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Many people living in the 'Diabetes Belt' are plagued with medical debt

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Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#2
"Seventy-nine out of the 100 counties with the highest levels of medical debt are in states that have not expanded Medicaid under the ACA"

Who benefits in these 10 states that have still failed to expand Medicaid? What is the upside, to either the populations of these states or the politicians who run these states and make those decisions? Because the downsides are obvious and seem to directly harm a lot of people.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#3
If you like this, you might enjoy The Price We Pay[0] by Marty Makary. It talks about the incentives in the US health system, and how they combine to create a system where even people with insurance can end up with unmanageable medical debt.

The book points out both genuinely bad actors (e.g. companies that pay kickbacks to medical staff for pushing patients into unnecessary helicopter rides) and also problems that happen due to the design of the system, despite the best intentions of individual actors.

[0] https://www.amazon.com/Price-We-Pay-American-Care/dp/1635574...

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#4

"Seventy-nine out of the 100 counties with the highest levels of medical debt are in states that have not expanded Medicaid under the ACA" Who benefits in these 10 states that have still failed to expand Medicaid? What is the upside, to either the populations of these states or the politicians who run these states and make those decisions? Because the downsides are obvious and seem to directly harm a lot of people.

> Who benefits in these 10 states that have still failed to expand Medicaid?

The people who run on this as a component of their platform.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#6
This is as much a cultural problem as a financial one. Somehow we've convinced ourselves that in spite of the fact that we can afford to provide everyone with good food and access to medical care, that we'd rather give you bad food which causes health care issues and then treat those because it contributes to GDP.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#7
Related: ProPublica investigation on doctors performing unnecessary amputations on poor black diabetes patients, because they don't pay enough attention to the patients and also get paid more to amputate.

https://features.propublica.org/diabetes-amputations/black-a...

Another link if you are skeptical there is a racial issue: page 12 of https://data.dartmouthatlas.org/downloads/reports/Diabetes_r.... Among Medicare beneficiaries with diabetes, black people are still way more likely to have a leg amputated.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#8

This is as much a cultural problem as a financial one. Somehow we've convinced ourselves that in spite of the fact that we can afford to provide everyone with good food and access to medical care, that we'd rather give you bad food which causes health care issues and then treat those because it contributes to GDP.

> This is as much a cultural problem as a financial one.

I live in one of these Diabetes Belt counties. I'd like to add another aspect to the "cultural problem", which is that the median person here eats absolutely horrendously and doesn't exercise at all.

> we'd rather give you bad food

I'd like to believe that people have the agency of choosing what they eat.

Re: Many people living in the 'Diabetes Belt' are plagued with medical debt

#9

This is as much a cultural problem as a financial one. Somehow we've convinced ourselves that in spite of the fact that we can afford to provide everyone with good food and access to medical care, that we'd rather give you bad food which causes health care issues and then treat those because it contributes to GDP.

I wonder how the broken window fallacy plays into this. I would assume a healthy population is more productive than a diseased one.

That effects healthcare profits though, so incentives aren't exactly aligned.

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