A Canadian born with the fatal lung disease cystic fibrosis can expect to live a decade longer than an American, according to a new study, a stark disparity that is likely to add fuel to the debate over the quality and cost of U.S. health care....................................................
The median life expectancy for Canadians with the disease is 50.9 years, compared with 40.6 years for Americans, according to the study, published on Monday in the Annals of Internal Medicine.
Relatively few cystic-fibrosis patients in either country receive lung transplants, however, suggesting the differences in the countries’ health care and social-welfare systems have been bigger factors, said Patrick A. Flume, a cystic fibrosis specialist at the Medical University of South Carolina, who co-wrote an editorial published alongside the study.Why do Medicaid patients fare so poorly? Possibly because of the lack of money for non-covered expenses such as diet and ability to go to medical appointments (lack of transportation, perhaps, and inability to miss work?)
The study evaluated clinical data for about 51,400 patients in the two countries from 1990 to 2013.
To estimate median expected survival, the researchers analyzed patients over a five-year period ending in 2013. After adjusting their analysis for factors including age and disease severity, the researchers found Canadians had a 34% lower risk of death over the five years than American patients.
Of patients who died over the five-year period, the median age at death was 31.9 for Canadians and 26.9 for Americans, a five-year difference that was statistically significant. The researchers discovered the 10-year difference in life expectancy by looking at both patients who died during the period and those who lived.
The differences between the two countries varied significantly based on insurance coverage, with U.S. patients covered by government programs faring worse than those with private insurance. The risk of death over the five-year period was 44% lower for Canadians compared with U.S. patients continuously covered by Medicaid or Medicare, government programs that insure the poor, disabled and elderly. But Americans with other insurance, primarily employer-sponsored, were no more likely to die than Canadians, the study said.
Christopher Goss, a co-author of the study, said Medicaid often provides cheaper and more comprehensive coverage for cystic fibrosis than private insurance does. Medicaid and Medicare patients likely fared worse in the study because of factors linked to poverty, rather than insurance, he said.The GOP demand that we cut back on Medicaid and social spending for low income families, and deny workers of the right to go to medical appointments without losing their jobs or pay comes with a hidden bill---years of life for people with chronic illness. We don't need the death panels of paranoid conspiracy mongers to snuff people---the very real republican agenda does that quite efficiently.
Low-income patients have less help from family members in getting to doctors’ appointments, and are less able to afford the high-calorie and high-fat diets that help patients maintain a healthy weight, said Dr. Goss, a cystic fibrosis specialist at the University of Washington Medical Center in Seattle.
“If you’re scraping by to make ends meet, it’s very hard to take care of a child with cystic fibrosis,” he said.