Human services in the U.S. what's more, the World.

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Social insurance in the U.S. also, the World Martin Donohoe Determinants of Wellbeing Time Financial status Sex Race Area Environment Hereditary qualities Wellbeing Propensities Access to Care Medicinal services Avoidance Determination Treatment The Condition of U.S. Social insurance 45 million uninsured
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Medicinal services in the U.S. what\'s more, the World Martin Donohoe

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Determinants of Health Era Socioeconomic status Sex Race Location Environment Genetics Health Habits Access to Care

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Health Care Prevention Diagnosis Treatment

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The State of U.S. Human services 45 million uninsured 45,000 passings/year due Millions more underinsured Remain in deadlock occupations Go without required consideration and/or medicines Marry

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The State of U.S. Human services US positions close to the base among westernized countries in general populace wellbeing (#24), future (#42), baby and maternal mortality, and so forth 20-25% of US kids live in destitution

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Health Care Expenditures per Capita U.S. = $8,160 Canada, Australia, Japan, Europe: $3,000 to $6,000 Typical poor African/Asian nation = $5-$50

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Who Pays for Health Care? Government (elected, state, and neighborhood) Medicare, Medicaid, VA, IHS, correctional facilites and jails Private protection Primarily manager based Out-of-pocket

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Health Insurance Industry Delisting Cherry picking Pre-existing conditions High authoritative expenses 15-30% (versus 2-3% for Medicare and Medicaid) Large overall revenues Loyalty: shareholders (not patients) Corruption

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Distribution of National Health Expenditures

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Some Reasons for Rising Health Care Costs Aging populace Chronic sicknesses Technological advances Exploding medication costs Procedural variability Administrative expenses

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Drug Companies’ Profits (“Drug organizations costs scarcely take care of R &D costs and risks.”) third rank Fortune Magazine

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Drug Companies’ Expenses Structure

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Innovation: Published Research Leading to Drugs

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Lobbying 15,000 full-time lobbyists Health protection, pharmaceutical, and composed solution spend colossal totals of cash to impact enactment and strategy

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The “Global Economy” 53 of the world’s 100 biggest economies are private partnerships; 47 are nations Wal-Mart is bigger than Israel and Greece AT&T is bigger than Malaysia and Ireland

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Major Contributors to Illness and Death 40% of US mortality because of tobacco, terrible eating routine, physical dormancy, and abuse of liquor Every $1 put resources into projects covering above things spares $5.60 in human services costs

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Poverty and Hunger US: 13% of inhabitants and 18% of kids live in neediness Rates of destitution in Blacks and Hispanics = 2X Whites Poverty connected with more awful physical and psychological wellness

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Economic Disparities Women 60 ȼ/$1 Men Median salary of dark U.S. families as a percent of white U.S. families more or less 60% (no change subsequent to late 1960s)

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Racial Disparities in Health Care: African-Americans Higher maternal and baby mortality Higher demise rates for most ailments Shorter futures Less wellbeing protection Undergo less symptomatic tests/remedial strategies

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Racial Disparities in Health Care: African-Americans Equalizing the death rates of whites and African-Americans would have turned away 686,202 passings somewhere around 1991 and 2000 Medical advances deflected 176,633 passings

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Outside the US One billion individuals need clean drinking water and 3 billion need sanitation 13,000-15,000 passings for each day worldwide from water-related maladies Hunger kills the same number of people in two days as kicked the bucket amid the nuclear besieging of Hiroshima

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Water Amount of cash required every year (notwithstanding ebb and flow uses) to give water and sanitation to all individuals in creating countries = $9 billion Amount of cash spent every year on beautifying agents in the U.S. = $8 billion

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Human Poverty

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Percentage of populace living on under one dollar for every day

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HIV Prevalence

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Malaria Deaths

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Overpopulation World populace - exponential development 1 billion in 1800 2.5 billion in 1950 6 billion in 2000 6.8 billion in 2009 est. 8-10 billion by 2050

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Status of Women do 67% of the world’s work Receive 10% of worldwide salary Own 1% of all property

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Worldwide, consistently 380 ladies get to be pregnant (190 spontaneous or undesirable) 110 ladies experience pregnancy-related complexities 40 ladies have perilous premature births 1 lady kicks the bucket from labor or dangerous fetus removal Reason: Lack of access to conceptive wellbeing administrations

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Deaths in War 18 th Century = 19/million populace 19 th Century = 11/million populace 20 th Century = 183/million populace Civilian Casualties: 10% late 19 th Century 85-90% in 20 th Century

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Contemporary Wars 250 wars in the 20 th Century Most clashes inside of poor states Many over oil

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War Deaths, 1945-2000

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Inverse Care Law Those nations that need the most human services assets are getting the minimum

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The Medical Brain Drain Five times the same number of moving specialists stream from creating to created countries than the other way

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Tobacco Cigarettes most intensely advertised items on the planet $2 billion/year in the U.S. U.S. driving exporter of cigarettes

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Consequences of Environmental Destruction Global warming: 160,000 passings and 5.5 million inability balanced life years lost every year (will twofold by 2020) Air contamination: 60,000 - 75,000 unexpected losses/yr. (U.S.); 1.8 million around the world

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Consequences of Environmental Destruction Pesticides in nourishment → 1,000,000 passings in the course of the most recent 6 years; 1 million malignancies in flow era of Americans Lead and mercury presentation multi-billion dollar issues Other poisons – connected with coronary illness, asthma, growth, barrenness, Parkinson’s sickness, Alzheimer’s, a mental imbalance, and so forth

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Toxic Pollutants ¼ US residents live inside of 4 miles of a Superfund site Environmental Racism Waste dumps/incinerators more basic in lower SES neighborhoods e.g., “Cancer Belt” (Baton Rogue to New Orleans)

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Extinction/Species Loss Mass Extinction More than 1/2 of the main 150 doctor prescribed medications from plants, other living beings More than 250,000 known blossoming species <0.5% studied for therapeutic quality

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Overconsumption (“Affluenza”) U.S. = 6.3% of world’s populace Owns half of the world’s riches U.S. in charge of: 25% of world’s vitality utilization 33% of paper utilization 72% of perilous waste generation

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New Remote Control Can Be Operated by Remote: No More Leaning Forward To Get Remote From Coffee Table Means Greater Convenience For TV Viewers

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But Are We Happier? Normal American meets expectations 200 more hrs/yr than in 1960 (#1 in world) Vacations shorter 8/10 Americans need another employment Fewer dear companions More forlornness/melancholy Pharmaceutical fixes

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Worldwide Health: Can Aid Help? US positions 21 st on the planet in remote guide as a rate of GDP (0.7%) Foreign Aid: 1/3 military 1/3 monetary 1/3 sustenance and advancement

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Worldwide Health: Can Aid Help? U.S altruistic giving pretty nearly $250 billion/year 2.5% of wage 2.9% at tallness of Great Depression Poor give higher rate of their earnings than rich; blacks more than whites Most stays in US

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US Charity Care Suffering Public doctor\'s facilities and ERs shutting Hospitals swinging to lucrative activities to enhance money related circumstance Cosmetic surgery, extravagance centers, forceful charging works on (counting charging uninsured more than guaranteed), enlisting well off remote patients

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Maldistribution of Wealth Top 250 tycoons overall worth $1 trillion, the consolidated salary of base 2.5 billion individuals (45% of world’s populace) U.S: Richest 1% of the populace possesses half of the country’s riches - poorest 90% own 30% - largest hole of any industrialized country

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Income Inequality Kills Higher wage imbalance is connected with expanded mortality at all per capita pay levels

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Maldistribution of Wealth In nations with moderate levels of riches, joy is most elevated where wage disparities least Major class baseball groups are more effective when players’ compensations are all the more impartially dispersed

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Maldistribution of riches Less than 4% of the joined abundance of the 225 wealthiest people on the planet would pay for continuous access to fundamental instruction, social insurance( (counting conceptive medicinal services), satisfactory nourishment, safe water, and sufficient sanitation for all people

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Health Requires Equality “All men are made equal” Declaration of Independence “Some individuals are more equivalent than others” George Orwell

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Hudson River, 2009

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U.N. Affirmation of Human Rights “Everyone has the privilege to a way of life satisfactory for the wellbeing and prosperity of himself and of his family, including nourishment, garments, lodging and medicinal care”

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Solutions Pay as you go Insurance Government-run program VA, IHS Current Congressional Proposals

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"If anyone...has a superior approach that will cut down premiums, cut down the shortage, cover the uninsured, reinforce Medicare for seniors, and stop insurance agency misuse, let me know." - President Obama, State of the Union, 1/27/10

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Single Payer Cradle to grave, compact protection for everybody All therapeutically important administrations secured Free decision of specialist and clinic Global and neighborhood planning dictated by doctors, patients, other wellbeing experts Co

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