send them to [email protected].

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  • Death and debt by deductibles

    Death and debt by deductibles

    Note: This post was originally published on The Potter Report.

    Congrats, America! Earlier this month you passed an annual milestone: Two days after Tax Day, you made it to… Deductible Relief Day!

    What’s that? It’s the day where the average person with employer-based health insurance has spent enough on health expenses to finally meet their deductible.

    Health insurance deductibles have been rising so rapidly (year after year after year) that the Kaiser Family Foundation decided to track the trend to show how severely Americans are getting ripped off (and sick). And it’s bad.

    As you might guess, the Deductible Relief Day is being pushed further each year. In 2005, you had to wait until February 28. By 2009, you wouldn’t be popping champagne until March 18. In 2019, you waited two months more than that.

    As the Kaiser Family Foundation noted, in 2009, the average deductible was $533 for a single person. In 2018, it was $1350. How? The insurance industry strategy of moving all of us into high-deductible plans (one of the many gross abuses I saw first-hand at Cigna) has paid off well for my former employers.

    In 2018, about 85% of covered workers were enrolled in a high-deductible plan, up from just 50% ten years earlier. Another way of looking at this: Average enrollee spending on deductibles more than tripled between 2007 and 2017.

    And Kaiser didn’t look at people who buy their coverage on their own through the ACA exchanges. They’re in even *worse* shape. The Commonwealth Fund found that 40% of people in ACA plans are underinsured because of high out-of-pocket charges – and many likely never meet their deductibles.

    As a result, millions of Americans are not going to the doctor or picking up prescriptions. Insurers LOVE that. It’s far fewer claims to pay! It’s why, when many other businesses went belly up during COVID-19, insurers made record profits: medical treatment was less accessible!

    President Biden, are you paying attention to this? You must.

    Millions of people WITH insurance who voted for you, including folks on Obamacare, CAN’T USE IT because of deductibles! Insurers can charge families up to $7,200 before they’ll pay a dime. It keeps going up. Every. Single. Year.

    No wonder more and more Americans with insurance are turning to GoFundMe or bankruptcy court. It’s not just the premiums you gotta worry about, Joe. Deductibles are eating us alive. You and Congress need to pay attention before NO Americans can meet their deductibles.

    Here’s more from Just Care:

  • Coronavirus: Senator Casey proposes legislation to protect nursing home residents and workers

    Coronavirus: Senator Casey proposes legislation to protect nursing home residents and workers

    As of now, more than 170,000 older Americans living in long-term care facilities and their caregivers have died from COVID-19. That works out to more than one in three people in the US who have died from COVID-19. Senators Casey, Whitehouse, Warnock, Booker and Blumenthal have introduced legislation to bring down the number of nursing home deaths. 

    Large numbers of nursing homes and other long-term care facilities were unprepared for the novel coronavirus. They did not have the personal protective equipment and other resources they needed to ensure the safety of their staff and residents.

    If passed, the COVID-19 Nursing Home Protection Act would provide additional money to states to ensure that residents and workers had necessary resources for their safety. Money would be available for infection control help and for organizing local workers to assist with both patient care and managing COVID-19 outbreaks. Money could also go towards ensuring everyone in these facilities got vaccinated.

    Significantly, the COVID-19 Nursing Home Protection Act would also mandate that the Department of Health and Human Services collect and publicly report demographic data regarding the number of cases of the virus and virus deaths in nursing homes. Among other things, information on age, race and ethnicity would be required.

    The pandemic’s toll has been greatest on older people of color. Nursing homes with high proportions of Black and hispanic patients had disproportionately high case and death rates. Three times more people of color died from COVID-19 in these facilities than in facilities that had mainly white patients.

    Nursing home residents are among the most vulnerable Americans. The COVID-19 Nursing Home Protection Act is designed to protect them. The Democrats have majorities in the House and the Senate. The question is will some of the more moderate members of this Democratic Congress support this legislation or will they put the kibosh on it?

    Here’s more from Just Care:

  • FDA is hiding information on supplements that are dangerous

    FDA is hiding information on supplements that are dangerous

    The FDA regulates dietary supplements, including beauty products, sexual enhancement products, and workout supplements. But, it does not make a determination about the safety or efficacy of these supplements before they become available to the public. Because these supplements can literally kill people, the FDA is supposed to disclose reports of harm from supplements. Why is the FDA hiding information about supplements that are dangerous?

    To protect Americans, the FDA has a database, CAERS, that is supposed to include information on supplements that are reported dangerous, including product complaint reports. CAERS is open to public scrutiny because Americans should know when a supplement is dangerous.

    But, Consumer Reports has found that the Trump administration is not disclosing information about many supplements that are dangerous; prior administrations have also not done so to the extent required. According to Consumer Reports, the CAERS database does not disclose the names of hundreds of manufacturers of products that have been reported to cause harm. Rather, the FDA is giving many manufacturers an exemption, putting the businesses of manufacturers ahead of the safety of Americans.

    The FDA has always exempted a small class of products from being reported for public view (<5 percent) in an effort to encourage manufacturers to report consumer complaints to the FDA. The FDA appears now to be applying this exemption far more broadly, counter to FDA policy.

    With products that cause death or hospitalization, a manufacturer must let the FDA know. And, the FDA is supposed to make that information available to the public. Also, when an individual or a physician submits a report about a product, the product’s name is supposed to appear in the CAERS database.

    After analyzing documents released because of a Freedom of Information Act request, Consumer Reports found that the FDA exempted more than 400 supplements, even though they were reported to have caused hospitalizations or deaths. The FDA is now saying that these reports were “mislabeled,” acknowledging that the products should have been disclosed.

    The CAERS database came into being in 2003 to make consumers aware of safety issues from supplements. But, in 2015, the FDA began exempting 15 percent of product names from public view. During the Trump administration, those exemptions have doubled to more than 30 percent of product names.

    Millions of Americans take supplements on a daily basis. And, many swear by them. But, there is little scientific evidence that they provide benefits in most cases. And, lots of evidence that they can cause serious harm.

    On top of the failure of the CAERS database to disclose information critical to the health and safety of Americans, the CAERS database is hard to search. The FDA also operates a FAERS database in which adverse events related to drugs are reported. That database is easily searchable.

    Here’s more from Just Care:

     

  • Coronavirus: How many more nursing home residents will die before the Senate acts?

    Coronavirus: How many more nursing home residents will die before the Senate acts?

    Not only has the US not been able to contain the spread of the novel coronavirus, it has allowed COVID-19 to kill tens of thousands of vulnerable older adults and people with disabilities living in nursing homes. How many more nursing home residents will die before the Senate acts?

    Here are the numbers: Every hour eighteen nursing home residents die. Every week, more than 3,000 nursing home residents die. In the last five months, more than 50,000 nursing home residents have died. When will this plague end?

    Many of these mothers, fathers, sisters, brothers, aunts, uncles, friends and neighbors would still be alive today were it not for COVID-19. They’d still be alive today were it not for the failure of US leadership in containing the novel coronavirus. They’d still be alive today were it not for their nursing homes’ mishandling of the novel coronavirus.

    Nursing home residents represent more than one in ten COVID-19 cases. Yet, four in ten people who die of COVID-19 are nursing home residents. In some states, nursing home residents represent more than half of COVID-19 deaths. And, these are the reported cases. Lord knows how many of these deaths are going unreported.

    Tens of thousands of nursing home COVID-19 deaths were preventable. Everyone knew that nursing home residents were at especial risk because of their age and compromised health. Still today, with deaths skyrocketing, our federal government is failing to act.

    President Trump and Senate Majority Leader Mitch McConnell (R-KY) won’t ensure that nursing homes have the money and resources needed so that their residents and staff are safe and healthy. They are focused on helping wealthy corporations, wealthy hospitals, and wealthy executives, including nursing home executives. The nursing home industry has a powerful lobbying machine that continues to be successful at protecting nursing home profits rather than nursing home people.

    Nursing home owners, including many private equity firms, take government money for nursing home care to benefit their investors, leaving nursing homes without the funding to properly care for their residents or pay their staff. Nursing homes have been given immunity from prosecution on many grounds, notwithstanding preventable deaths among their residents and staff.

    The US House of Representatives has passed the HEROES Act, which would protect nursing home staff and residents. The HEROES Act allocates money for testing and personal protective equipment. It sets aside funds for COVID-19 only nursing homes to isolate and contain the spread of the virus. These measures would help prevent nursing home residents from dying needlessly from COVID-19.

    To be sure, beyond the HEROES Act, more must be done to protect older and disabled Americans, to ensure they have a good quality of life and can live with dignity. They need better quality care in nursing homes, and they need expanded Social Security benefits. For our collective health and our collective conscience, we must insist on that.

    Here’s more from Just Care:

  • Berwick: Medicare for All lowers costs and reduces confusion and paperwork

    Berwick: Medicare for All lowers costs and reduces confusion and paperwork

    How do we keep Americans from dying for lack of health care? That’s the question every policymaker and pundit should be asking, along with which health care reform proposals will best prolong people’s lives. Don Berwick, former head of the Centers for Medicare and Medicaid Services (CMS), explains in a USA Today op-ed that Medicare for All guarantees health care for all, lowers costs, and reduces confusion and paperwork.

    Berwick is an expert, who has had a 360 degree view of our nation’s health care system. In addition to having been head of CMS, he is a pediatrician and researcher at Harvard Medical School, who has witnessed the challenges with our health care system firsthand. He has a very different perspective from the pundits and the politicians who too often parrot right-wing talking points; they don’t understand the challenge of fixing our health care system as long as private insurance companies can drive up costs and profit from denying care, Berwick appreciates that Medicare for All would sharply reduce the inappropriate denials and high costs.

    Berwick explains that Medicare for All guarantees everyone coverage and lowers costs significantly. It would let us spend our health care dollars on public health crises instead of administrative waste. It would help us invest in disease prevention. It simplifies and streamlines our fragmented health care system.

    Proposals such as Medicare for those who want it, sometimes called the public option, or Medicare Advantage for All do not simplify the system, nor is there data to suggest they deliver savings. As Elizabeth Warren suggested, Medicare for all who want it is a euphemism for Medicare for people who can afford it. It retains a complex and costly health care system that does not allow for simplification or waste reduction.

    By current estimates, Americans (federal and state governments, employers and individuals) will spend a total of $52 trillion over the next ten years on health care without Medicare for All. With Medicare for All, we will spend about $52 trillion and everyone has comprehensive benefits. Projected new federal spending (which is simply a shift from private spending) is $20.5 trillion over ten years.

    Medicare for All guarantees access to care and prevents tens of thousands of needless deaths and bankruptcies. Medicare for All reduces health care costs for families. In the last ten years, health care premiums were up 54 percent, with workers paying about 71 percent of those costs. Yet, wages have only increased 26 percent.

    Medicare for All does not change the way we get our care, only who pays for our care. We still go to private doctors and hospitals. What’s different is that we no longer have to worry about whether they are in network or what we will have to pay.

    If you support Medicare for all, please let Congress know. Please sign this petition.

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