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Thursday, May 26, 2016

Economic downturns kill people. With cancer.

Architect David Adjaye's rendering of the projected Gahanga International Children's Cancer Center near Kigali, Rwanda, where health insurance is mandatory (with zero premiums for the poor). Via De Zeen
And government-run health care systems prevent it. A study by Mahiben Maruthappu, Johnathan Watkins, et al. reported in The Lancet this week found in a study of cancer outcomes in 75 countries from 1990 to 2010 that
Unemployment rises were significantly associated with an increase in all-cancer mortality and all specific cancers except lung cancer in women. By contrast, untreatable cancer mortality was not significantly linked with changes in unemployment. Lag analyses showed significant associations remained 5 years after unemployment increases for the treatable cancer class. Rerunning analyses, while accounting for UHC [Universal Health Care] status, removed the significant associations. All-cancer, treatable cancer, and specific cancer mortalities significantly decreased as PEH [Public Expenditure on Health] increased. Time-series analysis provided an estimate of more than 40 000 excess deaths due to a subset of treatable cancers from 2008 to 2010, on the basis of 2000–07 trends. Most of these deaths were in non-UHC countries. 
Let's just say that again.

In countries without Universal Health Care systems like the United States and Russia, a rise in unemployment as in the global economic crisis of 2008 causes a severe increase in the number of people who die of treatable cancer. The size of the increase correlates inversely with the amount of money the government spends on health care, that is the more money the country spends the fewer people die, and in countries that feel they can afford Universal Health Care systems like Britain, France, Japan, and Thailand and Rwanda, the effect doesn't exist at all.

The study didn't actually look at US data, but
Medscape Medical News asked Dr Maruthappu about an analysis for the United States alone. "Although not included in this study, subsequent analyses estimate that the US experienced up to 18,000 additional cancer deaths between 2008 and 2010," he said. "We believe this is possibly due to the economic crisis and lack of universal healthcare during this time period," he added.
It doesn't matter whether it's a single-payer system like Canada's or a hybrid system as in the Netherlands, or the maybe overly hybrid one partially implemented in the US since 2014. Obamacare saves real lives, and when it's universal it will save many more.

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