Tag: health

America the Sick and Anxious

And so too are our kids

BILL ASTORE

NOV 25, 2025

“America’s children are unwell.” From the New York Times this morning:

Nearly one in four 17-year-old boys in the United States has attention deficit hyperactivity disorder. In the early 1980s, a diagnosis of autism was delivered to one child in 2,500. That figure is now one in 31. Almost 32 percent of adolescents have at some point been given a diagnosis of anxiety. More than one in 10 have experienced a major depressive disorder, my colleague Jia Lynn Yang reports.

And the number of mental health conditions is expanding. A child might be tagged with oppositional defiance disorder or pathological avoidance disorder. “The track has become narrower and narrower, so a greater range of people don’t fit that track anymore,” an academic who studies children and education told Jia Lynn. “And the result is, we want to call it a disorder.”

Why did this happen? A lot of reasons. Kids spend hours on screens, cutting into their sleep, exercise and socializing — activities that can ward off anxiety and depression. Mental health screenings have improved.

And then there’s school itself: a cause of stress for many children and the very place that sends them toward a diagnosis.

I can’t read the main article since it’s behind a paywall. The gist of the article is that American schooling is hyper competitive, constricting, perhaps too demanding, and therefore a big part of the problem.

Maybe. Schools are also chronically underfunded. Teaching remains an underpaid profession. Classrooms can be overcrowded. Standards vary widely. And parents are stressed as they try to get their kids into the “right” schools. It’s not hard to see how that educational ecosystem might amplify distress.

But the explosion in ADHD diagnoses, autism, and anxiety is surely also driven by Big Pharma.* “We’ve got a drug for that” should be the motto of these companies. Americans are bombarded every day with drug ads promising to change our lives. I’m not a parent myself, but if my kid had trouble focusing or otherwise had behavioral issues, I’d explore medication as an option. I’m guessing it’s easier to get a prescription for Adderall or Ritalin than for kids to get wise treatment and sustained counseling from a psychiatrist or other mental health specialist.

Not just “mother’s little helper”

Some parents may even feel that particular diagnoses confer a kind of status— confirmation that their child is not merely struggling but exceptional in some “high-functioning” or creatively gifted way. That, too, reflects broader cultural forces.(“Annie is autistic and really too intelligent/creative/artistic/sensitive for this world.”)

But beyond parental dysfunction, omnipresent screens, school pressures, and pharmaceutical marketing, there’s a deeper question: Are our kids simply mirroring the broader dysfunction of American society? We live in a culture marked by relentless competition, materialism, polarization, and chronic stress. There’s little about our adult world that could be described as calm or balanced. If our society itself is unwell, why would we expect our kids to feel—or behave—otherwise?

I know it’s not easy, but surely kids need to unplug more (especially from social media, with all its pressures). They need to get outside more. They need to play more—they need more unstructured time. They probably need less stimulation—and arguably more time to be, in a word, bored. To find their own way to play, their own hobbies and interests to pursue, their own path in life.

A dysfunctional society produces dysfunctional kids. If that’s true, how do we make a society that better serves everyone? If American society and culture is uniquely disorienting and destabilizing, can’t we change that? Can’t we make a better saner world for our kids?

Grim factoid: In 2008, Americans consumed 80% of the world’s opioid supply. Though that percentage has dropped to roughly 40% today, what is it about American life that is so painful? Why are we so addicted to (legal and illegal) drugs? And now our kids too?

Readers, what do you make of all this?

*By no means am I dismissing mental illness; my brother Stevie had his first schizophrenic episode when he was sixteen in 1973 and never fully recovered from it. I have friends with a daughter with severe Asperger’s syndrome. My concern here is the vast increase in ADHD, autism, and similar diagnoses and the potential reasons for this.

In America, Health Care Is Wealth Care

W.J. Astore

Private health insurers make money denying care–not providing it

Luigi Mangione, the young man who shot and killed a senior health insurance executive, is emerging as a folk hero of sorts in America. This requires some explanation for people outside of America.

Luigi Mangione

Most peer countries to the United States have national health care systems. Countries like Britain, Germany, France, Japan, New Zealand, and the like. These national health care systems, run by the government, are not perfect, but overall they are cheaper and produce better results for patients than the American system, where health care is basically wealth care for the rich and privileged.

America primarily has a privatized health care system where profit is the prime directive. (Programs like Medicare* and Medicaid are a public-private partnership and are government-funded; the former focuses on people 65 and older, the latter on the poorest of Americans.) Most Americans get their private health insurance with their job, else they’re required to buy private health insurance on their own nickel. These health insurance plans are expensive and often come with high deductibles and co-pays.

So, for example, when you visit a doctor for a routine appointment, your co-pay is likely between $50 and $100 per visit. If you get seriously sick, break a bone, etc., your health insurance provider may not start paying your bills until a certain yearly deductible is met, which may sit between $5000 and $10,000. Not surprisingly with these deductibles, co-pays, and the like, Americans often declare bankruptcy due to medical bills even when they have health insurance and are in theory “covered.”

A quick Google search reveals that an unsubsidized private health care plan for a family of four in America cost an average of $24,000 a year in 2023. Other figures suggest a cost of roughly $18,000 a year, but it depends on what state you live in as well as your age. The various plans that you can buy are quite complicated and include the aforementioned deductibles, co-pays, and other complexities. Employer-based plans cost less; perhaps in the neighborhood of $6000 to $8000 per year.

Again, health insurers’ #1 priority isn’t to provide health care. It’s to make money for shareholders—and for the senior executives in the industry. So their profit-driven approach to claims is the now infamous “deny, delay, depose (or defend)” strategy. As often as possible, they seek to deny claims outright, forcing sick and desperate people to fight an incomprehensible bureaucracy shrouded in fine-print legalese. Or they seek to delay payment on claims. Or they take Americans to court (“defend and depose”), forcing people to hire lawyers (quite expensive) while aiming for the quickest and cheapest settlement.

For the insurers, this strategy makes all the sense in the world. They are in this business to maximize profits and earnings, not to provide generous health care benefits.

Efforts to create a fairer and more just system for Americans have failed due to political corruption at the highest levels as well as propaganda (remember those rumored “death panels” if the government ran health care). The idea of a national non-profit healthcare system is nothing new; the Truman administration advocated for it after World War II, and various other proposals were floated by LBJ in the 1960s, the Clintons in the 1990s, and even tepidly by the ultimate sellout Barack Obama with his Affordable Care Act, which is unaffordable for many and less than generous with its care. These and similar efforts have failed as Big Pharma, the AMA, health insurers, and other forces have combined to exert tremendous pressure so as to prevent meaningful reforms that would cut into their profits, salaries, and market share.

Basically, the U.S. health wealth care system costs roughly double that of comparable countries with worse outcomes for patients. Again, this isn’t a surprising result, since the health and well-being of patients isn’t the guiding priority. It never has been. The U.S. system is all about producing the highest possible salaries and profits for Big Pharma, for health insurers, for privileged doctors (specialists often make yearly salaries in the high six-figures), and for all the other stakeholders (and shareholders) in the current system.

Here in America, the Hippocratic oath of “first do no harm” in medicine doesn’t apply. Our oath is the Gordon Gekko one of “Greed is good.” It doesn’t matter if people go bankrupt or die as a result. It’s wealth care, not health care, silly!

It’s unlikely the Trump administration will do anything to change this. Its top priority seems to be the expulsion of immigrants. Members of Congress are completely in the pocket of Big Pharma, the health insurers, and powerful medical lobbies, so don’t look for meaningful change there.

That’s why so many Americans, deeply frustrated with an exploitative system of healthwealth care, where costs rise year by year as benefits shrink, sympathize with Luigi Mangione, even if they disagree with his murderous method of expressing his anger and disgust.

Put bleakly, America’s health wealth care system is another way of enriching the few while impoverishing the rest. It is also a form of social control. (Act out, protest—lose your job, your health care, maybe your life.) Only the most revolutionary acts are likely to change this system. That is exactly why the government, the mainstream media, and corporate elites are acting to suppress sympathy for Mangione.

Consider this article by Ken Klippenstein about a mom who, frustrated with her health insurer, repeated “deny-delay-depose” while saying “you people are next” on the phone; she quickly apologized, but not before the police and FBI were called in and charged her with threatening “an act of terrorism.”

Know your place, Americans. Stay supine and obedient or they’ll take away your health insurance. Better yet, they’ll finally give you affordable health care—in prison.

*More on Medicare, courtesy of the Center for Medicare Advocacy

Most people think Medicare is a government program. That’s only partly true. While Congress created Medicare, and continues to develop Medicare coverage and appeal rules, decisions to pay claims are actually made by private companies. The government does not make those decisions. This was one of the compromises made in order to pass Medicare in 1965 – and the public-private partnership continues to date.

Indeed, the entities granting or denying coverage, and those deciding whether or not to pay claims, are mostly private insurance companies. For example, Anthem is the parent company of “National Government Services,” one of the major Medicare claims administrators. Another Medicare administrative contractor, “MAXIMUS,” is a for-profit company that helps state, federal and foreign governments administer programs.

In addition, about 30% of Medicare beneficiaries are enrolled in private “Medicare Advantage” plans. These plans are also run by private companies, mostly within the insurance industry, and they make Medicare initial coverage decisions for their enrollees.

We know that when Medicare is working right and covering necessary care, everyone is content. But, if coverage is denied unfairly… don’t blame the government. It’s probably not “Medicare” that made the decision; it’s most likely a private insurance company that’s paid by Medicare to make coverage decisions.

Thanks to a reader, Sally Moore, for pointing out the public-private nature of Medicare. It’s more complicated than I thought—I should have known better.

Update: A classic cartoon from Tom Tomorrow seems appropriate here:

America Is the Greatest Country? Look At Our Health Care — And Weep

Image

This is also featured at Huffington Post

Americans generally, and politicians in particular, proudly proclaim that we live in “the greatest” country. But how should we measure the greatness of a country? I’d suggest that quality of life should be a vitally important measure.

And what is more fundamental to quality of life than ready access to health care? When you’re sick or suffering, you should be able to see a medical specialist. And those costs should be — wait for it — free to you. Because health care is a fundamental human right that transcends money. Put succinctly, the common health is the commonwealth. And we should use the common wealth to pay for the common health.

Here’s the truth: We all face the reality of confiscatory taxation. If you’re like me, you pay all sorts of taxes. Federal, state, and local income taxes. Property taxes. School taxes. Social security. State lotteries are a regressive tax aimed at the poor and the gullible. We pay these taxes, and of course some for health care as well (Medicare/Medicaid), amounting to roughly 30 percent of our income (or higher, depending on your tax bracket, unless you’re super-rich and your money comes from dividends and capital gains, then you pay 15 percent or lower: see Romney, Mitt).

Yet despite this tax burden, medical care for most of us remains costly and is usually connected somehow to employment (assuming you have a good job that provides health care benefits). Even if you have health care through your job, there’s usually a substantial deductible or percentage that you have to pay out-of-pocket.

America, land of the free! But not free health care. Pay up, you moocher! And if you should lose your job or if you’re one of the millions of so-called underinsured … bankruptcy.

Health care is a moral issue, but our leaders see it through a business/free market lens. And this lens leads to enormous moral blind spots. One example: Our colleges and universities are supposed to be enlightened centers of learning. They educate our youth and help to create our future. Higher Ed suggests a higher purpose, one that has a moral center — somewhere.

But can you guess the response of colleges and universities to Obamacare? They’re doing their level best to limit adjunct professors’ hours to fewer than thirty per week. Why? So they won’t be obligated by law to provide health care benefits to these adjuncts.

Adjuncts are already underpaid; some are lucky to make $3000 for each course they teach. Now colleges and universities are basically telling them, “Tough luck, Adjunct John Galt. If you want medical benefits, pay for health insurance yourself. And we’re limiting your hours to ensure that you have to.” 

So, if Adjunct John Galt teaches 10 courses a year (probably at two or three institutions of “higher” learning) and makes $30,000, he then faces the sobering reality of dedicating one-third of this sum to purchasing private health insurance. If that isn’t a sign of American greatness, I don’t know what is.

I groan as much as the next guy when I pay my taxes. But I’d groan a lot less if I knew my money was funding free health care for all (including me and mine). Commonwealth for the common health. With no death panels in sight.

As “Dirty Harry” said in a different context, “I know what you’re thinking.” Free health care for all is simply too expensive. We say this even as we spend a trillion dollars a year on national defense and homeland security, to include the funding of 16 intelligence agencies to watch over us.

A healthy republic that prides itself on “greatness” should place the health of its citizens first. That we don’t is a cause for weeping — and it should be a cause for national soul-searching.

Astore writes regularly for TomDispatch.com and can be reached at wjastore@gmail.com.