{"id":28013,"date":"2023-08-20T13:01:53","date_gmt":"2023-08-20T20:01:53","guid":{"rendered":"https:\/\/occupysf.net\/?p=28013"},"modified":"2023-08-20T13:46:08","modified_gmt":"2023-08-20T20:46:08","slug":"how-do-we-fix-thescandal-that-is-americanhealth-care","status":"publish","type":"post","link":"https:\/\/occupysf.net\/index.php\/2023\/08\/20\/how-do-we-fix-thescandal-that-is-americanhealth-care\/","title":{"rendered":"How Do We\u00a0Fix the Scandal That Is American Health Care?"},"content":{"rendered":"\n

Text by Nicholas Kristof<\/a> (NYTimes.com)<\/p>\n\n\n\n

Photographs by September Dawn Bottoms<\/p>\n\n\n\n

Mr. Kristof is an Opinion columnist reporting from Greenwood, Miss. Ms. Bottoms is a photographer from Oklahoma whose work focuses on mental illness, family and poverty.<\/p>\n\n\n\n

This is the third in the series \u201cHow America Heals\u201d <\/strong>in which Nicholas Kristof is examining the interwoven crises devastating parts of America and exploring paths to recovery.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

It\u2019s not just that life expectancy in Mississippi (71.9<\/a>) now appears to be a hair shorter than in Bangladesh (72.4<\/a>). Nor that an infant is some 70 percent<\/a> more likely to die in the United States than in other wealthy countries.<\/p>\n\n\n\n

Nor even that for the first time in probably a century, the likelihood<\/a> that an American child will live to the age of 20 has dropped<\/a>.<\/p>\n\n\n\n

All that is tragic and infuriating, but to me the most heart-rending symbol of America\u2019s failure in health care is the avoidable amputations that result from poorly managed diabetes.<\/p>\n\n\n\n

A medical setting cannot hide the violence of a saw cutting through a leg<\/a> or muffle the grating noise it makes as it hacks through the tibia or disguise the distinctive charred odor of cauterized blood vessels. That noise of a saw on bone is a rebuke to an American health care system that, as Walter Cronkite reportedly observed, is neither healthy, caring nor a system.<\/p>\n\n\n\n

Dr. Raymond Girnys, a surgeon who has amputated countless limbs here in the Mississippi Delta, one of the poorest and least healthy parts of America, told me that he has nightmares of \u201cbeing chased by amputated legs and toes.\u201d<\/p>\n\n\n\n

\"A
Dr. Raymond Girnys checks Burt Saucier\u2019s foot after his toes were amputated.<\/figcaption><\/figure>\n\n\n\n

\u201cIt starts from the bottom up,\u201d Dr. Girnys said, explaining how patients arrive with diabetic wounds on the foot that refuse to heal<\/a> in part because of diminished circulation when blood sugar is not meticulously managed in a person with diabetes. Dr. Girnys initially tries to clean and treat the lesions, but they grow deeper, until he has to remove a toe.<\/p>\n\n\n\n

When more wounds develop, he takes off the foot in the hope of saving the rest of the leg. New wounds can force him to amputate the leg below the knee and perhaps, finally, above the knee. After that, Dr. Girnys said, the patient is likely<\/a> to die within five years.<\/p>\n\n\n\n

A toe, foot or leg is cut off by a doctor about 150,000<\/a> times a year in America, making the United States a world leader of these amputations.<\/p>\n\n\n\n

I\u2019ll be blunt: America\u2019s dismal health care outcomes are a disgrace. They shame us. Partly because of diabetes and other preventable conditions, Americans suffer unnecessarily and often die young. It is unconscionable that newborns in India<\/a>, Rwanda<\/a> and Venezuela<\/a> have a longer life expectancy than Native American<\/a> newborns (65) in the United States. And Native American males have a life expectancy of just 61.5 years<\/a> \u2014 shorter than the overall life expectancy in Haiti<\/a>.<\/p>\n\n\n\n

But there are fixes, and three in particular would make a huge difference: expanding access to medical care; more aggressively addressing behaviors like smoking, overeating and drug abuse; and making larger societywide steps to boost education and reduce child poverty. One reason to believe that we can do better on health care outcomes is that much of the rest of the world already does.<\/p>\n\n\n\n

This is the third essay in my series about how we can better help the millions of Americans left behind. We in journalism mostly cover problems: We typically write about planes that crash, not planes that land. But this series aims to offer solutions to challenges our nation faces.<\/p>\n\n\n\n