Decommodify

From The Lancet:

Key messages

•Economic inequality in the USA has been increasing for decades and is now among the highest in developed countries.

•Differences in life expectancy have been widening, with the wealthiest Americans now living 10–15 years longer than the poorest.

•Despite coverage gains from the Affordable Care Act, about 27 million Americans remain uninsured—a number that is likely to increase under the reforms advocated by Republicans now empowered in Washington, DC.

•Both overall and government health spending are higher in the USA than in other countries, yet inadequate insurance coverage, high cost sharing by patients, and geographical barriers restrict access to care for many.

•Financing of health care in the USA is regressive, with poor and middle-class individuals paying a larger share of their incomes for care than the affluent, thereby deepening inequalities in disposable income.

•Rising insurance premiums for employer-sponsored private coverage have eroded wage gains for middle-class Americans.

•Medical indebtedness is common among both insured and uninsured Americans, and often leads to bankruptcy.

•To achieve health-care equality, a non-market financing scheme that treats health care as a human right is essential.

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