by Stephen Lendman (stephenlendman.org
The UK-based, 1823-founded Lancet is the oldest, best known, and highly respected medical journal.
In early April, it examined the effects of racial discrimination, mass incarceration, economic inequality and lack of universal healthcare as factors in declining US health outcomes.
Affordability puts proper care for serious illnesses increasingly out of reach for tens of millions.
The Lancet explained a growing survival gap between rich and poor Americans - a difference of up to 15 years, US marketplace medicine responsible for a healthcare crisis affecting millions of households.
These and other issues were addressed in five papers titled "America: Equity and Equality in Health" - data and analysis provided by prominent US health researchers, vital information ignored by Congress, hellbent on retaining dysfunctional marketplace medicine under Obamacare or Trumpcare.
Republicans want a fundamental human right denied to tens of millions because of increasing proper healthcare unaffordability.
America has the world's best system - based on the ability to pay, millions more to be left uncovered under Trumpcare than under Obamacare if enacted into law - America's poor and low income suffering most, a majority of the nation's population.
America's wealth disparity is the severest among developed nations. The top 1% controls as much as the bottom 90%.
Extreme poverty is a national catastrophe, millions of Americans attempting to survive on around $2 per capita per day - more than double the number since the neoliberal 90s.
Economic inequality goes hand-in-hand with inequality in health. Instead of efforts by the world's richest country to remedy things, GOP hardliners want them worsened.
Uninsured and inadequately insured US households can't afford the high cost of vital healthcare for expensive illnesses, diseases and injuries. Their deprivation and higher mortality than well-off American is the shame of the nation.
House and Senate versions of Trumpcare make America's dysfunctional system far worse - a crime against humanity if enacted into law.
Structural racism and inequality in healthcare define how America is run - for its privileged class exclusively at the expense of most others.
Being Black or Latino is associated with adverse birth outcomes, higher infant mortality, increased risk of serious chronic diseases and decreased longevity.
According to New York City Department of Health and Mental Hygiene Dr. Mary Basset, "(r)acial and ethnic health disparities in the United States are well documented, but structural racism is rarely discussed as a root cause."
It "refers to all the ways in which systems foster inequitable outcomes, whether in housing, education, employment, media, health care or the criminal justice system. All have profound effects on health. If we don't address structural racism, health inequities will persist."
One of my earliest articles was titled "The US Gulag Prison System: The Shame of the Nation."
America has the world's largest domestic prison system - besides its global gulag, Guantanamo the tip of the iceberg. Around 2.2 million US citizens are incarcerated.
About two-thirds are Blacks and Latinos, many on charges too minor to matter, often possession of illicit drugs, many others imprisoned despite innocence of any crime, including on death row.
Mass incarceration greatly affects inequality in health. Incarcerated individuals have increased vulnerability to infectious diseases and chronic illness.
Prison healthcare is deplorable, woefully inadequate. Incarceration is a permanent black mark against inmates when released, adversely affecting their ability to earn a living, preventing them from being able to afford proper healthcare coverage - locked in a "health-poverty trap."
Since the late 1970s, incomes for poor, low and middle-income households haven't kept up with inflation. Since 2000, they declined. America's most significant growth industry is poverty.
According to Lancet researchers, reasons poor and low-income households, along with less educated ones, have poor health outcomes include:
"(1) less access to technological innovations in medicine and information about complex health risks and preventive behaviors;
(2) increasing geographical segregation that creates inequalities in access to health care;
(3) reduced economic mobility and increased persistence of poverty;
(4) rapidly increasing incarceration rates; and
(5) the erosion of public subsidies for health insurance and other health inputs, and increasing exposure to market prices."
Increasing unaffordability of proper healthcare under America's marketplace system jeopardizes the health and well-being of tens of millions of households.
It shows the world's richest nation doesn't give a damn about the welfare of its most vulnerable - on their own, sink or swim.
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