Deaths of Despair: Why America’s Medical Industry Explains Working-Class Suicides
From The Guardian: “The US healthcare system is helping to kill people in staggering numbers. And when it isn’t driving Americans to an early grave, the medical industry is bleeding the rest of the country of resources at the expense of decent jobs, crucial infrastructure and schools, according to a new [2020] book by two of the country’s leading economists.
As America’s health system faces its greatest challenge of recent times in the coronavirus, Anne Case and Angus Deaton, who won the 2015 Nobel prize for economics, say the pursuit of profit by medical corporations has played a leading role in the surge of ‘deaths of despair’ since the 1990s, led by opioid overdoses, alcoholism and suicide.
The Princeton economists were the first to reveal the phenomenon which by 2017 was claiming the lives of 158,000 Americans every year – a number they liken to three 737s’ worth of passengers falling out of the sky every day. Case and Deaton, who are married, also discovered that the surge in deaths of despair was overwhelmingly among white working-class Americans without a university degree, and that it was forcing down life expectancy in the US.
Now their new book, Deaths of Despair and the Future of Capitalism, explores why this tragedy is an unusually American phenomenon and concludes that the greed of the US’s medical corporations was both an important driver in creating the conditions for the rise in deaths of despair and in providing the means for many to kill themselves.
The book springs from Case and Deaton’s shocking revelations five years ago about the causes of so many Americans dying in middle age and younger, a phenomenon not seen in any other industrialised country. Life expectancy rose sharply in the US through the 20th century but over the past two decades fell by 25% for white Americans without a university degree even as it continued to rise for the better educated and for other races. The geography of this tragedy – people dying younger in West Virginia and Mississippi and living longer in New York and California – reflects the country’s deepening class divide.
The couple concluded that the medical industry is at the heart of two key drivers in making those deaths an American phenomenon.
‘One fact is that they unleashed these extremely powerful opioids on to the general public as if they were jelly beans at an Easter parade and that has not happened in Europe,’ said Case. ‘The second is the way that we organise our healthcare system. We have the most expensive healthcare in the world and how do we pay for that? We pay for that per person.’
That has created a system Case and Deaton described as ‘Sheriff of Nottingham redistribution’ in the fleecing of the poor to give to rich corporations while the high cost of healthcare forces companies to shed jobs and drives firms to bankruptcy.
‘The American healthcare system is a leading example of an institution that, under political protection, redistributes income upwards to hospitals, physicians, device-makers, and pharmaceutical companies while delivering among the worst health outcomes of any rich country,’ the economists write.
That in turn has contributed to the retreat of steady, decently paid work in working-class communities at the cost of social cohesion and helped drive the retreat to drugs and alcohol, and an increase in suicides.”
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