Take a Bow, America

Infant Mortality is Up. It Took Hard Work to Get Here

A lot of Healing and Stealing posts focus on ways in which monied resistance to health care keeps us sick, broke and scared. Healing and Stealing also thinks it’s important to remind ourselves occasionally that good things are possible and that brave, smart, caring people work themselves to exhaustion every day to take care of us.

Unfortunately, that will have to wait. Today’s news is so dismal that we have to take a moment to acknowledge it: the CDC reports that U.S. infant mortality increased for the first time in 20 years last year.

As always, Black, American Indian, Native Alaskan, Hawai’ian and Pacific Islander* babies died more often than anyone else, with shockingly large increases among American Indian and Native Alaskan children. But apparently the U.S. really is becoming an inclusive society, as White babies also died statistically significantly more often in 2022 than 2021.

Since the development of public health statistics, the ability to keep children alive for at least twelve months has been one of the crucial indicators of shared prosperity. In elite Western circles, it has long been considered a dividing line between “developed”, “rich” or “civilized” nations and a few billion less fortunate people around the world.

To the extent that the U.S. has been willing to throw some useful assistance to actual human beings into the basket of weapons, sanctions and election interference that makes up its foreign policy, much of the money and the energy of many goodhearted people has gone toward helping the world’s poorest families nourish and protect young children. Similarly, to the extent that nations have tried to work together through multinational agencies, the health of the smallest among us has always been a - if not the - priority.

Even the threadbare U.S. “safety net” is organized significantly around child well-being. Medicaid’s most generous eligibility provisions offer care to pregnant women and infants before requiring them to get poorer to get insured once a child reaches their first birthday. Federal nutrition programs focus heavily on feeding children and their parents.

Given the instinct to nurture and protect children that runs so deeply in human beings, Healing and Stealing would like to take a moment and congratulate the business and political leaders of the United States on their extraordinary achievement last year.

Think how much effort it takes to achieve an increase in infant mortality in a country as wealthy and powerful as the U.S., a country that spends twice as much per human being on “health care” as any other society in the world. Not only do you have to make sure the most expensive health care system in the world avoids directing needed resources to infants and mothers, but you have to make sure people don’t earn enough and have the time to get support from other sources.

So many well-compensated people have to lobby against Medicare for All and fight to preserve absurd patent protections for lifesaving medicines so their clients can keep earning seven, eight or nine figure compensation. So many politicians have to spend so much time posturing and doing nothing. So many corporate executives have to spend so much time busting unions, stealing wages and fighting minimum wage, mandatory sick leave and overtime pay laws, complaining about toothless occupational safety and health rules and buying meaningless insurance that leaves families shackled to medical debt.

So many doctors have to not listen to so many African-American and Native American mothers as they plead for help to save their children and themselves. So many insurance companies have to deny so many claims. So many experts have to keep telling the world that Americans get too much health care and we need to pay doctors not to treat us and call it “value.” So many reporters and pundits have to pretend this is all normal, that it really does make sense to leave millions of employers who know nothing and care less about health care in charge of buying it, and that people actually like “shopping” for cheap doctors and hospitals when they’re sick, injured and scared.

Not a week goes by where at some point while poring over a journal article or talking to a source that I don’t pause and exclaim in genuine astonishment “So. Much. Money. There’s just so much damned money sloshing through this industry. And it goes everywhere but actual health care.” On just raw dollars spent, the U.S. health care economy is larger than that entire economy of every nation except China, Japan and Germany. And yet here we are - U.S. life expectancy reached its lowest point in two decades in 2021 and now infant mortality, an essential measure of a decent society, is increasing.

Yes, infant mortality is also affected by things other than “health care.” But when top health care executives drone on about the “social determinants of health” while denying claims to enrich investors at the expense of patients’ lives and wallets, cashing huge “charitable” paychecks, cutting staffing to the bone and pretending to be powerless to change our oh-so-complicated health care system while spending millions lobbying to stop Medicare for All or any other coverage expansion that doesn’t subsidize health insurance investors, it can’t be understood as anything other than a bully’s mockery.

So congratulations to the people who run this country and our medical system on a monumental achievement. Healing and Stealing recognizes how hard you’ve worked. Maybe take a long vacation.

*The race and ethnicity labels are CDC’s official categories drawn from the U.S., used here to align with the data in the charts. Healing and Stealing recognizes that many people identify themselves with different language and intends no harm or offense through their use.