Demographic changes create an urgent need:
Improved medical care and prevention efforts have contributed to dramatic increases in life expectancy in the
United States over the past century. They also have produced a major shift in the leading causes of death for all
age groups, including older adults, from infectious diseases and acute illnesses to chronic diseases and
degenerative illnesses. Currently, about 80% of older Americans are living with at least one chronic condition.
Th e growth in the number and proportion of older adults is unprecedented in the history of the United States.
Two factors — longer life spans and aging baby boomers — will combine to double the population of Americans
aged 65 and older during the next 25 years. By 2030, there will be 71 million American older adults accounting
for roughly 20% of the U.S. population.
America’s older adult population also is becoming more racially and ethnically diverse. At the same time, the health status of racial and ethnic minorities lags far behind that of non-minority populations. Th e burden of many chronic diseases and conditions — especially high blood pressure, diabetes and cancer — varies widely by race and ethnicity.
Data from the 2004 National Health Interview Survey (NHIS) indicated that 39% of non-Hispanic white adults aged 65 years or older reported very good or excellent health, compared with 24% of non-Hispanic blacks and 29% of Hispanics.
Source: Centers for Disease Control and Prevention and The Merck Company Foundation.
The State of Aging and Health in America 2007.
Whitehouse Station, NJ: The Merck Company Foundation; 2007.
Any successful attempt to reform health care in the United States must accommodate two realities.
Reality 1: The current system is increasingly inaccessible to many poor and lower-middle-class people (about 47 million Americans lack health insurance, up from about 40 million in 2000); those lucky enough to have coverage are paying steadily more and/or receiving steadily fewer benefits; the increasingly complex warfare between insurers and hospitals over who pays the bills is gobbling up a great deal of money and resources; and the end result is that the United States pays roughly twice as much per capita for health care as Canada, France, and the United Kingdom yet experiences slightly lower life expectancy than those countries and significantly higher infant mortality. The problems inherent in the U.S. system of health care are literally killing people.
Reality 2: Open discussion of a “single-payer” system in which the government pays for and regulates health care is verboten within the political mainstream because it is presumed that Americans would never accept socialized medicine. Whatever solution arrived at by Congress and the president (in all likelihood, not this president) will have to harness market forces because, it’s widely believed, markets will always outperform the dead hand of government. The lesson of “Hillarycare,” a sweeping proposed health-care reform that died in Congress and may have delivered the House and Senate to the Republicans in 1994, weighs heavily on Democrats’ minds (even though Hillarycare was not a socialized-medicine scheme but rather an attempt to reorder the private insurance market).
Global Health Care – Issues & Policies
Although the United States is the most developed nation with a state-of-the-art healthcare system of delivery, it is important to note that the United States does not have the longest male and female life expectancy rate. For example, in 1999, life expectancy in Japan was 3 years longer for men and 4 years longer for women than the US life expectancies. In 2002 the infant mortality rate actually increased for the first time since 1958. Overweight, obesity, and physical inactivity are currently significant risk problems for adults and children and lead to chronic diseases such as diabetes, hypertension, and heart disease. For the first time ever, children are developing significantly high rates of type 2 diabetes. Overall rates for cancers have declined since 1990s for males and have remained stable for females. For people over 65, activities of daily living (ADLs) have not declined since 1992 (CDC, 2004)
The National Governor’s Association reports that the US healthcare system in not cost-effective for the amount of money spent yearly. The United States spends more than any other developed country ($1.7 trillion annually) in the world, which is equal to $5267 per person on health care. Neither public nor private funding can be sustained indefinitely as costs continue to go upwards, fewer people will be able to afford private health insurance and will need to apply for Medicaid and the State Children’s Insurance Program (SCHIP) or Medicare (National Governors’ Association, 2005).
Equality in Health Care
The world collectively lacks an equal rights-based approach in the distribution of health care. Disparities in health care are now a major challenge for health care agencies around the world. Nelson Mandela stated, “The greatest single challenge facing our globalized world is to combat and eradicate its disparities” (Mandela, 1998). The burden of disease is growing disproportionately in regions of the world, which are also commonly effected by “brain drain”. Doctors and nurses from Africa, Asia, and Latin America are leaving the rural area for cities while others are leaving their countries altogether and relocating in developed nations. The irony is that more health care providers in developed countries are now working; at least part of their working lives, in developing countries, while a “brain drain” is pulling some of the most competent health care providers out of their home countries in which they are needed. Regardless of the causes, many developing countries, with the least amount of human and economic resources are confronted with the largest burden in public health. In the developed world, 15% of the world’s population consumes more than 60% of the world’s energy than the developing world (Farmer, Furin, & Katz, 2004).
(Source Global Health Care, Issues & Policies. Edited by Carol Holtz
Global Health Foundations supporting local Initiatives
Global health is a defining issue of our time, and universities have a tremendous responsibility to help reduce the burden of disease in communities around the world and help build an infrastructure for progress and understanding through research, education, and service.
Global health activity encompasses a wide range of practitioners and researchers across medicine, public health, biomedical research, and social science to provide sustainable solutions in partnership with communities and institutions in Africa, India, Southeast Asia, the Caribbean, and the Pacific.
The overall goal of the this advocacy is to advance and improve the need for health care for those living in the developing world by improving the effectiveness of programs and increasing overall funding for these programs.