That was a reasonable picture of medicine well into the 20th century, as the table below shows, when infectious diseases dominated U.S. deaths. But by 1950, heart disease and cancer had displaced infections as the nations most potent killers. (Diseases of early infancy was still the fourth-leading cause of death in 1950. By 2010, they had dropped off the table entirely.) Changes in Causes of Death (number of deaths per 100,000) Source: http://www.dailymail.co.uk/news/article-2168836/Cause-death-American-100-years.html Today, more than 75% of all U.S. health-care costs are due to chronic conditions (like heart disease) with a strong behavioral component i.e., smoking, diet, exercise, etc. A sedentary life revolving around high calorie food may be many things, but its not an Act of God. The picture gets even more complex when you break down life expectancy by geographic and racial factors as Harvard researchers did in 2006 . They found not one America, but eight, divided by lines that dont map neatly to income or race. Asians in the U.S., it turns out, live longer than any other cohort, and have for the last few decades. The second longest-lived group were Midwestern whites with lower than average income. Overall, Harvard researchers noted that the gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 years. The mix of genetics, income, education, and culture implied by the Eight Americas is dizzying. How to raise life expectancy for the group with the poorest life expectancy (urban black males) is, indeed, a worthy topic of public policy discussionbut is it one that should be dominated by health insurance or health care? And what ethnic-cultural-genetic life expectancy melange should we adopt for our national standard? Optimistically, Obamacare tasks doctors, especially primary-care physicians, with creating medical homes for patients, hopefully addressing the variation in health outcomes and reducing costs associated with managing serious chronic illnesses.
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This post is strictly meant to be a hypothetical exercise for me in the hopes of helping others to navigate their own particular states Health Insurance Exchange. The parameters of my hypothetical exercise are as follows. I am a 30 something that has had 7 surgeries since 2003 and is currently battling chronic Gout and Osteoarthritis. My income falls in the $15-20/hour range, own my own home, and dont smoke. Due to the swelling and pain associated with these types of arthritis, I need a plan with a prescription drug component. Im single, no dependents, work out 2-4 a week, and work full-time.
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The Anchoress 