{"id":29606,"date":"2013-10-22T12:03:46","date_gmt":"2013-10-22T11:03:46","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=29606"},"modified":"2013-10-22T12:03:46","modified_gmt":"2013-10-22T11:03:46","slug":"edward-davies-obamacare-its-time-to-stop-rooting-for-failure","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/10\/22\/edward-davies-obamacare-its-time-to-stop-rooting-for-failure\/","title":{"rendered":"Edward Davies: Obamacare\u2014it\u2019s time to stop rooting for failure"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" style=\"float: left\" alt=\"Edward Davies\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/eddavies.jpg\" width=\"160\" height=\"110\" \/>\u201cObamacare\u201d is much in the headlines right now and not for the right reasons. Having been the bargaining chip of choice for Republicans during this month\u2019s shutdown, the \u201chealth exchanges,\u201d through which patients can purchase insurance, are suffering some fairly major glitches.<\/p>\n<p>The consequence is that it is now open season on the Affordable Care Act. You would expect an organ such as Fox News to relish the problems with headlines such as &#8220;<a href=\"http:\/\/www.foxnews.com\/politics\/2013\/10\/21\/obamacare-meltdown-even-media-liberals-are-appalled\/?cmpid=cmty_twitter_fn\">Obamacare Meltdown&#8221;<\/a> and &#8220;<a href=\"http:\/\/www.foxnews.com\/politics\/2013\/10\/21\/obamacare-damage-control\/?intcmp=trending\">Obamacare Damage Control<\/a>.&#8221; Less expected are the headlines from traditionally more sympathetic media\u2014the <em>Huffington Post<\/em> talks about the <a href=\"http:\/\/www.huffingtonpost.com\/2013\/10\/18\/obamacare-train-wreck_n_4118041.html?ncid=txtlnkusaolp00000058\">Obamacare train-wreck<\/a>, and a <em>New York Times<\/em> op-ed headline reads \u201c<a href=\"http:\/\/www.nytimes.com\/2013\/10\/20\/opinion\/sunday\/douthat-obamacare-failing-ahead-of-schedule.html\">Obamacare: Failing Ahead of Schedule.<\/a>\u201d<!--more--><\/p>\n<p>And so today Obama addressed the nation and implored them: \u201cIt\u2019s time to stop rooting for failure.\u201d<\/p>\n<p>The American health system has two major problems which Obamacare seeks to address. The first is spending\u2014America simply spends twice as much on health per capita as almost any other developed nation on earth for little extra return on morbidity and mortality. The second is the number of people that simply don\u2019t have healthcare insurance. While the first is a big problem, the second is a giant moral carbuncle on the face of a great nation.<\/p>\n<p>The very nature of the situation makes good data hard to come by but, however you measure it, tens of thousands of Americans die every year because they don\u2019t have enough or any\u00a0 insurance. Predictions in the last few years include, at the bottom end of the scale, advocacy group <a href=\"http:\/\/www.reuters.com\/article\/2012\/06\/20\/us-usa-healthcare-deaths-idUSBRE85J15720120620\">Families USA, who estimated last year<\/a> that more than 26,000 working-age adults die prematurely in the United States each year because they lack health insurance. In 2009 research published in the <em>American Journal of Public Health<\/em> came up with the figure <a href=\"http:\/\/www.pnhp.org\/excessdeaths\/health-insurance-and-mortality-in-US-adults.pdf\">that 45,000 annual deaths<\/a> were associated with a lack of health insurance.\u00a0 Last year, Public Citizen used that research to arrive at the conclusion that the figure would now be <a href=\"http:\/\/www.citizen.org\/Page.aspx?pid=5268\">over 50,000<\/a>.<\/p>\n<p>To put this insurance coverage position in a global context, the USA sits just below Mexico (32nd) in terms of the population coverage according to OECD <a href=\"http:\/\/www.oecd-ilibrary.org\/social-issues-migration-health\/data\/oecd-health-statistics\/oecd-health-data-social-protection_data-00544-en\">health data<\/a>, and just above Chile (34th). It can only aspire to the universal coverage achieved in countries like Italy, Ireland, and Israel.<\/p>\n<p>But it is the individual, personal cost that is far more striking. Colorectal cancer is one of the leading causes of cancer death in the USA and the American cancer society predicts it will <a href=\"http:\/\/www.cancer.org\/cancer\/colonandrectumcancer\/detailedguide\/colorectal-cancer-key-statistics\">cause over 50,000 deaths in 2013<\/a>\u2014the same as Public Citizen expects will die through lack of insurance. The figures for deaths in which diabetes was the underlying cause are not much higher at around 70,000 and this is with America\u2019s obesity epidemic.<\/p>\n<p>Put in a wider social context, almost twice as many Americans will die due to a lack of insurance this year as will die in <a href=\"http:\/\/www-nrd.nhtsa.dot.gov\/Pubs\/811630.pdf\">motor accidents<\/a>\u2014the single biggest cause of non health related deaths in the US. On the Public Citizen estimate, as many Americans will die this year due to a lack of insurance as died in the entire <a href=\"http:\/\/www-nrd.nhtsa.dot.gov\/Pubs\/811630.pdf\">Vietnam War<\/a>. Indeed even at the lowest estimate of 26,000 deaths per year due to the lack of insurance, that is still more than 10 times as many Americans as have died in all military operations in <a href=\"http:\/\/icasualties.org\/oef\/\">Afghanistan since 2001<\/a>.<\/p>\n<p>The insurance gap is death on the scale of 9\/11 every month. It is your very literal neighbour dying of something you won\u2019t. It is tens of thousands of real people dying, hidden by the lack of health data that will simultaneously cause their death.<\/p>\n<p>And in a country with the ethos, charity, and beneficence that the USA truly has at its core, it should not be allowed to stand unchecked. Americans are consistently among the world\u2019s greatest <a href=\"http:\/\/www.huffingtonpost.com\/2011\/12\/19\/world-giving-index-us-ran_n_1159562.html\">donors and doers of charity<\/a>. Indeed, the country is founded on a declaration that all men are created equal\u2014something said to be self-evident. So why is it so spectacularly not evident in healthcare? Why does this great nation allow such mass inequity to continue unabated, to the tune of 50,000+ deaths?<\/p>\n<p>Which brings us back to Obamacare\u2014because at long last something is trying to abate this tragedy. And for all its doubtless manifest failings, for the trials it may cause small businesses, the difficulty of the websites, the government infringement on liberty, it is a fundamental attempt to rectify a massive moral failing at the heart of the nation.<\/p>\n<p>So I\u2019m with Obama on this one. Nobody said change would be easy, but it\u2019s time to stop rooting for failure.<\/p>\n<p><em><strong>Edward Davies<\/strong> is US news and features editor, <\/em>BMJ.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cObamacare\u201d is much in the headlines right now and not for the right reasons. Having been the bargaining chip of choice for Republicans during this month\u2019s shutdown, the \u201chealth exchanges,\u201d [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/10\/22\/edward-davies-obamacare-its-time-to-stop-rooting-for-failure\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1357],"tags":[],"class_list":["post-29606","post","type-post","status-publish","format-standard","hentry","category-us-health-care"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Edward Davies: Obamacare\u2014it\u2019s time to stop rooting for failure - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/10\/22\/edward-davies-obamacare-its-time-to-stop-rooting-for-failure\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Edward Davies: Obamacare\u2014it\u2019s time to stop rooting for failure - The BMJ\" \/>\n<meta property=\"og:description\" content=\"\u201cObamacare\u201d is much in the headlines right now and not for the right reasons. 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