I found this piece by Scott Atlas on improving healthcare for minorities and the poor at RealClearPolitics interesting. The article itself is a sort of grab bag of complaints about the U. S. healthcare system and, particularly, Medicaid. Here’s a snippet:
The goal should be to increase access to high-quality health care and improve health, not simply to label people as “insured.†But Medicaid patients fare worse than patients using private insurance in study after study – even after standardizing for medical differences among patients. Those bad outcomes include more frequent complications and more deaths in treated cancers, heart procedures, transplants, and major surgeries. A 2013 Oregon randomized study’s most striking conclusion was that Medicaid fails to improve physical health beyond no insurance at all.
and here’s an example of what he’s complaining about:
Infant mortality rates have been improving in the U.S. since 1995, with the lowest in history for all races recorded in 2020, but infant mortality rate by race of the mother for blacks (10.38) remains double to triple that of infants born to whites (4.4), Hispanics (4.69), or Asians (3.14). Similarly, Hispanic Americans and whites have a life expectancy six years longer than blacks, not counting data since the pandemic.
That difference in health outcomes has been put forth as a key reason to expand single-payer health insurance in the United States. An inexplicably ignored logical flaw in that argument is that those very same health disparities for minorities are seen in the countries with the longest history of single-payer healthcare systems. For instance, in the government-run system of Canada, Inuit and First Nation infant mortality was two to four times that of non-indigenous Canadians and Quebecois. The same goes for the United Kingdom, where black Caribbean and black African infant mortality rates are double those of whites.
Decreasing infant mortality is a worthy goal but achieving it is not trivial. The very examples cited above illustrate the problems. Under the British system everyone is insured under the same system of national health. If the black mothers in the UK experience the same level of infant mortality as they do here in the States, it calls into question bringing everybody under the same system as a solution. Canada, where insurance is handled by the provinces, has problems on roughly the same scale. The infant mortality rate among Hispanics is roughly the same as among whites regardless of income.
There appears to be a pretty close correlation between low birthweight babies and infant mortality and there appears to be a correlation between substance use in pregnancy and low birthweight babies. Could it be that social issues have more to do with it than care or genetics?