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Americans Are Seriously Sick

jd writes "A study by US and British researchers on frequency of illnesses shows that even when you compare like groups in the US and the UK, people in the US are considerably sicker than their counterparts in the UK. This is after factors such as age, race, income, education and gender were taken into consideration. The most startling conclusion was that although the richest Americans were better off than the poorest Americans, they did no better (health-wise) than the poorest of the English. Previous studies of the entire population had shown similar results, with America placing around 25th amongst industrialized countries on chronic disease prevention, but it had been assumed that minorities and economics were skewing the results. This study suggests that maybe that isn't the case."

30 of 1,519 comments (clear)

  1. Answer is easy. by Whiney+Mac+Fanboy · · Score: 5, Insightful
    Have a look at table 8 in this report on industrial relations.
    Statutory minimum annual leave plus public holidays

    UK: 28 days (four weeks + public holidays)
    US: 10 days (0 weeks + public holidays)
    US's work culture of long working days, unpaid overtime & too few holidays is killing you. Add to that the stress of the burden of health care falling on individuals and you have the sort of mess tfa talks about.

    No doubt many other people are going to write in talking about "fat americans" being the problem - and its true that nutrition in America is a serious problem, but the comparison is to England, so not the cause of the differences.

    Personally, I work on average 8 months a year and spend the rest of the time travelling - I am rarely stressed and almost never sick.
    --
    There are shills on slashdot. Apparently, I'm one of them.
    1. Re:Answer is easy. by Propagandhi · · Score: 5, Interesting

      From TFA:

      Even the U.S. obesity epidemic couldn't solve the mystery. The researchers crunched numbers to create a hypothetical statistical world in which the English had American lifestyle risk factors, including being as fat as Americans. In that model, Americans were still sicker.

      I'm sure their methods were a little more rigorous than your heresay. I'd say that the GP is bang on, we're working ourselves to death.

      Another interesting tidbit:

      [...] the United States spends more on health care than any other industrialized nation, yet trails in rankings of life expectancy.

      The United States spends about $5,200 per person on health care while England spends about half that in adjusted dollars.


      Spending is only going to keep you alive for so long when you're overweight and out of shape from a poor diet and little exercise. That culture of 50 hour work weeks (or worse) just compounds these problems and shortens lives even more.

    2. Re:Answer is easy. by Barnoid · · Score: 5, Insightful

      I've never needed to miss a day off work yet, and I'm still vigorously healthy! But that's not because of any shirker reason like holidays, but because I eat correctly for the human body I have, which is to eat vegetarian.

      Don't think what's right for you is right for everybody.

      I know you'll shake your head at it like everybody does, but the typical vegetarian gets no cancer, never gets influenza (yes your flu last year could be avoided if you dumped meat) and will never have the depression, bowel disease, heart problems and overweight that inflict meat eaters!

      My mom's cousin has been a vegetarian since childhood. She died two years ago of breast cancer.

    3. Re:Answer is easy. by mowph · · Score: 5, Interesting
      US's work culture of long working days, unpaid overtime & too few holidays is killing you.

      Japan has the same minimum leave policy (10 days + stats), but on top of that, the leave policies are rarely enforced. It would normally be seen as selfish and inconsiderate of one's coworkers to actually use all of your leave, anyway. In many cases, company employees work completely unpaid "service overtime" out of obligation. Still, Japan is among the healthiest and longest-lived countries in the world.

      I'd say there must be more to the picture. Like any complex system, the health of a nation probably can't be pinned on one single factor.

    4. Re:Answer is easy. by Young+Master+Ploppy · · Score: 5, Interesting

      Walking. Seriously!

      In British cities, we generally do a lot of walking compared to US cities. I once asked *in the visitor's centre* for directions to the public library in a US city. After getting a load of driving directions, when I told them I didn't have a car, the woman behind the counter looked horrified, and was stunned into disbelieving silence for several seconds, before giving the classic response :

      "Well in that case, I don't think you can get there from here..."

      Turns out it was only a ten-minute walk away. And virtually every car I passed on the way honked at me. Why? Because they thought I was a bum - after all, only bums don't have cars, right?

      I'm not saying this is true of every US city - certainly people seem to walk in New York, for example - but by way of contrast, I live in London and I probably do about an hour of brisk walking every day just getting between tube stations, the office, and my home. That's not counting actual "exercise time", that's just getting about day-to-day. Even when I used to work in the northern cities like Leeds and Stockton-on-Tees, which don't have the Tube, I still did about an hour walking around at lunchtime.

      I'm not trying to troll here, but I think this picture says a lot : Only In America.

      --
      http://instantbadger.blogspot.com
    5. Re:Answer is easy. by Haeleth · · Score: 5, Interesting

      the United States spends more on health care than any other industrialized nation

      Wait, I thought the free market and privatization was supposed to make things cheaper? While state-run systems like the British NHS were supposed to be horribly inefficient and expensive?

      Any economists care to explain what's going on here? Is the free market a failure, or is this the way it's supposed to be? Are those extortionate health costs translating into increased prosperity for America in some way?

    6. Re:Answer is easy. by Peter+Mork · · Score: 5, Interesting

      The answer is indeed simple: among industrial nations one of the most significant predictors of health is the gap between rich and poor. The larger this gap, the worse the health of both groups. It is not surprising that poor people have worse health, but it is interesting that riches don't buy better health. More information is available here, and here's a related editorial from Newsweek.

      In short, the study looked at the following health factors: life expectancy, infant mortality, death rates, disability, quality of life, self-assessed health, happiness and well-being. The high-level summary from the linked article: "Populations whose income is below a threshold (about $5,000 - $10,000 in US per capita income) generally have poorer health. Increasing income in such societies leads to better health. Above the threshold, national health is not necessarily related to absolute income, but rather to the gap between rich and poor. Studies in the past 15 years found that where income gaps are smaller, health appears to be better."

      The researchers' hypothesis is that societies with a large gap between the rich and poor have a more hierarchical organization. Such an organization is based on coercion and resignation. More egalitarian societies do not engender the negative emotions needed to sustain a hierarchy.

      Perhaps what is most surprising is that despite the maturity of this research, it seems (at least to me) that very few people are aware of it.

    7. Re:Answer is easy. by Lord+Azrael · · Score: 5, Interesting

      you are right that there belongs more to the picture that Japan belongs to the healthiest and longest-lived countries in the world although the average working time might is much higher than in most of the other industrial countries.

      the other factor which comes in here which benefits the japanese is the way they eat or better, what they eat. A lot of fish, a lot of vegetables, green tea... To sum it up: they eat little fat and healthier stuff.

      compare this to USA or UK, where fast food dominates what people eat, where coffee and coke often is the only stuff people drink the whole day.

      other thing: the majority of my american coworkers here never go to doctors. they take pills and drugs the whole day. instead of changing their way of life, calming down, solving their personal problems, eating better stuff (!) they try to cure everything with drugs, drink coke the whole day, eat a kilo of steak every day and then complain that they suffer from heartburn and again take pills against heartburn ....

      of course this is not representative, might be strange co-workers here. but on the other hand i noticed something the last time i was in new york when i watched TV ads: i have never travelled to a country where there are dozens of tv ads every hour for products to reduce heartburn - this confirms my observation. instead of eating different stuff people buy these drugs. this is obviosuly not the right solution. in the long run this affects your health.

      --
      Lord "not Gargamel's Cat!" Azrael
    8. Re:Answer is easy. by SerpentMage · · Score: 5, Insightful

      Having gone through multiple health care systems from 100% private to 100% public, let me say that you will not get a cheaper rate from private health care because it is not in their interest.

      1) To have a free market is to make money (not saying this is bad), but reality is that you can't make money with health care. Fixing a broken bone can be made profitable because it is a known science. Fixing a disease is not profitable and costs quite a bit of money. In your proposal where people "save" the money, ha! Diseases are a loss!

      2) In a private system there still would be paperwork. Paperwork exists to create accountability! In a private system people will want accountability.

      As much as I like free markets, health care and free market do not go together. Healthcare is a societal issue because health care from a profitability factor is a money looser. Healthcare is not like a car insurance. With a car you can try and avoid an accident, you can stop speeding. Accidents do happen, but there are ways to reduce them. Car accidents are human errors! Diseases on the other happen and there is nothing we can do to avoid them. They are a fact of life. You can diet, excercise, and lead a healthy lifestyle, but you can still be hit with cancer or some other disease! You can try to avoid them, but they will always hit you!

      --

      "You can't make a race horse of a pig"
      "No," said Samuel, "but you can make very fast pig"
    9. Re:Answer is easy. by SacredNaCl · · Score: 5, Informative

      Truly privatized would be your work place paying you money to obtain your own health care. Whether you bank it and pay straight cash after that(frequently gets a 50% discount), or buy a health care insurance program, or some combination of the two is up to you.

      Have you every tried paying cash in the US Health Care system? I had a dentist that I loved dearly, compared to some of the other dentists I've seen - this guy is the best in the field I've come across. My insurance used to pay him $650 for a root canal and crown. But he charged a cash customer $1500 for the same thing.

      I have to pick up a couple medicines every month at the pharmacy. (Now I suppose Walmart & Costco are a few bucks cheaper, but not on my pharmacy plan) I pay a trivial deductable ($1 each on generics) for my medicines and a straight percentage for non-generics. They pay $65 for one of my scripts, but the cash price for it is $128 at Walgreens. They don't even hide that they are paying half what I would, I have hard caps on the policy and everything everyone is paid out is listed. Go try to find a pair of MRIs with & without contrast for $530 paying cash. I know why my GP isn't always happy to see me either, I know what he is paid for it.

      Cash wont get you far in the American Health Care system, they rape cash customers blind. $50 for a hot towel, $75 for an ice pack... (*This is from my physical therapy bill before insurance, and these are the cash billing prices.)

      I know there are some doctors you can negotiate with, and there is always the Doc-In-The-Box for routine things, but if you need anything more than the very routine, its a very expensive proposition. Some of the health care system is pure price gouging, but its targeted at the cash customer the worst.

      I'm currently working as a contractor, and using COBRA for my old insurance policy. When its up, I'm going to buy this policy outright, its far from cheap, but I've done the math both ways. I can't win paying cash, and can't afford the risk of needing some specialized bit of care if I have any complications.

      I'll tell you what I really think causes the difference between here and the UK. Although I haven't lived in the UK, I spent a year working in Germany. Its the food, its the stress, and its the climate of work. Half of the additives to the food you wont find in theirs - it makes a difference. The work environment was a lot better, shorter hours, less pressures for overtime (I was reminded of this several times when I suggested time tables that would be perfectly acceptable here - just work people 55 hours a week to do it.), very little stress coming out (there was virtually no crime where I was at). Even though I had the stress of dealing with a language I hadn't mastered, navigating a city I barely knew, and a bit of culture shock - I still came home with less need to unwind. Where I was at less traffic as well, of course it was expensive to drive. It was very typical on any job site I was at for them to offer us good coffee, and a few minutes to talk to everyone before starting. (That almost never happens here, just get led to the problem and dive in and avoid talking to anyone unless you have to, or they will think you are slacking off.)

      --
      Freedom is merely privilege extended unless enjoyed by one and all.
    10. Re:Answer is easy. by Saven+Marek · · Score: 5, Funny

      This is not "activist" pictures, it is documentary images I have seen on national TV.

      I propose an addendum to godwin's law. If someone mentions "It's true, I saw it on national TV" then they lose and the debate is over. Oh and everyone gets to laugh at them for weeks.

    11. Re:Answer is easy. by SerpentMage · · Score: 5, Insightful

      No.... I am right here...

      Let's take cancer. People don't know where cancer comes from and think that some habits are better than others. Yet we all can get cancer, regardless if you excercise, etc. We think that certain habits will increase the liklihood, but we cannot say, "Excercise and you will not get cancer".

      Let me give you an example; Lance Armstrong, incredibly healthy and a great athlete, yet he was on the brink of death due to cancer. Or how about Andres Galarraga? Or how about Scott Hamilton? How about Mario Lemieux?

      This is why I say healthcare is a societal issue because healthcare saps money and is a money looser! With a spin on the car insurance ananlogy. When a driver has an accident we as a society don't mind charging that driver more or not giving him car insurance. If a person gets cancer can we say, "No you can't get coverage, you are on your own?" This is exactly what private healthcare providers do. I know, my mother survived breast cancer, but the private healthcare providers are refusing to cover her for cancer. If she gets cancer again she is on her own. This is wrong! But it is business because she is a "problematic" person.

      --

      "You can't make a race horse of a pig"
      "No," said Samuel, "but you can make very fast pig"
  2. Pies by Loquis · · Score: 5, Funny

    So who ate all the pies?

  3. Duuuuuuuuh by Anonymous Coward · · Score: 5, Funny

    Socialism == Medical

    US != Socialism

    HENCE

    Medical != US

    Sheesh.. when we'll we learn?

  4. "Americans Are Seriously Sick" by ben0207 · · Score: 5, Funny

    Whereas Canadians are "x-treme", and the French are "to the max"

    --
    cmd-q.co.uk - some sort of stupid fucking internet bullshit
  5. Re:This is a trash study by pryonic · · Score: 5, Insightful
    But the fact is that the NHS provides free treatment to ALL UK citizens, not just those who can afford it. In America you can be seen quickly as long as you're willing to pay. Fine if you can afford it or if your employer gives you health insurance, but if not you're screwed.

    I believe health care is a right, not a privilege for the rich, and I'm proud to pay my taxes towards the NHS that provides top notch treatment to EVERYBODY.

    I'm guessing you're one of the lucky ones with private health insurance. Try living on the povery line and making a choice between getting that lump looked at or eating for a month. I know what most people are forced to choose in your so called land of the free...

    --
    Never underestimate the power of stupid people in large groups.
  6. Call me a pessimist... by jgdobak · · Score: 5, Insightful

    ...but, working in the healthcare profession in the US, no one gets paid unless you're sick. Sadly, healthcare here is definitely for-profit. So of course we're all 'sick.'

    (Not a supporter of socialist programs in general, but healthcare is too important to be trusted to human greed.)

  7. Michael Moore's new movie about health care by Anonymous Coward · · Score: 5, Informative

    Michael Moore is going to expose the rotten health care system in the USA in his new movie called Sicko:
    http://www.michaelmoore.com/words/message/index.ph p?id=193

    The health insurance industry is a parasite the purpose of which is to interfere with your patient-doctor relationship and to deny your treatment.

  8. Fast food by PenisLands · · Score: 5, Insightful

    Maybe it's because of the fast food? I live in England and I eat pretty much entirely home cooked and prepared meals, except maybe apart from the odd sandwich from Sainsbury's.
    I recently went out to stay at a friends house for a weekend, and on the first day we ate McDonalds in the evening. The next day I was feeling pretty sick. All I ate about two burgers and some chicken nuggets.

  9. free as in beer by lovebyte · · Score: 5, Insightful

    Let me quote this from the BBC article:
    Rates of smoking are similar in the US and England but alcohol consumption is higher in the UK.
    There you have it, folks, DRINK!

    (I am only half joking)

    --

    I'll do it for cheesy poofs.

  10. Nationality by Anonymous Coward · · Score: 5, Informative

    The official nationality of people from the UK is British, not English. By referring to Brits as "English", you're pissing off a sizable number of people who are proud to be Scottish, Irish, Welsh, etc. Us English did some pretty nasty things to them in the past, so calling them "English" isn't exactly going to ingratiate yourself with them.

    By referring to people from the UK as British, you're still going to piss off some Irish, but at least you're correct in your terminology. Yes, British is the correct term to use for somebody from the UK, even if they aren't from Great Britain. References:

    Having read the article, I have no clue exactly which region of the world it is talking about, because it seems to use different regions as synonyms. It could be the UK, which is a country and member nation of the UN. It could be Great Britain, which is a geographical region within the UK comprised mainly of England, Wales and Scotland. Or it could be England, which is a region, home nation and constituent country of the UK, but which doesn't have its own government.

    If I had to guess, I'd say that they were talking about the UK, even though they don't use the word "UK" at all, instead opting for "British" and "England". I base this guess on years of experience with peopel from the USA getting it wrong and the sentence "Those dismal results are despite the fact that U.S. health care spending is double what England spends on each of its citizens." Hint: England spends nothing whatsoever on its citizens. The NHS in England is run by the UK government. It's the NHS in other parts of the UK that belong to their respective constituent countries - England actually has very little to call its own these days.

    England, Great Britain and the UK are three completely different things. Mix them up, and you piss people off. It's a bit like mixing up California with the USA with North America. You'd think somebody was pretty ignorant to do that, right?

  11. Re:Universal Healthcare? by Propagandhi · · Score: 5, Insightful

    According to TFA coverage isn't the issue here. The purpose of the study was to compare health across the board, not just of the working class or poor (who would benefit from a universal healthcare system) and it found that regardless of income Americans were less healthy than UKers. Which is bizarre, considering we (the US) are still the richest country in the world, and should therefore have the best top tier healthcare.. or at least one would think.

    At any rate, as cool as universal healthcare would be, TFA really isn't bringing that issue up. Rather, I think it alludes to the hire levels of stress or maybe more generally the unhealthy ways we Americans live. Universal Healthcare can't make you sleep 8 hours every night or eat all your vegetables, and I think that's really the point that should be driven home by the article... as Americans, we just aren't living healthily (and no amount of healthcare can make up for that.)

  12. Re:This is a trash study by arethuza · · Score: 5, Informative

    Because we decided as a nation that it should be a right that want to grant to our fellows - and I'm very proud of this fact.

  13. Strange Result by praksys · · Score: 5, Interesting

    Averege expected life spans for the US and the UK are nearly identical, and the average expected life span for non-hispanic white Americans is considrerably better than the UK average. So what does this study mean?

    (1) Being more sick more often won't actually make a difference to how long you can expect to live? Sounds implausible.
    (2) Americans get sick more often but their health care is better so they live just as long or longer? Sounds more plausible, although it seems like too much of a coincidence that better healthcare is almost exactly balancing worse health.
    (3) Maybe better access to health care in the US results in a higher rate of diagnosis, rather than a higher rate of illness? That would explain the nearly identical lifespan, but only if the better access to healthcare makes little difference to lifespan.
    (4) A difference in medical culture, where doctors in the US are more likely to diagnose and attempt to treat problems that doctors in the UK would just tell their patients to live with? I know that psychiatrists and psychologists in the US are very quick to diagnose and prescribe drugs compared to Japan or New Zealand (the other two countries that I am familiar with). Maybe there is something similar going on with the medical profession in general.

  14. One more point: poverty by Bombula · · Score: 5, Insightful
    Mod parent up.

    Spot on, poster. One point you missed though: despite the long hours and few vacation days in the US, there are more Americans in poverty now in real terms than at any time since the Great Depression. For tens of millions of Americans, despite all the work they are still dirt poor. This is for several reasons:

    - Minimum wage is not tied to any meaningful cost of living index.

    - The official 'Poverty Line' is similarly not based on any meaningful cost of living index (it is uselessly taken as 3 times the cost of food; food is dramatically cheaper now than even 25 years ago, and much less healthy, so this metric is positively retarded).

    - Rent on property has gone sky high as the economy has grown, meaning the cost of even the crappiest housing is essentially unaffordable for a minimum wage worker.

    And lastly, Employers are becoming increasingly exploitative, harkening back to 19th Century labor practices. Labor is less organized now and unions are weaker (where is a Wal Mart workers union for their 900,000 employees?). With so-called 'unskilled' jobs, employers encourage high turnover so they don't have to give pay increases with all sorts of draconian practices.

    On this last point, culpability falls largely on the government. Without regulation, unbridled capitalism is taken America steadily in the direction of Asian sweatshops. Supply and demand in the labor market defies all textbook economic logic because workers have no time to shop around for the best jobs, or to switch jobs when a better one becomes available and because they have no access to information about what other jobs might be available. Sure, you might get a dollar an hour more somewhere else, but if they withhold the first weeks' pay there, you can never switch because you won't ever be able to pay the rent or buy food if you miss a week's wages. Millions of people are that close to the edge. And so without rules - without government regulation - keeping companies from fucking low-wage workers, guess what? Those workers get fucked.

    So the point you missed is that millions of Americans are in a state of profound poverty. Sure, the US has pretty good general public infrastructure - roads, water, electricity - so it doesn't seem like poor people are living in the same poverty and desperation that exists in places like India, but in many instances they are. The toll on a person's health from the stress of poverty alone probably outweighs the toll of long working hours and few vacations. Bill Gates works 80-hour weeks, so I hear. He probably doesn't have the kind of stress-related health problems that a single mother holding down two jobs has, even if she only works a 60 hour week.

    Be sure to read Nickel and Dimed for more information about the impossibility of surviving in America on minimum wage.

    --
    A-Bomb
  15. How sick? by caluml · · Score: 5, Funny

    American employee: Hello Boss, I can't come into work today. I'm seriously sick.
    American employer: Oh, how sick?
    American employee: Well, I'm in bed with my sister.

  16. "Self-reported health issues"? by silasthehobbit · · Score: 5, Interesting

    I was reading this report on the BBC website earlier today, and I thought then that there is always the possibility that there is a flaw in the study method itself. As the study looks at self-reported health issues, you could also draw the conclusion that people in the US are more aware of health problems than the British.

    I'm British and I haven't been to the doctors in about five years. I know several people who aren't even registered with doctors. No-one I know of my age (36) has had tests for prostate cancer, checked themselves for testicular cancer or even has regular annual check-ups.

    There's a possibility, IMHO, that relying on self-reporting of illness would produce this kind of result in the older generation of Brits, as they're still following the "just get on with life and don't bother the doctors" mentality of those who grew up in the aftermath of WWII.

    My mother had a lot of pain in her lower back for years - when I eventually persuaded her to go to the doctors he got her to go to hospital. They did a scan of her lower back - nothing wrong with it - but noticed something wrong with one of her kidneys (it had never grown from when she was a child). So they took another scan higher up to have a better look at that. Then noticed something wrong with her liver. So they took another scan higher up and saw that she had severe cancer of the liver (despite her being a non-smoker and a very light drinker). She died about 6 weeks later.

    She would never have thought of getting either her kidneys or her liver checked out. If she had then maybe she would still be alive. But, like so many people from her (and her parents) generation going to the doctor was only something you avoided as you didn't like to bother him/her.

    As usual, your views may vary.

    --
    silas

  17. Re:This is a trash study by Tim+C · · Score: 5, Informative

    The fact that we democratically decided that it should be.

    The fact that it's basic human decency to help those less fortunate than yourself, particularly those in potentially dire need.

    The fact that when a single life is needlessly cut short, the whole society is affected in some way.

    Failing all that, simple enlightened self interest. Even if you can afford to pay for your healthcare or insurance now, can you be sure of that in the future? Heaven help you if you fall on hard times, or require treatment that your insurance won't cover.

  18. you're complete wrong by idlake · · Score: 5, Insightful

    The truth is, there are only two markets in the US that consistently see greater than inflation price increases: medicine and education. Please note both markets are broken by government action.

    The US government-run health care institutions and programs are the most efficient in the nation, handily beating private health care systems in terms of cost, overhead, and at least equalling it in quality. And I believe if you looked into it, you'd find the same for education. Both health care and education have been broken by the market.

    I'm sorry, Adam Smith's invisible hand works almost everywhere, and frequently when it doesn't, it's failure is because of government, not big business

    Adam Smith's invisible hand has a long list of preconditions to work, preconditions on the numbers and sizes of competitors, on information available to competitors and buyers, on the kinds of goods being exchanged, etc. Claiming that it "works almost everywhere" is just completely wrong and demonstrates an utter unfamiliarity with economic principles.

    For health care and education, several of the preconditions are violated and therefore a free market approach doesn't work; the current failures of the US health care and educational system are a direct consequence of that (however, aspects of both health care and education can be left to the market--it just requires careful planning and design).

    The free market works wonderfully when its preconditions are satisfied. It's the purpose of our government to ensure that free markets exist in as many goods and services as possible. It is also the purpose of our government to ensure that the small subset of goods and services the free market cannot supply efficiently are provided in some other way.

    People like you, who have an irrational and factually wrong belief in the universal applicability of free market economics are at the source of a lot of our economic ills. It's adding insult to injury that after wrecking our health care and educational systems, you then turn around and blame the government for the mess you made through deregulation and privatization.

  19. The System is Down by jreedy21 · · Score: 5, Informative

    You're right, but for different reasons -- the twisted economics of private health care in the U.S. are such that insurance companies run like hell away from anyone who is sick.

    When you see health plans marketed here in the States, it's done by showing healthy, happy people, not showing sick people receiving good health care. That's because insurers want to recruit customers who are in good health and leave those with diabetes or other chronic conditions for some other company. It's like a game of hot potato: who gets stuck with all of the diabetics and their lifelong health problems?

    As for health care being a societal issue, that's right on. Some people can take action to be healthy and remain that way, and others may take action but still wind up getting heart disease or diabetes because of family history, etc. The people who live healthy lives and stay healthy, as well as the people who live less healthy lifestyles but still wind up not getting diseases -- these are the people who "pay" for the people unfortunate enough to get sick. The healthy peoples' low costs subsidize the costs of those who wind up getting sick. In a nationalized health care system, those costs are spread out over the entire society, and it's a wash overall.

    In a private system, it's in the interests of insurers to seek out only the people who don't get sick -- also known as people without pre-existing conditions (those who haven't already been sick). Those with pre-existing conditions (diabetics) or those at risk for health problems (smokers, older people, etc.) are passed up, or charged far higher premiums, essentially locking them out of health care coverage if they aren't covered through their employer.

    Here's an interesting factor that would be very, very difficult to isolate, but that may be having an effect on health in the U.S. vs. the U.K. -- how many Americans are staying in stressful, underpaid, overworked jobs because they don't want to lose their health coverage? Seriously, that's one of the top priorities for basically anyone here, whether they can keep their health coverage or not. If big employers like General Motors or Ford or Boeing start to phase out health coverage because of the cost it adds to their products, it's going to start to get even worse for us.

    Not that it isn't already bad -- this is National Cover the Uninsured Week here, which is a good time to remind everyone of the following:

    * There are 46 million people in the U.S. without insurance (about 20 percent of the population).
    * The country spends more than 20 percent of its GDP on health expenditures.
    * We spend more per person on health care than most industrialized nations, and despite our "top of the line" care and technology, we have significantly lower indicators or health than most of those nations.
    * Hospitals (emergency rooms in particular) that provide charity care are becoming the first point of contact for many people who are uninsured, which is making it hard for some hospitals to stay financially solvent.

    It's not at all an exaggeration to say our health care system is in a crisis right now.