The Dying of the Poor White Americans

The gap in life expectancy between the top and bottom 1 percent of income for American men is nearly 15 years. For women, it's 10 years.


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"Cirrhosis didn't kill her, being poor did," explained my cousin Sue about our cousin Teresa who died in her mid-40s more than a decade ago. Teresa, a vibrant personality who enjoyed drinking her beer, spent most of her life in small town eastern Tennessee. Sue believes that had Teresa been richer with better health insurance that she might have qualified for a liver transplant.

My cousin Myra also died in her early 40s. Myra, who weighed over 300 pounds when she succumbed to heart failure, lived in all her life in small town southwestern Virginia. Their sad stories turn out to be part of an alarming trend of rising death rates among rural poor white Americans.

I cite the sad premature deaths of my cousins as illustrations of the findings in two terrific articles in today's Washiington Post. On the front page is "A New Divide in American Death," and inside is an article, "Where living poor means dying young." The second article is reporting the results from a new study, "The Association Between Income and Life Expectancy in the United States, 2001-2014," just published in the Journal of the American Medical Association.

In the New Divide article, the Post reports:

White women have been dying prematurely at higher rates since the turn of this century, passing away in their 30s, 40s and 50s in a slow-motion crisis driven by decaying health in small-town America, according to an analysis of national health and mortality statistics by The Washington Post.

Among African Americans, Hispanics and even the oldest white Americans, death rates have continued to fall. But for white women in what should be the prime of their lives, death rates have spiked upward. In one of the hardest-hit groups — rural white women in their late 40s — the death rate has risen by 30 percent.

Washington Post

The rising death among poor rural white women appears to result from a combination of opioid and alcohol abuse, increased obesity, and rising suicide rates.

The second article based on the JAMA study also finds that the death rates for Americans vary by geograpy. Death rates are higher in small town and rural areas but also in hollowed out Midwestern rustbelt cities and in the Deep South. One of the more striking results is the gap between the top and bottom 1 percent of income for men nationwide is nearly 15 years. For women, it's 10 years. And these disparities have widened since 2000.

Washington Post

From the JAMA abstract:

The analysis yielded 4 results. First, higher income was associated with greater longevity throughout the income distribution. The gap in life expectancy between the richest 1% and poorest 1% of individuals was 14.6 years (95% CI, 14.4 to 14.8 years) for men and 10.1 years (95% CI, 9.9 to 10.3 years) for women. Second, inequality in life expectancy increased over time. Between 2001 and 2014, life expectancy increased by 2.34 years for men and 2.91 years for women in the top 5% of the income distribution, but by only 0.32 years for men and 0.04 years for women in the bottom 5% (P?<?.001 for the differences for both sexes). Third, life expectancy for low-income individuals varied substantially across local areas. In the bottom income quartile, life expectancy differed by approximately 4.5 years between areas with the highest and lowest longevity. Changes in life expectancy between 2001 and 2014 ranged from gains of more than 4 years to losses of more than 2 years across areas. Fourth, geographic differences in life expectancy for individuals in the lowest income quartile were significantly correlated with health behaviors such as smoking (r?=??0.69, P? <?.001), but were not significantly correlated with access to medical care, physical environmental factors, income inequality, or labor market conditions. Life expectancy for low-income individuals was positively correlated with the local area fraction of immigrants (r?=?0.72, P?<?.001), fraction of college graduates (r?=?0.42, P?<?.001), and government expenditures (r?=?0.57, P?<?.001).

In an accompanying editorial, Economics Nobelist Angus Deaton notes that the differences in income could arise from the fact that people who have good health earn more. He further observes:

It is as if the top income percentiles belong to one world of elite, wealthy US adults, whereas the bottom income percentiles each belong to separate worlds of poverty, each unhappy and unhealthy in its own way. The life expectancy at 40 years of age in the top income percentile of the United States is better than the mean in any other country for life expectancy at 40 years of age. However, not by a lot, and likely not better than the top percentile in Sweden or the Netherlands. In contrast, the life expectancy at 40 years of age in the bottom income percentile of the United States is located between the mean for Pakistan and Sudan for life expectancy at 40 years of age.

For more background, see my article, "Poverty Is Deadly."

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  1. Sue believes that had Teresa been richer with better health insurance that she might have qualified for a liver transplant.

    Holy fuck.

    1. The liver transplant queues in the U.S. are fucking insane!

      Here in New England if you have liver failure, you are likely a dead man; the waiting list is so long and the rate at which transplant-able livers are entering the system is so low compared to demand that basically you get a few weeks window in which to get a transplant.

      Basically, the way you get to the front of the line is that the people ahead of you either get a new liver (occasionally) or they get too sick to be able to survive the surgery (majority outcome). And that usually happens when you are so sick that usually you only are a few weeks out from being too sick to be a candidate for the surgery.

      It’s a fucking travesty caused by the nutjobs who believe that donors or their estates shouldn’t be paid for organs but should only provide them altruistically.

      1. An alcoholic needing a new liver isn’t going to get a replacement, I don’t care good your insurance is. It ain’t going to happen.

        1. Outside of a very few highly-connected types, this is true.

        2. Unless the alcoholic is Mickey Mantle.

            1. Or a Vice Prez of the USA…

        3. If you are from a certain middle eastern family and go to a certain prestigious hospital, you can get a liver no problem.

          1. Mehmet Oz?

            1. Middle East? Turkey is so Europe now, dude.

        4. My wife’s cousin died earlier this year under this exact scenario. Her liver failed, giving here mere weeks to live. The transplant authorities refused to put her on the list until she was “clean” for at least 6 months. So a death sentence there.

          They also would not consider a directed transplant until she was clean for at least 6 months. So even if her daughter or one of her sisters was a match, tough luck.

          I suppose the only possible way out would have been to travel somewhere like India for a directed transplant. But she was way too sick for that, and probably too poor, but I don’t know the cost.

          She had insurance that probably would have paid for the transplant though. And as far as I know, medicaid will happily pay for a transplant as well.

      2. Are there really still people out there who aren’t organ donors? If so, why?

        (And yes, I agree, let people sell them.)

        1. Because of the fear that they will get the plug pulled on them prematurely in order to harvest their parts.

          1. It’s not so much a fear, as a cold hard fact. I’ve heard stories that don’t sound completely implausible and fulfill my preconceived biases of human nature regarding this issue.

        2. I brought this up during the Planned Parenthood video fiasco. I was surprised even libertarians were outraged that the fetal body parts were allegedly being sold. If you are pro-life, the outrage should be about the abortion, not the selling of organs. I thought all libertarians supported organ sales, but apparently many still think it is somehow immoral.

            1. Yeah, because it’s a mis-quote.

              “The love of money is the root of all evil” is how it actually goes.

              (And I find little to complain about in it; loving money for its own sake is a vicious trap.

              Loving the things you can get in exchange for it is another matter.)

          1. Yeah, but that was rationalization. Everyone who was pro-life was outraged. Everyone who was pro-choice said it was all perfectly fine.

            If you had gotten them alone in a room before they figured out which team was interested in which outcome, I guarantee the results would have been much more mixed on the topic.

            Motivated reasoning is a powerful force.

          2. If it’s human enough that body parts are fungible and can be swapped out for the greater good, it is not amiss to have a moment of pause and a sense of caution.

            1. Body parts are definitely not fungible.

              But I don’t think any libertarian would ever argue that anyone other than a body part owner had any say as to what should be done with his/her body part. If you are referring to some future possible State decrees to confiscate people’s kidneys, I think it is safe to say no one here would even entertain that.

              1. If you are referring to some future possible State decrees to confiscate people’s kidneys, I think it is safe to say no one here would even entertain that.

                Why would you think that? You can find people around here entertaining the confiscation of one’s freedom for life over Snickers bars and borrowed shopping carts. Confiscating one’s citizenship for racial or religious reasons. There’s a troll down below arguing to confiscate doctor’s autonomous medical choices because he’s having some feelz.

                Most people have a bugbear that they’re happy enough to inflict on those around them, imagining the benefit to them will outweigh any negatives to others – always others, because the negatives would never bite their own personal ass.

                And it doesn’t matter about us in here anyway. Us in here aren’t driving the conversation. It’s them out there, and witnessing the amount of self-control and long-term thinking going on by them out there, “Whoa Nellie, guys, let’s think about this for a sec” seems an entirely rational reaction.

          3. I was surprised even libertarians were outraged that the fetal body parts were allegedly being sold.

            To me, it wasn’t so much the selling of the parts (although that does set up a pretty disturbing incentive for PP), its that it was being done in clear violation of current law (which actually allows it so long as you only charge your cost), and everybody looked the other way.

            I despise double standards. I’m actually fine with abortion up to a point, but the special treatment and exemptions abortion and abortion providers get from the law and enforcement drive me nuts.

          4. I thought all libertarians supported organ sales, but apparently many still think it is somehow immoral.

            In cases of abortion, the consent of the organ donor (the aborted fetus) was neither sought nor obtained.

            1. Which reminds me of what I always bring up when it comes up here – there is no one inherent libertarian position on abortion.

              Libertarian theory offers no obvious, unambiguous answers to the questions “when does personhood actually begin?” and “how can competing personhood and self-ownership claims be evauated?”

              Hell, most (all? None I’ve seen!) libertarian theory offers no answers at all to those linked questions.

              1. There are plenty of answers, if all you want is an answer. The problem is that there is no good answer. For the foreseeable future, that will continue to be the case. The best libertarianism can offer in this regard is that the state is not the appropriate apparatus for resolving the issue.

          5. morning wood-

            I thought all libertarians supported organ sales, but apparently many still think it is somehow immoral.

            There’s that whole “consent” thing going on… After all, I’m perfectly happy to sell your organs- you might disagree.

      3. the way you get to the front of the line is that the people ahead of you either get a new liver (occasionally) or they get too sick to be able to survive the surgery (majority outcome). And that usually happens when you are so sick that usually you only are a few weeks out from being too sick to be a candidate for the surgery

        My buddy got a liver transplant after a decade w/ Hep C (I think). The above is pretty much his experience.

        He basically explained that to be a contender for a transplant, you have to be in a sweet spot between ‘near death’ and ‘not sick enough’. And you have to be in that zone when matching donor organs come available.

        As you note = it only exists for a few weeks (or less). Its basically a luck-of-the-draw thing at that point.

        My buddy gamed this a bit by drinking. Basically, he knew that he needed to get sicker to qualify, so he steadily beat his liver into almost-collapse. And then he hit the jackpot when some mormon died in a car-crash just near his preferred hospital.

    2. Upper middle class people with good insurance drink themselves to death too.

      1. NOOOOOOOO!!!

      2. Bit they do it from stemmed glasses or snifters.

  2. So the poor have too much to eat, and enough money to buy lots of heavily taxed smokes and liquor? Fucking tragic.

    1. All: Folks, I fully realize that my cousins made some choices and suffered the consequences – the point is that the recent research shows that they are far not alone.

      1. “bad choices” and “far from being alone” in making such choices.

        1. Wait…

          Even the royalty goes without an edit button? THIS IS AN OUTRAGE!

          1. All are equal in the eyes of the server squirrels and commenting plugin.

            1. For now, it’s “four legs and a bushy tail good, two legs bad.” But soon, it’s gonna be “some two legs are more squirly than others.”

        2. Right, so it’s actually their choices that are killing them, not “being poor”.

          1. It’s possible to acknowledge that poverty and diminished expectations are responsible for destructive lifestyles without proposing another transfer program to deal with it. Quite the opposite, really, transfer programs have been hugely destructive for their victims. Williamson may have been heartless but he’s absolutely right, some places simply need to whither away. No amount of subsidy will revive their economies.

            1. I mean, hell, up until a little while ago I carried a perverse expectation that I would never improve my lot in life, forever uncredentialed and underemployed. And I am from a modestly successful family. There’s no reason other than a dour mindset to think that working hard won’t eventually pan out. I drank heavily, isolated myself, and entertained an almost constant stream of abusive thinking. I can’t imagine what being surrounded by impoverished and equally despondent people would have done to me, but suicide certainly isn’t out of the question. Was that a choice on my behalf? Absolutely, one for which I constantly attempted to atone and then used my guilt as further proof that I deserved to be unhappy. Going on paroxetine helped tremendously. People living in Bumfuck VA or AK or TX need a little more drastic course of action.

              1. I hear you. Surrounding oneself with the unloved and unlucky tends to drag one down. Negative thoughts can become self-reinforcing. Self-destructive behavior becomes a perverse coping mechanism. For me the solution has been exercise, learning new skills, and making things. When I get despondent it is usually because I’ve been neglecting myself.

            2. Yeah. It is a choice. But choices aren’t made in isolation.

      2. But, Ron, isn’t the whole idea to let people make whatever choices they want without hysterical pronouncements about public health policy? ESPECIALLY when they really aren’t justified?

      3. Hello, Cause I would like to introduce you to Effect.

      4. This just in: recent research indicates Bailey has many more cousins than he knew about.

        1. That’s often how it goes here in ole Virginny.

    2. They have too much to eat because the corporations provide them with prefabricated food that is bad for them, but these poor people are tricked into buy the stuff because the corporations sell it for cheap! If the corporations didn’t force poor people to eat bad food, then they wouldn’t have all these health problems! This is 100% the fault of the corporations, taking advantage of poor people and killing them for a profit!

    3. If you were related to Ron Bailey, you’d drink yourself to death, too.


    4. Hey, you have to be really rich to afford Whole Foods “superfoods” and the ability to spend all day doing Yoga and exercising.

      And otherwise you die.

      (I kid.

      Mostly I suspect it’s just a matter of poor, rural people having a culture less focused on health and prevention and worse access to medical care if they do want it.

      The above joke answer does make a little more sense applied to the top two quintiles, though.)


    Oh, and if you read that WaPo article, you can see that those women DEFINITELY didn’t die of hunger or starvation.

    This is a rich country’s disease…

    1. PS I fucking hate the goddamn “media” in this country… and all countries…

  4. The rising death among poor rural white women appears to result from a combination of opioid and alcohol abuse, increased obesity, and rising suicide rates.

    An earlier H&R article suggested a possible solution.

  5. I’ll admit, I’m not versed in all aspects of libertarian/Libertarian philosophy but… isn’t “if the poor can’t pay for medicine, oh well” a pretty uncontroversial libertarian/Libertarian thought?

    1. You first heard about this “libertarianism” thing on Salon, huh?

      1. Nope.

    2. Artificially inflated prices and monopolies nurtured by government makes it… nuanced. Which, really, just gives us more opportunity to argue why we’ve been right all along. So, bonus?

      Vote for us, shit gets cheaper, yo!

    3. Yes. But that doesn’t mean that you have to ignore trends like this. If you want the libertarian angle, consider how much of the poor health choices the rural poor make are enabled by government programs.

      1. And have actually been ENCOURAGED by government dietary guidelines for generations, now.

        Yum – sweet, sweet High Fructose Corn Syrup – how do I love thee?

      2. If you want the libertarian angle, consider how much of the poor health choices the rural poor make are enabled by government programs.

        Enabled or exacerbated.

        Not that the opposite doesn’t occur, but Statewide taxes that benefit the several million people crowded into a municipality while nearly literally fucking over the rest of the state are not uncommon.

        A non-profit can make a tax-subsidized killing on urban real estate that can’t be had out in the middle of nowhere.

        1. Enabled or exacerbated.

          Both, I think. A lot of rural towns can only continue to exist because of welfare programs. And that doesn’t exactly encourage a healthy lifestyle.

          1. A fair number of businesses that might allow those towns to exist without welfare never get off the ground, or are closed, due to the regulatory state, as well.

            1. Yes, good point. Between regulatory burden on businesses and welfare enabling people to stay put while being unproductive, many small rural communities don’t have a chance.

      3. I do want the libertarian angle. That’s why I come to read a purportedly-libertarian news site. Hence my confusion that the article lacked a libertarian angle.

    4. Someone doesn’t understand libertarianism.

    5. “if the poor can’t pay for medicine, oh well”

      Yep, you’ve got us pegged.

      *Dives into Scrooge-McDuck-style swimming pool*

      1. “Yep, you’ve got us pegged.”
        Sorry, I’m monogamous. If you want to be pegged, you’ll have to find someone else interseted in doing it.

        That said, Scrooge was a *capitalist*. Any libertarianism on his part was incidental.

        And *that* said, going through the comments here… quite a few objected to my tone, but I’m not seeing anyone that actually suggests the government has any role beyond deregulation and abandoning welfare.

        1. It’d prolly work as well as anything we’re doing now. Face it, sometimes life just sucks, and there isn’t anything to be done for it.

          1. As I said, “oh well”.

            1. You’re already delivering “oh, well”.

              What happens with long lines at the VA? “Oh, well”
              What happens with Medicare fraud? “Oh, well”
              What happens when premiums go up and choices are narrowed because of the PPACA? “Oh, well”

              1. In big government’s defense, poor white people dying is the quickest way to turn them into Democratic voters.

              2. … and?

                I’m not the one arguing that the libertarian angle isn’t “oh well”. There is a long list of posters who seem upset at this notion though.

                1. The “libertarian angle” is “oh well, gov’t isn’t working, so maybe I should do it myself”.

                  But, you probably knew that already…

                2. I’m not upset at the notion, I’m calling you intellectually dishonest.

                  There’s a difference, but apparently you can’t appreciate it.

        2. I’m not seeing anyone that actually suggests the government has any role beyond deregulation and abandoning welfare

          Right, because it doesn’t. And there’s no aspect of deregulation and abandoning welfare that is an afterthought, or “oh well.” The argument is quite affirmatively that these steps will do far more to alleviate the problem than any proposed government action.

          Just because you’re some do-gooder who associates the identification of a problem with the automatic, reflexive introduction of a host of new government activities designed to alleviate it, doesn’t mean we’re ambivalent to this or any other problem.

          By logic parallel to yours, one must conclude that nobody, for instance, opposes prohibition for any reason other than an “oh well” attitude to the pernicious effects of drug use. It’s entirely impossible that we do care about these problems ? in fact that we care more than the well-intentioned who don’t bother to verify their brilliant ideas actually work as intentioned ? and that we merely identify existing government action as an exacerbating factor.

          1. impossible = possible

    6. Are you really here to learn or are you just a troll?

      1. It’s Tulpa.

        1. In the end, aren’t we all Tulpa, really?

          1. Isn’t that the capital of Oklahopa?

          2. No.

            No we’re not.

      2. Meh, he’s a noob around here. Best case scenario he challenges our assumptions, worst case scenara he’s another Tulpa/American Idiot sock.

        Anyways, no, libertartians, don’t think that people should suffer because of the excessive cost of medicine.

        In fact, part of the reason medicine is so expensive is because it costs a shitton of money to go through FDA procedures to get a pill approved approved. So the first pill costs a billion dollars, then the second pill costs a buck. Then the drug companies have to amortize that cost.

        1. That’s a really good way to put it. Thanks.

        2. “Anyways, no, libertartians, don’t think that people should suffer because of the excessive cost of medicine.”
          At best (worst?) I suggested apathy to suffering, not that people *should* suffer.

          That said, we’ve seen that drug companies are quite willing to jack up prices of old paid-for drugs, not to research other drugs, just for profit. So I find this notion that without the FDA drug prices would plummet to require far more faith in humanity then I’m prepared to give.

          So if someone is unable to pay for their medical care, what answer do we give other then “oh well”? Taxing and forced services are out, and “charity” is not a government solution and cannot/shouldnot be relied on.

          1. I see your grasp of economics/business is on par with your grasp of libertarianism.

            Both, shall we say, lacking?

          2. The government can’t be relied upon. The government doesn’t produce jack shit. The President isn’t a biologist. How many Senators studied pharmacology? How many physicians are in the House?

            If the tax base up and left, or people stopped practicing medicine, or the evil greedy corporations stopped producing medication, then what? How are you going to fulfill your promises of guaranteed medical care?

            You can’t promise reliability because you can’t deliver on that promise. You require other people to make it happen, no different than charity or markets, except that your way requires a lot more force and coercion.

          3. The only reason they CAN jack up those prices is the FDA granted monopoly, itself an outgrowth of government force-backed notions of the exclusivity of intellectual property. There are layers upon layers to this stinking onion of a problem.

          4. Escher, this issue is about how a truly free market operates. Any government dictum, however well intended, skews the market, causes misallocation of capital, lowers marginal utility, and eventually higher prices (boom) and then deflation (bust). This is an expensive, wasteful, and entirely predictable process, which has been thoroughly explained by Mises. Also, there is no charity by stealing from one to give to another. Charity is a choice. Therefore, the l/L answer is based on the free market. Get gov out of the way and let people do as they will with their resources/property. If this means contributing to a church, health for poor, or roll it up and smoke it, then we must defer to the individuals values and priorities. Besides, the govt. only keeps the honest people honest and causes triple indemnity on them (theft through taxes, then theft through inflation, and finally having to deal with the inevitable deflation).

        3. Yes and no.

          Libertarians as a whole have no one policy on that.

          By which I mean, you have options all the way from Hayek’s “safety net” welfare state (which would presumably socialize/subsidize at least some medicine) to Rothbard’s anarchism.

          An anarchist might say “no one SHOULD suffer because a medicine costs more than they can afford” – but they equally can’t say “… and thus someone else MUST pay for it”, because a “must” like that is incompatible with a Stateless society.

          (I can say nobody “should” suffer in the sense that an ideal world would not have that happening.

          What policy prescriptions to make from that “should” is a radically different matter – any time we start to “override” the prices of real goods, we’re in dangerous territory, and must be careful lest we end up “corercting” “problems” we’ve made endlessly … and ending up with something like, well, the ACA.)

      3. Why can’t I multi-task?

        That said, go through the comments on the article. I may have been harsher, but am I wrong?

        1. So, yes, you are a troll.


          Yes, you are completely wrong for all of reasons already pointed out. Your premise, that the only way to ensure the poor can acquire medicine is to force others to provide it to them for free, is quite simply, false.

          1. “Your premise, that the only way to ensure the poor can acquire medicine is to force others to provide it to them for free, is quite simply, false”
            That’s not my premise.

            My premise is, and I quote myself:

            “[…] isn’t “if the poor can’t pay for medicine, oh well” a pretty uncontroversial libertarian/Libertarian thought?”

            So far I’ve gotten a lot of confused responses, in which people seem to agree I’m wrong. But they can’t actually articulate why “oh well” isn’t the appropriate response when the poor inevitably can’t pay for their medicine.

            1. The only one confused, is you. The price of healthcare can be brought down to be affordable by nearly everyone using libertarian/free market principles. The rest can be taken care of through charity.

              Your implication is that libertarians are heartless. Simply not the case. We use intellect to solve problems rather than our feelz.

            2. isn’t “if the poor can’t pay for medicine, oh well” a pretty uncontroversial libertarian/Libertarian thought?”


              Conventional libertarian thinking is “if Escher thinks this is a problem, Escher can pay as much to change that as he wants”.

        2. No, not really. But again, sometimes life just sucks, and libertarians have no unicorn to offer. But neither does anyone else.

          1. libertarians have no unicorn to offer. But neither does anyone else.

            This is the point that so many will profusely refuse to recognize. There is no magical system that guarantees anything. Even the technocrats’ “but it works in Europe” nonsense fails to materialize as often as not. And when it does materialize, it comes at great cost–try suing an NHS doctor for malpractice, or getting an MRI in a timely fashion in the UK. Or take France, where you can generally get better quality of care than in the UK, but you will pay twice as much in taxes (and still generally can’t sue anybody for malpractice).

          2. Which was my understanding.

            As demonstrated, there’s quite a few other posters that take offense to this.

    7. “if the poor can’t pay for medicine, oh well”,

      Two thoughts:

      (1) I’ve gotten good and tired of people who are too poor to pay $400 for an ER visit, but who can always find $400 to fix their damn car. Which, too often, is nicer than what I drive.

      (2) Charity. Its a thing. Even a libertarian thing. And you know what? Right now, today, billions of dollars of care every year are provided to po’ folks by charitable organizations.

      1. $400 for an ER visit? Hell, pre-insurance, my last trip to the ER was a couple of thousand. And all they did was stare at the husband’s face and say “yep, that’s not a stroke, it’s Bell’s Palsy. It’ll get better on it’s own.”

        That said, while charity is nice, it’s not reliable or dependable. If your system depends on it, then your system is accepting that it will fail some people. Hence “oh well”.

        1. Please, show me the system that doesn’t fail someone.

          It may, in fact, fail some people. But, it will fail fewer than any alternative you can propose.

          1. “Please, show me the system that doesn’t fail someone.”
            Seeing as I haven’t tried to argue that any system is better or worse then any other one, I’m not sure why you want me to start.

        2. And all they did was stare at the husband’s face and say “yep, that’s not a stroke, it’s Bell’s Palsy. It’ll get better on it’s own.”

          Assuming they were correct in their diagnosis, and assuming you aren’t lying about the amount you paid, then it may well be thousands of dollars well spent avoiding more costly diagnosis.

          If you want to reduce the cost of ER care, then you should seek repeal of EMTALA.

          1. You’re assuming motives where none were expressed. I was simply surprised at Dean’s estimate of the cost for an ER visit.

            1. Dean works for a hospital.

    8. No, maybe you’d heard that in conservative circles. Maybe even some liberal circles, depending on whose death was imminent.

      Libertarianism is about trying to use the least amount of Force possible. Desirous outcomes maybe similar to those of the left or right, just not using Force to bring about the result. Ideally, having access to medicines and treatments would be reasonably priced, performed by well educated people, and done in a timely manner. Just as with any other good or service, medical care might be afforded better by some than others. Those with more may volunteer assistance, or found societies to assist those who can’t.

      But for many people, this is too loose and uncertain. Force must be used to make sure. And even when those measures make things, in total worse, than had existed before, there’s a lot of “oh well, we HAVE to do something” coming from those who unleash the Force. In short, libertarians don’t buy cheap senses of superiority and bathe in conceit of Forcing Good upon others.

      1. Well said.

      2. “Libertarianism is about trying to use the least amount of Force possible.”

        So at what point is it acceptable to demand a doctor work without compensation? Or are we going to steal (that is, tax) other people to pay for the care?

        You can spin whatever ideal you want for why that would be minimized, but you didn’t actually say a word that undermined what I said.

        1. So at what point is it acceptable to demand a doctor work without compensation?

          Um…never? It’s simply not required.

        2. So at what point is it acceptable to demand a doctor work without compensation?

          The same point it is acceptable for someone to demand you work for free. On a related note, if you’re so willing to work for free, you can give a gift to the United States Treasury.

        3. Never.

          But you wouldn’t have to, anyway. That’s the point.

          In a truly free free-market society, charities would easier be able to pick up some of the tab because health care would be cheaper because medical professionals would be the deciders, not politicians and lawyers in Washington.

          Worse came to worst, the doctor would probably just bill you. Remember, he doesn’t make any money off of you if he turns you away outright. Better that he accepts you now and takes your money later.

          There’s more to it. This is just a simplification of a few ways it would work. I hope this is the honest answer you were looking for.

  6. Can you really say that a person who died from cancer or organ failure died ‘prematurely’? That just seems like the wrong word to use.

    1. Sounds to me like they probably died right on schedule.

      1. I intend to die late, man.

        1. Sorry, but that’s one appointment everyone keeps.

          1. You’d be surprised how behind i am.

          2. “Everybody says he died suddenly, but that that’s how everybody dies. He’s alive, he’s alive, he’s alive. Now he’s dead.”

            1. +1 sudden stop at the end

      2. Do you know who else died right on time?

          1. I came in with Halley’s Comet in 1835. It is coming again next year, and I expect to go out with it. It will be the greatest disappointment of my life if I don’t go out with Halley’s Comet. The Almighty has said, no doubt: ‘Now here are these two unaccountable freaks; they came in together, they must go out together’.

            That’s spooky. As someone born on the last arrival of Haley’s Comet does that mean I’m doomed?

            1. Well, are you an unaccountable freak?

    2. “Although many authors have emphasized the importance of the concept of premature mortality, there is no consensus on a functional definition or the best means of deriving a quantitative measure”

      Most places use a “you probably woulda died at 75 naturally” guess as shorthand, it looks like – so anything earlier is, actuarially speaking, or at the broad population level, labeled “premature”.

      (The link above is not about the 75 assumption, strictly, but talks about issues with calculating “Years of Prospective Life Lost”.)

      Though if one dies of organ failure because one was doing something known to be dangerous to the organs and entirely voluntary, well, “premature” in some senses makes perfect sense – it was hardly fate that caused that alcoholic’s liver to fail at 35; it was drinking far too much for far too long.

      They could have easily enough lived to e.g. 75 … thus, “premature death”.

      It’s just a statistical analysis, really, if done properly.

  7. Poor whites engaging in self-euthanasia. Corks are popping on campuses and at proggy meeting places all over the country.

    1. Completely unrelated; cities adopt $15 min. wage at record pace and SCOTUS declares both Union dues and healthcare to be mandatory for all.

  8. That last chart is awful. Draw the chart with the y-axis showing 0-100% and it doesn’t look like there is nearly as much of a difference. Classic way to make a problem look worse than it is.

    1. There are a lot of folks who use “How to Lie with Statistics” as an instruction book.

      This is a particular pet peeve – graphs that should be zero-based, but are truncated to help grind a particular ax.

      1. “How to Lie with Statistics”

        Well, it sounds like the title of an instruction book.

        1. That was his goof (and hook to get sales, I guess) – but his stated intent was to wise up the marks.

        2. It is. A classic by Darrell Huff. An easy read, entertaining, and instructive.

          1. See also “The Visual Display of Quantitative Information“, Edward Tufte.

            Not limited to deceitful graphs, but covers them.

      2. This is a particular pet peeve – graphs that should be zero-based

        Then there will be a great many graphs where the actual variance of interest, while statistically significant, will be pixel-wide because the values involved are not particularly small. Clear labelling is more relevent than always starting at zero.

        1. True – the intent is key.

          Are you presenting the data this way to clearly illustrate it, or to obfuscate it and advocate for some particular point of view?

          The latter, all too often.

  9. “Where living poor means dying young”

    AKA Planet Earth.

  10. Want to meet a girl? come on http://goo.gl/ESXruj
    the Best adult Dating site!

    1. OMWC is not interested in adult dating sites.

      1. Come now – even Warty may want to branch out…

        1. Those aren’t branches, they’re eldritch appendages somewhere between tusk and tentacle.

          1. A.K.A, “The Doomcock of Doom”.

            1. You’d consider yourself very fortunately indeed merely to behold The Doomcock of Doom. It’s among his less terrible arsenal of limbs, but luckily its his most fun to use.

              1. Fun for him. Not for anyone else.

  11. The gap in life expectancy between the top and bottom 1 percent of income for American men is nearly 15 years. For women, it’s 10 years.

    More male privilege.

    1. Naw – the women live longer at every point in the graph.

      This is poor women privilege!

  12. With the one-to-one entitlement burden we now have, one worker for every one entitlee, every person under 50 that drops down dead leaves one more entitlee that has be shared by the rest of us. Of course, we could try and make it that the person drops down dead on top of someone over 65 and hope both get taken out.

    1. I’m pretty sure poor rural people are not the ones supporting all the entitlees.

  13. You know what will help solve this? More unskilled immigrants to drive down wages! Yeah, that’s the ticket!

    1. Could we harvest their livers? Asking for a friend…

      1. Who likes fava beans and a nice Chianti?

        1. I prefer a side of lotion with my human cracklings.

          1. Cracklings need to be crisp.

            Lotion just makes them soggy.

            And taste funny.

      2. Most of the immigrants I’ve met, you wouldn’t want their livers. They’re nice guys, but they like the sauce. Now some of those nice teatotalling Muslime immigrants, you might be able to make a profit organlegging them. Mormons might work as well, but people might notice them missing if you chop them up for organs.

    2. I’m glad you were able to bring immigration into this.

      1. When all you have is ‘tardation, every problem looks like cake.

      2. Are you folks libertarians who think supply and demand works everywhere, except for low-skilled labor? It’s idiotic to think that immigration is not a factor here.

        1. There are many factors here. And we’re all lucky to have you zero in on the same one, every time.

          1. Why not mention all factors? I bring it up because it’s one many libertarians don’t want to think about, and so it often goes unmentioned (as it did here). Sorry if that makes you uncomfortable.

        2. It would be nice if you understood supply and demand. You see? When it come to labor, when you increase the supply, you also increase the demand. Pretty basic stuff.

          1. Are you joking? You do know that there is a decreasing need for unskilled labor in advanced societies, right? That’s been the trend for decades. Adding more unskilled labor doesn’t magically create more demand for it. What it does do is drive down low-end wages.

            1. You do know that there is a decreasing need for unskilled labor in advanced societies, right?

              That’s funny, we do an awful lot of trade with places that have lots of unskilled labor.

              Oh, you mean the government has forced out unskilled labor? Well, that’s a different story, isn’t it?

            2. Now for a more serious response.

              Adding more unskilled labor doesn’t magically create more demand for it.

              This much is true: supply does not (generally) drive demand. But demand scales with price.

              What it does do is drive down low-end wages.

              This much is also true, at first. Wages will generally trend downward as the pool of available candidates increases. Until such a point as effective mechanisms for sorting that pool develop, whereupon wages will stop declining and may start increasing. The idea that Joe and Bob are indistinguishable as workers is a MBA fantasy. But it just isn’t so. The problem is that people confuse leverage for indispensability. You may be worth twice your wage, but your employer may not give you a 100% raise because a) he wants to do other things with his money and b) you aren’t the only person who wants a raise, even if you’re the only person who deserves one.

              It is also very short-sighted to focus on averting this as a political goal. Yes, it buys you votes and a certain smug satisfaction that you’ve “helped” people. Congratulations, pat yourself on the back, and ignore the stagnating standards of living. But cheaper employment also means more employment. What is better, that Bob earns $10/hr from his job and Joe collects $5/hr in welfare, or that Bob and Joe earn $7.50/hr from their jobs? Of course, nothing in life is so simplistic–but your analysis is hardly full of nuance to begin with.

        3. Regale us once more with how supply and demand only applies to labor, and propping up the price of labor is an essential function of government.

          1. And let’s also complete sidestep how the government has made vast swaths of the labor market illegal.

            Especially ignore that part.

            1. I’m not sidestepping that, duh. The minimum wage and welfare are two reasons why mass immigration is a bad idea.

  14. I guess phrase “correlation does not equal causation” no longer means anything?

    Ron – no discussion of how many of those poor people are on some form of government assistance/EBT and/or are buying food in accordance with the state-sponsored malnutrition guidelines (i.e. low fat, high-carb diet that’s been largely responsible for the epidemic in obesity, heart-disease, and cancer)?

    Please don’t give this kind of junk science any kind of props. It’s horrible. And what comes out of it may not be what you intended. Tell me with straight face that this couldn’t become the justification for some new government program to stave off this “tragedy.”

    1. But I have an anecdote that matches nicely with the correlation.

    2. Tell me with straight face that this couldn’t become the justification for some new government program to stave off this “tragedy.”

      Oh, I think we all know that’s exactly where the Wa-Po is going with this.

  15. Maybe there is more to life than cheap shit, free porn and drugs? The science is pretty clear that sustained stress is a huge determent to your health and life expectancy. And one of the biggest sources of long term stress on people is unemployment and under employment.

    We have a set of economic policies that might as well have been designed to produce long term structural unemployment among the lower middle class and working poor. Given that, it is no surprise these people are dying.

    1. Yup. And one of those policies is mass immigration.

      1. Hey, lets make sure the labor market is always tight so that employees have little or no leverage over employers and everyone who has a job has to work like they are a desperate peasant facing starvation if they expect to keep their job. What could possibly go wrong with that? How could that not make America a better place to live?

        1. No, let’s make it an employee’s paradise. Well, for the 20% of the country that’s still employed, anyway.

          I love how money does grow on trees and employers do have deep pockets whenever it’s convenient to the argument.

    2. Maybe there is more to life than cheap shit, free porn and drugs?

      You take that back.

      You take that back right now, you monster.

    3. We have a set of economic policies that might as well have been designed to produce long term structural unemployment among the lower middle class and working poor.

      It was exactly designed to that, you fucking halfwit.

      Sorry, I just wanted to use that phrase against you.

      Taxation, regulation, and welfare.

      But no, let’s harp on about cheap shit and immigration, because driving up prices is definitely going to improve the lot of the middle class and working poor.

      1. I don’t know how many times I have to point this out before someone will begin to understand it who doesn’t already, but there are people on the margins who don’t benefit from the cost of labor going up.

        Yes, having to compete with someone whose acceptable standards of living include sleeping 10 to a room in a bad part of town isn’t fun. But for every person who would view such competition as a step down, there is someone who–possibly absent welfare payments–would view such competition as on level or even a step up.

        The idea that someone renting a shack for $200/mo who struggles to make even those meager payments is benefited by there being $10/hr jobs that they’ll never get instead of $5/hr jobs that they might get is absurd. It should also be patently absurd that it’s better to have people on welfare than working productively.

        The problem is the welfare state, and harping about immigration vis-a-vis economics is completely missing the point. We don’t (yet) have an immigration problem; we have a political problem. Controlling immigration–or not controlling it, for that matter–is not a solution.

  16. Let’s raise the minimum wage. That should help. (jk)

    1. To $100/hr…

      Everyone will be rich.

    2. Just give everyone a million dollars.

      Then no one will have to work and everyone will be rich!!

      Economics—how does it work?

  17. It’s beyond disgraceful the way that our scum politicians have deliberately killed off millions of blue collar jobs, and at the same time made it all too easy for them to permanently go on the dole.

    At the same time, now matter how sad it is when someone has his job taken away from him for whatever reason, it’s his responsibility to bust his ass to get a new livelihood. I just don’t feel all that sorry for people who could work, but instead make a conscious decision to spend their lives in their trailer watching 14 hours of television a day and subsisting on deep fried Oreos and a 12 pack of Bud a day. These folks are becoming just as much of a burden on society as the urban stick-up men.

    1. Well, at least you’re not racist. Sort of.

    2. IT is because they don’t care. For most of our political class, left and right, their political ideology is nothing but a rationalization for getting what they want. The idea that the welfare of the entire country might require them to sacrifice anything is just not thought.

      A world where more people work and have jobs and a meaningful existence is worth having even if it comes at the expense of the elite being a little less wealthy and our political class having less control over everything would be better than what we have. That however would require the elites and the political class to sacrifice for their principles. And no one wants that.

  18. “No man is an island.”

    1. …but some are as big as one, amirite?

  19. Not to go all TEAM on you here, but the longitudinal study seems to show that rural areas are flat to improving for health, while urban areas are flat to declining for health.

    That would seem to correlate, as well, to which of the TEAMs has been in charge, broadly speaking of urban v rural areas, no?

    1. Ding! Ding! Ding!

      Because that is the intended purpose. The Eugenics Plot of the Minimum Wage

      At least the eugenicists, for all their pseudo-scientific blathering, were not na?ve about the effects of wage floors. These days, you can count on media talking heads and countless politicians to proclaim how wonderful the minimum wage is for the poor. Wage floors will improve the standard of living, they say. But back in 1912, they knew better ? minimum wages exclude workers ? and they favored them precisely because such wage floors drive people out of the job market. People without jobs cannot prosper and are thereby discouraged from reproducing. Minimum wages were designed specifically to purify the demographic landscape of racial inferiors and to keep women at the margins of society.

      Further, he wrote, “If we are to maintain a race that is to be made of up of capable, efficient and independent individuals and family groups we must courageously cut off lines of heredity that have been proved to be undesirable by isolation [emphasis added – tarran] or sterilization.”

      Basically, you make the lower classes’ lives as difficult, dispiriting and empty as possible, isolate them in tenements and flophouses and they won’t breed as much and live shorter lives.

      1. DOn’t forget the drug war and the regulatory state. Make it virtually illegal for them to make a living outside of being on welfare.

      2. That link needs to be posted in every discussion of the minimum wage.

      3. Basically, you make the lower classes’ lives as difficult, dispiriting and empty as possible, isolate them in tenements and flophouses and they won’t breed as much…

        Which is really kind of stupid when you think about it. You’ve created a situation where the “lower classes” literally have nothing to do… except fuck.

        1. Oh, and i might add they did this in an era before contraceptives were commonplace. Those eugenicists were truly TOP. MEN.

          1. But back then there was no government welfare. The idea was that the unfit wouldn’t be able to afford to have kids. Now, of course, we are in the Idiocracy era, in which it’s the middle classes and the rich who don’t have (enough) kids, but the welfare cases do.

            1. And more relevantly, that was also before antibiotics.

              “Have lots of kids” meant mostly a few of ’em lived to adulthood, and lots of women died in childbirth or soon after.

              Combine that with being super poor and in a city, and probably the eugenicists were correct in their belief that the better-off preferred group could out-reproduce the disfavored group, by having more kids actually live to adulthood.

  20. Ah, the HOLD MUH BEER AND WATCH THIS effect. An under-studied sociomedical phenomenon.

    1. You really can’t put a price on that kind of entertainment.

      1. And, you don’t need to! YouTube being free, and all.

  21. My sister’s mother-in-law just passed away. A lifelong heavy smoker, she looked a decade older than my parents and was actually 5 years younger. Sure my parents have more money, and they didn’t spend it on smokes, booze, and junk food.

    1. Here’s a controversial thought: maybe the poverty ALSO has something to do with certain life choices, which itself also leads to both lower life expectancies AND poverty??

      To wit – if you blow all of your money at a casino/on a 40/on oxycontin/etc. and have nothing left and find yourself homeless and eating from garbage cans, I guess this is a “poverty” problem when you die ten years earlier than the cohort that doesn’t buy cigarettes and instead saves to move to a nice neighborhood and be in a position for better life opportunities?

      Nahhh. This theory makes perfect sense. (Sounds like something from the “I fucking love science!” page).

      (And no, not every poor person does this. But many do. Yes, I can speak with authority on the subject having been raised by a single mother who was an orphan and grew up in a housing project in the inner city in the 60’s).

      1. See also future vs. present orientation, delayed gratification.

        The sort of person who gambles heavily or abuses intoxicants or have expensive habits … will probably end up poor pretty much no matter where they start.

        People who don’t do any of that will find it far easier to get out of poverty, if they end up there at any point.

        (No guarantees, of course, but it’s a significant factor.

        Even a pack of smokes a day, or a six pack, adds up. A lot.)

    2. Oh yeah? Well, MY sister’s mother-in-law just made $29089 last month working few hours on Google, i couldn’t believe it when i saw the bank draft! Copy and paste this link in your browser: http://www.totallynotspamyougu.ys

      1. Well, my wife’s husband made, umm, not that much killing himself in a high-stress job working Japanese salaryman hours! Top that!

    3. My sister’s mother-in-law just passed away.

      Oh yeah? Well, my sister’s mother-in-law made $8,638 working from home last week!

      1. Damn you, citizen X!

        1. Ha – his in-law made more too.

        2. Damn you, citizen X!

          Who are you, my wife? Damn yourself, friendo!

  22. OT, but related news – An indigenous community in northern Canada has declared a state of emergency after 11 people attempted to take their own lives in one day.


    1. They were just getting out of Canada.

    2. The Attawapiskat First Nation in Ontario saw 28 suicide attempts in March and more than 100 since last September, Canadian media said, with one person reported to have died.

      They’re not seriously trying, I take it?

  23. The increase is caused primarily by opioid and alcohol abuse. This suggests that we need better treatment for drug addiction. It’s not ‘intentional suicide’. What happens is that they get addicted and think, “Well, I’ll just take one more” and oops it’s one too many.

    1. Also doctors must restrict the excessive opiate prescriptions that are fueling this epidemic.

      1. Undermedication for pain is one of the more sadistic things we do together already. Glad to see you’re on board with inflicting even more pain and suffering on other people.

        1. There is an epidemic of heroin use fueled by prescriptions. It is killing drug addicts all over the country. If someone needs opiates then they should get them – but only enough to relieve the pain so they don’t get addicted. I am concerned for the suffering of the addicts. You should watch “Requiem for a Dream” if you want to better understand it.

          1. I am concerned for the suffering of the addicts.

            Addicts cannot exist because addiction is a myth.

            1. Not according to the NY Times: C.D.C. Painkiller Guidelines Aim to Reduce Addiction Risk: “WASHINGTON ? In an effort to curb what many consider the worst public health drug crisis in decades, the federal government on Tuesday published the first national standards for prescription painkillers, recommending that doctors try pain relievers like ibuprofen before prescribing the highly addictive pills, and that they give most patients only a few days’ supply.”

              1. So addiction is real? I AM SO CONFUSED.

                1. According to the CDC: “78 Americans die every day from an opioid overdose. We now know that overdoses from prescription opioid pain relievers are a driving factor in the 15-year increase in opioid overdose deaths.”

                  1. 78 Americans die every day from an opioid overdose.


                    1. +1

                      “So?” really is – no snark – the proper reply here.

                      It’s not like doubling down on the drug war any cracking down on legitimate painkilling use of opiates is going to lower that number at all

                      And it’s not like any of the costs would be justified if it did.

                      Want fewer dead junkies? Legalize smack and let them buy it with known purity; it’s bad dosing or bad cutting that kills them with ODs.

              2. Your sources are a socialist newspaper and Hollywood. Apparently science and logic don’t have the right feelz.

                1. No, that just means THE SCIENCE IZ SETTLED!!!1!!1!!!!!1!11!!!

                  Because Hollywood and media are totally experts on science. That and he FUCKING LOVES SCIENCE!!11!111!!!!!11

          2. You should watch “Requiem for a Dream” if you want to better understand it.

            Yeah, Jennifer Connelly gets desperate. Hot.

            1. Ahh yes, she and another young lady learn the importance of sharing.

          3. You should watch “Requiem for a Dream” if you want to better understand it.

            Myth, I work in a fucking hospital. I don’t need to watch a movie to understand it.

            1. So you know – they are dying of addiction, not intentional suicide.

              1. That’s a myth. They are dying from gubmint sponsored yoogenks.

              2. I know far too many of them are in way more pain that they should be.

                Due to people saying exactly what you say: that doctors should not be allowed to prescribe pain meds as they see fit.

          4. They only go to heroin when the Rx is cut off. Then they die from fentanyl.

          5. There is an epidemic of heroin use fueled by prescriptions.


            1. Non-zero numbers of people get hooked from a legitimate Rx and then find street drugs.

              This is true.

              More than zero is an epidemic, BECAUSE DRUGS.

          6. You should watch “Requiem for a Dream”

            I loved the movie. A cinematographic masterpiece. But I’m not going to base my position on addiction and/or legality of drugs on a good movie.

      2. Aaaaand there it is.

        “This is the action that must be forced upon others in order to correct this problem to my satisfaction!”

        It’s a pity, because you’re also wrong. Prescriptions are not fueling this epidemic. If pills ceased to exist tomorrow, the epidemic would rage on.

        Don’t fret, you’re far from the first to mistake the means with the cause.

        1. Wrong: ‘Fighting Heroin Addiction With My Mother on My Side’ “When I was a young teenager, my mother would watch tales of addiction on her nightly TV programs. Little did she know that I would become just like the characters in the stories that played out on her screen. I got my first taste of prescription opioids in the late ’80s. They had been casually prescribed for me after the extraction of my wisdom teeth.”

          1. While it’s clear you read neither my post nor your own link for comprehension, this is not the greatest problem. The sad, sad attempt at a rejoinder* is boring. Seriously, “yer wrong because I said so!” *links to NYT blog* Hush, child, the internet is talking.

            Stupid, unfunny and dull are no way to go through life, son. No points awarded.

            1. Ah, so I’m wrong because you said so. Got it, thanks.

              1. *looks up at Bailey’s article*

                Unintentionally funny doesn’t count, brah. Unintentionally hi-larious might, so keep making these mistakes and we shall see.

              2. No, you’re wrong because you failed to support your assertion with actual objective proof.

          2. I also enjoyed hydrocodone when my wisdom teeth were extracted. Then I went ahead and didn’t become a junkie. Fancy that.

            1. You must be lying, we all know if you ever get prescribed opiods, you get addicted and start shooting the H!

              *Nervously wonders when my addiction will arrive having been prescribed strong opiods in the past for back pain*

            2. I got an RX for codeine once, but didn’t even use them.

              I must be a stealth addict!

      3. Not sure if serious. But with your handle, I’m going to say no.

    2. FYI. AddictionMyth is a Scientoligist, the only way to prove your argument right in his eyes is to get a Thetan audit.

      1. Scientologists support a Drug Free World: “The Foundation for a Drug-Free World is a nonprofit organization headquartered in Los Angeles, California, and dedicated to the eradication of illicit drugs, their abuse and their attendant criminality.”

        I’ll leave it up to you to decide if I’m a Scientologist.

        1. You quack like a duck. Scientologists are usually the one’s arguing that addiction is a myth.

          1. Scientologists don’t believe in mental illness. But they certainly believe in addiction: “Narconon was founded in 1966 based on the discoveries and writings of author, humanitarian and Scientology Founder L. Ron Hubbard. Today, Narconon constitutes a worldwide network that daily helps people recover from the devastation of drug addiction.”

            1. So you’re going to quote L Ron Hubbard as proof that you’re not a Scientologist. I don’t think you’ve quite thought that one through.

              Maybe a couple of audits should help you not be such an obvious Scientologist shill.

              1. You seem to have the lingo down pretty well yourself. Hmm….

                1. Yep, I’ve been a con artist a few times. Yet you seem to be amazingly unwillingly to admit that you are a Scientologist. You spew the Scientologist party line. At the very least be honest about where your argument is coming form.

                  1. Yeah. I mean, quoting Scientologists saying addiction is real is fair in reply to a claim that Scientologists argue addiction is a myth, granted.

                    But pretty much anyone who isn’t in the wacko UFO cult would just say “no, of course I’m not”.

                    (Just like while I’ll happily argue theology for fun, and quote encyclicals on the matter, if someone said “You’re obviously a Catholic!” I’d say “no, I’m an atheist and I’ve never been a Christian of any sort – I just understand their views”.)

                2. All you have to do to prove you’re not a Scientologist is say you’re not a Scientologist. If that’s not your faith then it costs you nothing to renounce it.

  24. Why is the drug war even a question any more? Portugal decriminalized them ago and the society didn’t collapse. Nope, they’re going to fuck it up because of central bankers and government overspending, but that’s a different problem that needs fixing, too.

    1. Dear God man, think of the jobs that’d be lost if we ended the drug war.

      Cops, prison guards and DAs dying in the streets…

      Entire government agencies shut down…

      Ending the drug war is suicide!

      1. +5.6 million open, unfilled jobs in the trades

  25. Wasn’t there some crazy congressman from Florida who, back during the O-Care debates, kept explaining how the Republican health plan for poor people was very simple: they should all just “die quickly?”

    I wonder what happened to him. I’m surprised he isn’t running for pres this time around. He is no crazier/more retarded than the rest of the current field.

    1. You’re thinking of Bob Menendez. He’s currently under indictment on corruption charges.

    2. Alan Grayson (aka Shrek), truly a despicable mound of human filth.

    3. Dying quickly is how you keep healthcare costs down, though!

  26. Thats kinda scary when you think about it. Wow.


    1. What do you care robot? You’re going to outlive us all.

      1. Not in the director’s cut of Short Circuit.

        1. Yossarian Johnny Five Lives!

  27. People are dying because of drug addiction fueled by the opiate overprescription epidemic. Even the CDC and the Scientologists can agree on that. Here’s what happens: You tell a kid a million times “Don’t do drugs” but regardless they steal them from their parents’ medicine cabinet, and this creates a learning disorder that makes them steal the drugs from their neighbors’ medicine cabinet.

    1. Can’t tell if serious or sarcasm.. Poe’s Law, I guess.

  28. I’ve worked in health care for quite a while now, and often encounter the demographic this study studies; what I see as contributory to early death includes:

    Substance Abuse: ETOH, narcotics [prescription and illicit], and dual; high rates in this demographic

    Morbid obesity: parallels increased rates of Type II Diabetes and associated health problems [vascular, kidney, retinal, neurological]

    Tobacco: Much greater incidence than general population, even at $6 per pack prices

    Nutritional: poor diets, not necessarily because it is cheaper but easier and part of lifestyle of poor choices [much related to obesity: these folks are not dying of starvation]

    Inactivity and lack of exercise

    Failure to follow through with health care: even when it is paid for [as with MCD, greatly expanded in many states thanks to ACA] many such persons will wait until it hurts and go to the emergency room rather than follow up with a primary care provider; lack of adherence to medications and other care greater contributes to poor outcomes.

    Being poor is not just low income; it is also a mentality/lifestyle that leads to a lot of poor choices. Now tell me that I’m victim blaming and lack understanding. I can tell you that intensive intervention, case management, and a host of federally mandated initiatives and programs has not made a dent in this.

  29. RE: The Dying of the Poor White Americans

    This is because there is not enough government intrusion in their lives.
    Lesson learned.

    1. You’re right.

      Those rising mortality rates correspond with the Great Deregulation and the unprecedented reduction in the size and scope of government at all levels since 1990.

      1. Correct you are, Comrade Dean.
        If we have more bureaucrats, politicians and cronies micromanaging our lives, we would live longer, healthier lives.
        Just look at the life span of the North Koreans.

  30. Long-term studies at the Mayo Clinic show there are only three things that make one bit of difference in mortality rates of chronic disease (which will kill 70% of the people who die next year…and the year after that…and the year after that…) It is the same or worse in the developing world, too. The only things that make any difference are (1) whether or not you smoke; (2) diet; (3) exercise. That’s it.

    All the rest is bullshit. Neither pharmaceutical nor medical interventions make one fucking bit of difference. Full stop.

    Imagine that: the cures for PET positive cancers, and 70% of what kills the 2.2 million Americans who will die next year is diet, exercise, and smoking cessation. None of which requires a medical degree from Stanford, residency at UCSF, etc., etc. Same for everywhere in the world.

    All that someone needs is the wherewithal to spend their $$ on a fucking gym membership. Or, better yet, build your own gym at home with a few bucks and some improvised gear. A pullup bar alone would solve most of the obesity epidemic in the US. No one who can do twenty dead hang pullups is going to die from chronic disease. I’ll bet a paycheck on that.

    1. But there will be beaucoup government programs and reams of data tracking to address these “epidemics” of what is basically poor and dysfunctional behavior [smoking, obesity, drugs, alcohol] that will yield minimal outcomes at best; and then of course it takes more money and forcing medical providers to keep trying harder and spending more time and misguided and largely self serving [government bureaucracy] efforts.

  31. My hypothesis:

    A lot of poor people are poor because of a lack of foresight and self-discipline. Unless you’re born to rich parents, it takes a lot of effort to get rich. You have to work long and hard while giving up amenities and physical comforts. Being healthy also takes effort. It requires exercising when you’d rather be sleeping in. It requires eating oats, lentils, and tuna (and cooking them yourself) when you’d rather get some greasy drive-through food. People who are impulsive and short-sighted are likely to have both poor health and poor finances.

    I’m not denying that a fabulously rich person has a much better chance of surviving cancer, and I’m not denying that some very smart, hard-working people have been thrown into poverty by circumstances out of their control (such as government “regulators” fucking them out of their livelihoods). But a significant factor in both poverty and bad health is the mindset.

    1. Very true, but to the left, that counts as “blaming the victim.”

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