US Healthcare: Quality and Inequality

Another report on CNN today. We’ve heard this before. The US spends more on healthcare than any other wealthy country and gets inferior results:

  • Higher rates of death among newborns and their mothers
  • Higher rates of death from treatable diseases
  • Shorter life expectancy(1)

What the report says is true, but it doesn’t truly represent the reality of the situation.

The truth is that the US can provide excellent healthcare, if you have access to it.

  1. You have to live near where excellent health care is provided. In much of the South, the Midwest, Great Plains and the Rocky Mountain states, you’re out of luck.
  2. You have to be covered by a health plan that allows you to go to see the best doctors. Even the plans under the Affordable Care Act have geographic and other limitations. The best coverage is provided by large corporate health insurance and Medicare.

What do you call a person with a serious injury who is 90 minutes away from a Tier 1 trauma center?


Do you know where you need to go to get state-of-the-art care for any serious medical condition? You probably don’t. Unless you live in Boston, New York, Philadelphia, Baltimore, Durham, Chicago, Houston, St. Louis, Minneapolis, Los Angeles, or San Francisco, where you need to be probably isn’t in driving distance.

That’s why the US can offer excellent health care but the average person never sees it.

Proof of this inequality shows up in life expectancy, which varies by where people live in the US.(2)

Alabama is the worst, with an average life expectancy from birth of 75 years. In other words, when you get to full retirement age, you can expect only 8 years left to enjoy it. Still worse, since the start of Covid, these figures are trending downward.

The state images don’t tell the whole story. Within each state there is substantial variation. Take Nevada for example.

Even Clark County in the southern tip of the state, home to Las Vegas and most of the state’s population, contains both very good and very bad results. Again, the issue is access, with secondary concerns regarding nutrition and lifestyle.

Texas is an even more dramatically hideous mess, with much of the state having below average life expectancy.

In this context, it’s understandable why so many people in the US are frustrated and angry. They should be. The anger is misdirected, of course. It’s their local politicians who have sold them out, not some mythical conspiracy group.




  1. Vic, well said. It is not ironic the states who did not expand Medicaid under the ACA tend to be those who trail the pack in general healthcare measures. In addition to these healthcare deserts, a major problem is food deserts, where better food to eat is harder to come by. The fact the US lags so many countries on maternal mortality rates (meaning higher) and children mortality rates is a darn shame. Keith

    Liked by 1 person

  2. What an eye opener, Vic. I noticed Kentucky is pink, which looks like one of the better places to live, although the hospitals with the highest cure rate are too far from my location. Lifeflight has made them more accessible, but the family has to drive fast when a child is involved. No parent is allowed in the helicopter. I do have to say that Norton’s Hospital in Louisville took excellent care of my great grandson, now three months old and thriving. Jewish, also in Louisville is also excellent. Here though we have one hospital and all doctors have to work primarily for that hospital if they want to stay in the area. No competition means higher costs and limited services most of the time. One of the areas I have grown to love in our hospital is the kitchen area. I have to say the food there is excellent, but the rest? Don’t ask.


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.