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As far as I recollect discussing this before one will actually save younger children in most of Nordic countries e.g. than in the US, and infant mortality rate

As far as I recollect discussing this before one will actually save younger children in most of Nordic countries e.g. than in the US, and infant mortality rate is still much lower. There are several reasons the US rate is so much higher than in other developed countries. The US does not have universal health care, which means large sections of the US population does not get adequate follow up during pregnancy. If you look at health care for the poor in the US, it is generally geared towards emergency care. They will stitch you up if you are about to die. However it generally does not cover regular doctor visits and checkups. Hence in the US a lot of expensive effort goes into saving babies when born, when the problem could far more easily have been resolved early in the pregnancy with better checkups. The US system is simply not very geared towards simple preventative care. Where other health care systems tend to focus on simple cheap system. American health care is overly focused on advance equipment, complicated procedures and basically anything which gives a lot of prestige or profits. Problem is that such a health care system does not perform very well in the real world. You end up with very high costs and poor results. E.g. a lot of health problems in the US is actually caused by over-treatment. That is the irony of the US system. Poor people who need help don't get it. People with expensive health care plans OTOH are subject to invasive procedures they don't need because it brings in profit. E.g. the US has overuse of surgery. So basically people who don't need surgery are cut open in the US. And that does take a toll on your health. The opioid crisis killing Americans is a variation of this. Basically it is overmedication for the sake of profits. The health care system is actually a contributor to the bad health problems in the US. It really should lead people to question for-profit health care, but it seems impossible to question anything about capitalism in the US. You speak to deaf ears.

gleb 6y ago
Except that US does have universal healthcare for pregnant women. Most pregnancies and births in United States are covered by Medicaid. And Medicaid pays well for that.
- Blahah 6y ago
  It really isn't the same though. In most developed countries you don't have to worry about turning up to a hospital, for pregnancy or any reason. When a pregnant woman turns up to hospital in the UK (for example) she is absolutely not stressed about the potential cost of the care. If something goes wrong, she gets world class care at no cost to her. If some other medical problem is discovered while she's there, it will be diagnosed and treated and she doesn't have to stress about the cost. Not so in the US. It would be surprising if that alone didn't account for a significant number of adverse outcomes.
  - ars 6y ago
    > Not so in the US Yes so in the US. That's literally what the person you replied to just told you: For pregnant women, children, and poor people, it's all fully covered. It's really only the middle class that has it hard (i.e. expensive).
    - Blahah 6y ago
      No, it isn't literally what they told me. In many other countries, there is no possibility of being charged for any medical treatment you require when you visit hospital to give birth. It is free as in you don't need to have any money or any way to pay and you can be diagnosed and treated for any medical condition that might become relevant while you're there giving birth, and give birth and have any related issues handled, and you never have to pay anything at all. In the US, that is just not true [1]. 1: https://www.theatlantic.com/health/archive/2020/01/how-much-does-it-cost-have-baby-us/604519/ https://www.theatlantic.com/health/archive/2020/01/how-much-...
      - sgerenser 6y ago
        That link talks about people with employer provided health insurance. For those on Medicaid I would not expect them to pay anything out of pocket for pregnancy and birth. Do you have information that says otherwise?
      - rweir 6y ago
        this is a common pattern I see in discussions, the idea of "going to the hospital and not worrying about bankruptcy" is just unintelligible and so you end up with discussions like this, about how "pregnancy-related-costs are often covered by Medicaid" which completely ignores the conditioning and fear and logistics that means that loads of people in the US simply don't go and get routine preventative care, even if they have what they consider to be "good" insurance.
- thinkcontext 6y ago
  Technically true, however, like much of the US safety net there are significant gaps, like co-morbidities, bureaucratic hurdles, restrictive time windows, delayed care, etc. ProPublica, Vox and Texas Tribune did a great in depth article on this last year, "The Extraordinary Danger of Being Pregnant and Uninsured in Texas". Most of what they found is applicable across the country, Texas just happens to be particularly horrific. https://www.propublica.org/article/the-extraordinary-danger-of-being-pregnant-and-uninsured-in-texas https://www.propublica.org/article/the-extraordinary-danger-... edit: "And Medicaid pays well for that." > In Texas, as in other parts of the U.S., providers are paid only about half as much for Medicaid patients as for privately insured ones.
rayiner 6y ago
Re: universal healthcare. Latinos in the US have the highest rates of lacking health insurance (20% versus 5% for non-Hispanic whites). But they have the second highest life expectancy (81.8 years—longer than people in Denmark). And they have the lowest maternal mortality rates: https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-... > If you look at health care for the poor in the US, it is generally geared towards emergency care. They will stitch you up if you are about to die. However it generally does not cover regular doctor visits and checkups. Hence in the US a lot of expensive effort goes into saving babies when born, when the problem could far more easily have been resolved early in the pregnancy with better checkups. That’s absolutely false. Medicaid covers preventative services: https://www.kff.org/medicaid/issue-brief/coverage-of-preventive-services-for-adults-in-medicaid/ https://www.kff.org/medicaid/issue-brief/coverage-of-prevent... CHIP also covers pregnant women and children under 19 and covers pre-natal checkups and delivery.
- Blahah 6y ago
  IIRC both higher life expectancy and lower infant mortality are considered likely to be due to community support systems being much better and more pervasive in Latinx communities in the USA. Home births among Latinx are much safer than among most other subpopulations - reduced medicalisation and strong preservation of cultural knowledge about birth are major factors.
  - in_cahoots 6y ago
    Any chance you have a citation or article for this? I’m not trying to critique here, it’s just that this hits close to home as a black woman. I see that modern midwifery is largely restricted to affluent, white, women, while the art of midwifery has largely been lost in the black community. It’s a cultural tragedy that the knowledge was lost.
- pavlov 6y ago
  According to the link, the maternal mortality rate for Hispanics in US is 11.5, which is almost 4x higher than in Finland. For non-hispanic black women, the death rate is a staggering 40.8 — that's over 13x higher than Finland! Large parts of America are a third world country.

gleb 6y ago

Except that US does have universal healthcare for pregnant women. Most pregnancies and births in United States are covered by Medicaid. And Medicaid pays well for that.

Blahah 6y ago
It really isn't the same though. In most developed countries you don't have to worry about turning up to a hospital, for pregnancy or any reason. When a pregnant woman turns up to hospital in the UK (for example) she is absolutely not stressed about the potential cost of the care. If something goes wrong, she gets world class care at no cost to her. If some other medical problem is discovered while she's there, it will be diagnosed and treated and she doesn't have to stress about the cost. Not so in the US. It would be surprising if that alone didn't account for a significant number of adverse outcomes.
- ars 6y ago
  > Not so in the US Yes so in the US. That's literally what the person you replied to just told you: For pregnant women, children, and poor people, it's all fully covered. It's really only the middle class that has it hard (i.e. expensive).
  - Blahah 6y ago
    No, it isn't literally what they told me. In many other countries, there is no possibility of being charged for any medical treatment you require when you visit hospital to give birth. It is free as in you don't need to have any money or any way to pay and you can be diagnosed and treated for any medical condition that might become relevant while you're there giving birth, and give birth and have any related issues handled, and you never have to pay anything at all. In the US, that is just not true [1]. 1: https://www.theatlantic.com/health/archive/2020/01/how-much-does-it-cost-have-baby-us/604519/ https://www.theatlantic.com/health/archive/2020/01/how-much-...
    - sgerenser 6y ago
      That link talks about people with employer provided health insurance. For those on Medicaid I would not expect them to pay anything out of pocket for pregnancy and birth. Do you have information that says otherwise?
    - rweir 6y ago
      this is a common pattern I see in discussions, the idea of "going to the hospital and not worrying about bankruptcy" is just unintelligible and so you end up with discussions like this, about how "pregnancy-related-costs are often covered by Medicaid" which completely ignores the conditioning and fear and logistics that means that loads of people in the US simply don't go and get routine preventative care, even if they have what they consider to be "good" insurance.
thinkcontext 6y ago
Technically true, however, like much of the US safety net there are significant gaps, like co-morbidities, bureaucratic hurdles, restrictive time windows, delayed care, etc. ProPublica, Vox and Texas Tribune did a great in depth article on this last year, "The Extraordinary Danger of Being Pregnant and Uninsured in Texas". Most of what they found is applicable across the country, Texas just happens to be particularly horrific. https://www.propublica.org/article/the-extraordinary-danger-of-being-pregnant-and-uninsured-in-texas https://www.propublica.org/article/the-extraordinary-danger-... edit: "And Medicaid pays well for that." > In Texas, as in other parts of the U.S., providers are paid only about half as much for Medicaid patients as for privately insured ones.

rayiner 6y ago

Re: universal healthcare. Latinos in the US have the highest rates of lacking health insurance (20% versus 5% for non-Hispanic whites). But they have the second highest life expectancy (81.8 years—longer than people in Denmark). And they have the lowest maternal mortality rates: https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-... > If you look at health care for the poor in the US, it is generally geared towards emergency care. They will stitch you up if you are about to die. However it generally does not cover regular doctor visits and checkups. Hence in the US a lot of expensive effort goes into saving babies when born, when the problem could far more easily have been resolved early in the pregnancy with better checkups. That’s absolutely false. Medicaid covers preventative services: https://www.kff.org/medicaid/issue-brief/coverage-of-preventive-services-for-adults-in-medicaid/ https://www.kff.org/medicaid/issue-brief/coverage-of-prevent... CHIP also covers pregnant women and children under 19 and covers pre-natal checkups and delivery.

Blahah 6y ago
IIRC both higher life expectancy and lower infant mortality are considered likely to be due to community support systems being much better and more pervasive in Latinx communities in the USA. Home births among Latinx are much safer than among most other subpopulations - reduced medicalisation and strong preservation of cultural knowledge about birth are major factors.
- in_cahoots 6y ago
  Any chance you have a citation or article for this? I’m not trying to critique here, it’s just that this hits close to home as a black woman. I see that modern midwifery is largely restricted to affluent, white, women, while the art of midwifery has largely been lost in the black community. It’s a cultural tragedy that the knowledge was lost.
pavlov 6y ago
According to the link, the maternal mortality rate for Hispanics in US is 11.5, which is almost 4x higher than in Finland. For non-hispanic black women, the death rate is a staggering 40.8 — that's over 13x higher than Finland! Large parts of America are a third world country.