U.S. Health Care vs. The World: Another Infographic Showing the Monstrosity that is American Healthcare Costs

At this point, I think we can all agree that the American healthcare system has been discussed, dissected, criticized, and compared to just about every other healthcare system on the planet, almost ad nauseum. However, with the first major set of changes from the ACA set to take effect at the beginning of next year (just three and a half months from now), it’s never a bad idea to revisit these issues to reminded of our healthcare inferiority and thus be inspired to make our system better. Or something.

The following infographic has been created and circulated by George Washington University’s online MPH program. It was created with data from the WHO’s World Health Statistics 2013 report and compares American economic, health, and healthcare statistics with a handful of other countries. It’s a large image with a lot of information and can take a bit of time to digest. We have seen several of the metrics before (like here and here), and I am not quite sure why certain countries were selected (seeing Mongolia and Ghana in the array left me scratching my head a bit) – personally, I feel like it is more useful to compare America to countries with a similar population or economic size, or level or development. Nonetheless, it provides additional perspective.

015_Healthcare-VS-World-600

Jimmy Carter, New York Times’ Nicholas Kristof, and Carter Center’s Donald Hopkins To Cover Global Health Challenges in New Conversation on Google+ Series

The following is an announcement about an upcoming social media event hosted by the Carter Center.


On Sept. 10 at 3 p.m. ET, former U.S. President Jimmy Carter, New York Times Op-Ed Columnist Nicholas D. Kristof, and Carter Center disease eradication expert Dr. Donald R. Hopkins will hold a special video chat, “Global Health: How We Can Make a Difference,” to kick off a new Conversations on Google+ series that is launching later this fall.

Leading up to the event, from Sept. 4-10, President Carter and Mr. Kristof will participate in online discussions on the social media platform Google+ about the challenges of eradicating neglected tropical diseases (NTDs) when the world is focused on security issues and offer their ideas for progress.

HOW TO PARTICIPATE SEPT. 4-10:

Anyone can join the conversation, Sept. 4 – 10, 2013, when President Carter and Mr. Kristof will post discussion questions on global health to members of the American Public Health Association’s Google+ Public Health Community (direct link below).

Anyone on Google+ can join this Community and share their health-related comments with Carter and Kristof. Participants with the most insightful and thoughtful comments will be selected to join a special Conversations on Google+ online broadcast with President Carter, Mr. Kristof, and Dr. Hopkins live on Sept. 10.

Sign up for Google+, a social media platform, by visiting https://plus.google.com/.

Google+ users can join the Public Health Community by clicking on the “join community” button at the following link: https://plus.google.com/u/0/communities/109215334990434447518.

CONVERSATIONS ON GOOGLE+ LIVE BROADCAST SEPT. 10:

Tune-in on Tuesday, Sept. 10, at 3 p.m. ET for a live broadcast of a Conversation on Google+ hosted by The Carter Center and featuring President Carter, Mr. Kristof, Dr. Hopkins, and selected participants from Google+’s Public Health Community.

Conversations on Google+ allows everyday users the opportunity to engage global experts in discussions on the issues that matter to them. The Conversations on Google+ series will continue with other high profile speakers later in the year.

Anyone can watch the event live or in archive from several locations online:

TWEET WITH US: The Carter Center will be live-tweeting the Sept. 10 event from @CarterCenter using the hashtag #CarterConvo.

WHAT ARE NEGLECTED TROPICAL DISEASES?

NTDs are a group of 17 illnesses that affect more 500 million children and more than 1 billion people worldwide. Often found in the world’s most disadvantaged communities, NTDs can cause severe disability, robbing people of the opportunity to improve their own lives. Children suffering from NTDs often cannot attend school and adult sufferers may be less able to work, harvest food, or care for their families. The Carter Center is a leader in the eradication, elimination, and control of neglected tropical diseases, fighting six preventable diseases — Guinea worm, river blindness, trachoma, schistosomiasis, lymphatic filariasis, and malaria — by using health education and simple, low-cost methods.

ABOUT THE EXPERTS:

  • President Carter and his wife, Rosalynn, founded The Carter Center in 1986 in partnership with Emory University to alleviate suffering worldwide. A long champion of campaigns to wipe out neglected diseases, in 2002, President Carter was awarded the Nobel Peace Prize, “for his decades of untiring effort to find peaceful solutions to international conflicts, to advance democracy and human rights, and to promote economic and social development” through his work with the Center.
  • Nicholas D. Kristof is a two-time Pulitzer Prize-winning Op-Ed columnist of The New York Times, best known for writing about poverty, disease, and marginalization around the world.
  • Dr. Donald R. Hopkins is the Carter Center’s vice president for health programs and a former interim director of the U.S. Centers for Disease Control and Prevention. A medical doctor, he is internationally recognized for his work on NTDs and disease eradication, including smallpox and Guinea worm disease.

About Google+ :

Google+ is a sharing and communications platform that brings your real-world friendships and relationships online for a fun, interactive experience—as well as lets you make new friends and connections with people who share your passions and interests. Much more than a social network, Google+ makes it even easier to use other Google products, share content, and use integrated text and video chat—all for free. https://plus.google.com/

About The Carter Center:

A not-for-profit, nongovernmental organization, The Carter Center has helped to improve life for people in more than 70 countries by resolving conflicts; advancing democracy, human rights, and economic opportunity; preventing diseases; improving mental health care; and teaching farmers in developing nations to increase crop production. The Carter Center was founded in 1982 by former U.S. President Jimmy Carter and his wife, Rosalynn, in partnership with Emory University, to advance peace and health worldwide.

Follow Nicholas Kristof on Social Media:

The Many Paths Towards Universal Health Coverage: WHO Video Review

This post was written by Niniola Soleye.

Universal health care (UHC) is a hot topic in global health right now. The United Nations, World Health Organization (WHO), and World Bank have all endorsed UHC. Further, UHC has played a prominent role in discussions on the Sustainable Development Goals, which will build on the Millennium Development Goals and support the post-2015 development agenda. The WHO put together a video to explain UHC and show how some countries are providing universal access to basic health care services.

As Dr. Margaret Chan, Director General of the WHO said in the video, “Universal health coverage is the most powerful concept that public health has to offer.” The key to UHC is that it allows for equity within a health system. It guarantees health care to all members of a population and overcomes the challenges of unavailable or unaffordable services, which is often the case in modern health care settings.

The video highlights UHC in six countries – China, Oman, Mexico, Rwanda, Thailand, and Turkey. It shows how each country is addressing their health care system and making progress towards UHC.

I found it very interesting to see the differences between each country. It really drove home the point that there is no single UHC approach or model that will work for every country. The journey towards UHC is unique and varied. For example, in China the emphasis is on how to cover as many people as possible. In Oman, the focus is on access because their population, while small, is widely dispersed throughout the country. Mexico, Thailand, and Turkey are working on expanding the type and quality of services provided, while Rwanda has increased coverage from 7% to 97% in the last decade.

The main takeaways from the ten-minute video are the importance and benefits of UHC, the challenges in implementing it, and the various models that allow countries to work towards providing basic primary care to everyone.

Save the Date: CBPHC Pre-Conference

SAVE THE DATE: Saturday, November 2nd, 8 30 – 5 PM
EVENT: Community Based Primary Health Care APHA Pre-Conference: Effective CBPHC Tools for Effective Maternal, Newborn and Child Health
LOCATION: Boston Convention and Exhibition Center, 415 Summer Street, Boston, MA 02210
WHO SHOULD ATTEND: Current and future practitioners of CBPHC, and anyone interested in improving the health of poor and vulnerable populations in global health

GOALS OF THE WORKSHOP:

  • Sharing of maternal, newborn and child health knowledge and effective practices to improve the effectiveness of your CBPHC programs for greater impact in reducing child, newborn and maternal deaths
  • Learn from experienced health professionals about career paths in CBPHC
  • Network and collaborate with other public health practitioners

We will be sending more information on the agenda in the coming weeks. http://www.apha.org/programs/globalhealth/

REGISTRATION: To register, please contact: Sandy Hoar (e-mail: hoar@gwu.com)

The registration fee, including morning coffee, is $35 (students $25). To facilitate planning, please register ASAP but certainly by October 11th and indicate if you will be joining us for dinner afterwards.

For more information contact: Sandy Hoar, Laura Chanchien Parajon (lauraparajon@amoshealth.org), or Elvira Beracochea (elvira@midego.com)

Hope to see you at the conference!

Petition to Exclude Tobacco from TPP Negotiations

The following petition was forwarded to the IH leadership by section member Mary Anne Mercer, liaison to APHA’s Trade and Health Forum.


U.S. Trade Proposal Caves to Big Tobacco

U.S. Medical, Public Health, Public Interest Groups Urge Protection for Health & Wealth

Please sign here to protect tobacco controls from attacks by tobacco multinationals and their corporate allies.

The U.S. Trade Representative intends to introduce a proposal on tobacco at negotiations to create the Trans Pacific Partnership (TPP), a trade agreement among 12 nations, at meetings in Brunei this week. The proposal capitulates to multinational tobacco corporations, jeopardizing the nation’s health and economic welfare.

Tobacco companies have recently accelerated their use of trade rules to attempt to delay and reverse tobacco control measures that limit marketing  in the U.S., Australia, Uruguay, Norway, and Ireland. Trade rules grant corporations rights to contest nations’ public health and other policies. Countries that lose trade challenges face stiff financial penalties, payable to the complaining corporation.

Public health and medical advocates in the U.S. and abroad have urged the USTR to exclude tobacco control protections from trade challenges under the TPP.  The USTR informally floated a policy in 2012 that could create a “safe harbor” for some tobacco control regulations. Many legal and medical experts noted that tobacco companies could easily exploit the remaining substantial loopholes.

But the tobacco industry marshaled opposition claiming that the U.S. proposal might actually reduce tobacco use, tobacco-related deaths, and tobacco sales.  Other corporations backed up Big Tobacco, expressing concern that addressing the uniquely lethal effects of tobacco in trade agreements could set a precedent for reining in their own practices. On Aug. 15, USTR announced it would not advance that proposal.

The new proposal offers less than a fig leaf for trade rules that grant corporations rights over public health protections, and often eliminate them.  It proposes simply to refer to the TPP the general health exception described in two multilateral agreements under the jurisdiction of the World Trade Organization (WTO): Article XX of the General Agreement on Tariffs and Trade (GATT), and Article XIV of the General Agreement on Trade in Services (GATS), and inserts a statement into the exception that repeats the self-evident observation that tobacco measures are health measures.These exceptions offer significant loopholes that favor companies asserting trade charges.[1] The exceptions do not apply to investment claims that tobacco companies could bring under the TPP.  Even in trade disputes, the exceptions apply with great uncertainty in very limited situations.  They require multi-year, multi-million-dollar litigation to mount a defense – a burden that many countries cannot afford.  The tobacco industry exploits the cost and uncertainty of using the exceptions. (As a regional agreement, the TPP claims some latitude in varying from WTO rules.)

It also tacks on an additional layer of consultation among Health Ministers in the case of tobacco-related trade challenges between nations, added to the procedures and rules already provided.  In effect, it conscripts health officials to consult in the context of trade rules they had no role in shaping, over trade challenges they did not initiate and have no power to adjudicate.

Tobacco use costs the U.S. far more in lives and health care expenses than tobacco farming or manufacturing contribute to the economy.

  • Tobacco use kills 1,200 Americans daily. Cigarette smoking is responsible for an estimated $193 billion in annual health-related economic losses in the U.S. (nearly $96 billion in direct medical costs and an additional $97 billion in lost productivity).[2]
  • In contrast, total tobacco exports generate 0.10 percent (one tenth of one percent) of total U.S. annual exports (.07% unmanufactured, and .03% manufactured).[3] Tobacco manufacturing has declined exponentially in the U.S., and tobacco farming is also in decline, due in part to U.S. programs intended to facilitate the transition to more sustainable crops.[4]
  • Exports of cigarettes and other U.S.-manufactured tobacco products dropped from $3.9 billion in 1999 to $488 million in 2011, as large U.S. manufacturers sold off their international businesses or formed subsidiaries located abroad.[5] Ninety-eight percent of exported U.S. cigarettes go to 5 countries, only one of which is a TPP partner (Japan). Lower tariffs would lower the price of tobacco products, resulting in cheaper prices and increased consumption and use, especially among younger people. For this reason, international health policy and U.S. law prohibit the U.S. from using trade agreements to promote the sale or export of tobacco products. Yet the U.S. proposes to eliminate tariffs on tobacco products. Other TPP partners can reasonably object to encouraging the import of U.S. brand cigarettes.

Tobacco is the only legal consumer product that kills when used as intended. Tobacco use is the leading preventable cause of death worldwide, accounting for 6 million preventable deaths annually,[6] and is a major contributor to the global pandemic of non-communicable diseases, including childhood morbidity and mortality. As a unique product, it must be treated differently from other products and services that are traded across borders.

We urge TPP Partner countries to advance proposals that promote public health and stem preventable deaths from diseases related to tobacco, by guaranteeing nations’ sovereign domestic rights and abilities to adopt or maintain measures to reduce tobacco use and to prevent tobacco-related deaths and diseases:

  1. Exclude tobacco control measures from existing and future trade agreements.
  2. Do not request or agree to lower tariffs on tobacco leaf or products.
  3. Remove investor-state dispute settlement (ISDS) provisions; these grant tobacco corporations rights to contest nations’ public health and other policies directly for financial damages through the global trade arena.
  4. Set trade policy through a transparent public process.

President Obama’s 2013 State of the Union message promised to lead an economy for the 21st Century, to reduce preventable deaths among youth, and to conduct policy transparently. Trade negotiations that expand corporate rights and powers, while undermining the public’s health, cannot advance sustainable economic growth or wellbeing.

PleaseSign the petition to protect tobacco controls from attacks by tobacco multinationals and their corporate allies – and send this note to your lists. 

If the link does not work for you, please go to this web address: http://trustwomen.civicactions.org/CPATH/smoke_out_tobacco_from_the_tpp

Post on Facebook:  Sign the Open Petition to Smoke Out Tobacco from the TPP!

Twitter: Sign on to protect tobacco controls from attacks by tobacco multinationals and their corporate allies.  Please sign here: http://bit.ly/171EnTD #StopTPP #TobaccoOutTPP #SmokeOutTPP@CPATH @USTradeRep @CouncilofCDNs

Initial Sponsoring Organizations:

Action on Smoking and Health (ASH), Chris Bostic, MSFS, JD, Deputy Director for Policy

American College of Obstetricians and Gynecologists, Barbara S. Levy, Vice President, Women’s Health Policy

American College of Physicians

Center for Policy Analysis on Trade and Health (CPATH), Ellen R. Shaffer, PhD, and Joe Brenner, MA, Co-Directors

Corporate Accountability International, John Stewart, Campaign Director, Challenge Big Tobacco

Human Rights and Tobacco Control Network (HRTCN), Carolyn Dresler, MD, Chair

International Association for the Study of Lung Cancer, Mike Cummings, MD, Chair, Tobacco Control Committee

Initial Sponsoring Individuals:

Tom Houston, MD, McConnell Heart Health Center, Columbus, Ohio

Don Zeigler, PhD, Adjunct Associate Clinical Professor, UIC School of Public Health

[1] R. Stumberg, Safeguards for Tobacco Control: Options for the TPPA. America Journal of Law and Medicine, 39 (213); 382-441.
[2] Centers for Disease Control and Prevention. Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004. Morbidity and Mortality Weekly Report 2008;57(45):1226–8 [accessed Aug. 17, 2013].
[3] FDA, Report to Congress. United States Tobacco Product Exports That Do Not Conform to Tobacco Product Standards. 3/8/13.
[4] http://www.fsa.usda.gov/FSA/webapp?area=home&subject=toba&topic=landing
[5] U.S. Government Accountability Office report, “Illicit Tobacco: Various Schemes are Used to Avoid Taxes and Fees,” accessed August 18, 2013, from http://www.gao.gov/assets/320/316372.pdf
[6] Thomas H. Frieden. http://www.upi.com/Health_News/2012/06/14/US-smoking-related-diseases-cost-96B/UPI-56571339724113/#ixzz2cH5erl4c