The U.S. has the greatest healthcare in the world. The U.S. has the worst life expectancy statistics among developed nations. Can both of these statements be true? Unfortunately, the answer is yes. Many of the leading doctors and medical institutions are found in the U.S. and people from all over the world come here for the latest and greatest medical treatments. But you might live longer if you live in another country.

The graphic below shows life expectancy for the U.S. compared to other developed countries:

Brianna Abbott, writing in The Wall Street Journal, tells us much of the gap in life expectancy is due to deaths among working-age adults, according to Dr. Steven Woolf, a life-expectancy researcher at the Virginia Commonwealth University. “Americans die earlier and are sicker than people in other high-income countries,” he said. “This has been true for a long time, and the trend is getting worse.” Drug overdoses from opioids, alcohol, suicide and chronic diseases drive most of those early deaths, researchers said. The U.S. also took a bigger hit from Covid-19, even among younger adults who were at lower risk.

That was in part because Americans were already in worse health and more vulnerable to the virus’s toll. The U.S. obesity rate is nearly double the average of peer nations, disrupting prior decades of progress against heart disease. Around a third of U.S. adults have had multiple chronic conditions, the highest rate among our peers, according to the Commonwealth Fund.

Rates for conditions including hypertension and chronic obstructive pulmonary disease have held relatively steady in recent decades, and the rising prevalence of diabetes is in part because people are living longer with the disease, researchers say. But the U.S. still has higher rates of these conditions compared with peer nations.

Many preventable chronic diseases are related to four major risk factors: cigarette smoking, excessive alcohol use, physical inactivity and poor nutrition. In the U.S., people get less exercise, moving less than some European counterparts, studies have shown. The nation’s Western-style diet is heavy in sugars, processed meat and unhealthy fats. Americans also consume more ultra-processed foods, surveys suggest, and such diets have been linked to increased risks of obesity, Type 2 diabetes and some cancers.

The U.S. is arguably the best in the world at treating complex diseases, says Dr. Philip Landrigan, director of the global public health program at Boston College. But it is worse at providing access to care and services that help manage or prevent illness, he says.

Wealthy Americans have lower rates of chronic diseases and live longer than their low-income counterparts. The U.S. also has a wider gap in death rates between wealthy and poor Americans than European countries, a recent study found. But the wealthiest Americans still had mortality rates comparable to the poorest Northern and Western Europeans.

If you’re over the age of fifty, you’ve probably had a colonoscopy. Most doctors recommend routine colonoscopy every ten years to screen for colon cancer. Colon cancer is the second leading cause of cancer-related deaths in the U.S. Approximately one in 23 men and one in 25 women will be diagnosed with colorectal cancer in their lifetime according to the American Cancer Society.

Cologuard is a non-invasive test to screen for colon cancer that only requires providing a stool sample in a specially prepared container for laboratory analysis. This test looks for abnormal cell DNA shed in the stool, which can be an indication of cancer. Cologuard is advertised frequently in the media as an alternative to colonoscopy for low-risk patients. Barium enema is also done as an alternative to colonoscopy in some patients, particularly those who have abdominal adhesions that impair the ability to safely perform colonoscopy.

What other alternatives are available?

Amy Denney, writing in The Epoch Times, tells us of another option. She says, “Offering patients options to test for colorectal cancer may be a good strategy, according to the results of a study by Kaiser Permanente researchers presented at Digestive Disease Week. Investigators in this 20-year population-based study sent at-home kits for fecal immunochemical testing (FIT) and colonoscopy reminders to patients overdue for colonoscopies.”

“If you offer people more than one option for screening—such as colonoscopy or FIT—they’re more likely to get screened than if you offer either option by itself,” Dr. Douglas Corley, researcher and gastroenterologist, said in a news release. “To get above an 80 [percent] screening rate, you almost always have to offer people multiple options.”

What is FIT?

FIT tests are a noninvasive way to determine whether people have blood in their stool. People with positive tests should then follow up with a colonoscopy. FIT tests in particular are a great way to reach both patients who live in rural areas and young adults, who are experiencing more incidents of colorectal cancer even as the overall incidence declines, Corley said in an American Medical Association update.

“So there are a lot of positives about it,” he said. “And that’s one of the reasons why the U.S. Preventive Services Task Force kind of equally recommends colonoscopy and FIT for benefit in terms of decreasing the risk of death from colorectal cancer.

I first learned about FIT testing from my gastroenterologist. He expressed no confidence in the accuracy of Cologuard testing but was much more impressed with the results of FIT testing. He uses FIT when colonoscopy cannot be performed safely.

Screening rates—via colonoscopy, sigmoidoscopy, or FIT—grew from 37.4 percent in 2000 to 79.8 percent in 2019 across all racial and ethnic groups, according to the researchers. Giving patients more options in the type of colorectal cancer screening they received—including a FIT test mailed to their home—reduced the number of those who got cancer by one-third; reduced deaths by one-half; and eliminated nearly all the racial differences in screenings, diagnoses, and deaths.

Colorectal cancer deaths decreased by about 50 percent in the Kaiser Permanente study with the largest reductions seen in black patients who have historically had worse outcomes from colorectal cancer. Deaths among black patients declined from 52.2 per 100,000 to 23.5 per 100,000.

Colonoscopy is still the gold standard for detecting colon cancer. But FIT is a suitable alternative when colonoscopy cannot be performed, especially in low-risk patients. Ask your doctor about FIT instead of Cologuard next visit.

Television ads these days are filled with scare tactics that Republicans are going to cut Medicaid. No one is suggesting Medicaid should be taken away from those who need it. Don’t believe the lies that Democrats are pushing that Medicaid cuts will lead to children starving or babies dying. Those who are eligible for Medicaid will get what they need.

Here’s the truth about Medicaid and what’s happening in Congress. Karl Rove, writing in The Wall Street Journal, tells us the federal government admits it made $543 billion in inappropriate Medicaid payments from 2015 through 2024. Some experts think the real

number is actually $1.1 Trillion! The current House Republican proposal would cut the program’s spending by nearly $700 Billion over the next decade, according to preliminary Congressional Budget Office analysis.

That’s a lot of money but let me emphasize this is all about inappropriate Medicaid payments. That means payments beyond what eligible enrollees were supposed to receive. Let’s call it what it is: waste, fraud, and abuse. This has nothing to do with low-income, elderly or disabled Americans receiving the healthcare benefits they need.

Why is this a crisis?

Medicaid spending has skyrocketed in the last ten years. It has gone from about $450 Billion in 2013 to nearly $900 Billion in 2023. That’s way out of proportion to the rise in inflation and Medicaid spending now exceeds Defense Department spending. If we want to continue to have a strong military and be able to meet the real healthcare needs of low income and disabled Americans, we must reign in this out-of-control Medicaid spending.

How can Republicans get the truth to the American people?

Rove says, “Start by declaring a strong commitment to save the program. Because of Democratic policies, Medicaid is spending hundreds of billions on people it shouldn’t—those who are able-bodied and working-age. Republicans want this assistance to go to the people it was meant for—the elderly poor, disabled, and children in low-income families. Without reform, the program on which those Americans depend is at risk of rapidly becoming unsustainable.”

 He goes on to say the GOP should say that able-bodied adults on Medicaid should be required to work or look for work. “No freeloaders” on a program meant for the truly vulnerable is a powerful argument. A Feb. 25 Kaiser Family Foundation poll found 62% of Americans support “requiring nearly all adults to work or be looking for work” to qualify for Medicaid, while 38% were opposed. If told that such a requirement “could ensure that Medicaid is reserved for groups like the elderly, people with disabilities, and low-income children,” it was 77% support, 22% oppose.

Rove also says Republicans should drive home that—unlike radical Democrats—Republicans oppose illegal immigrants getting Medicaid. House Energy and Commerce Committee Chairman Brett Guthrie (R., Ky.) estimates that 1.4 million illegal aliens receive Medicaid. That isn’t only wrong; it encourages more aliens to try to cross our border illegally.

Make clear that Republicans want to end fraud while Democrats are content to perpetuate it. Specifically, Democrats have made it harder for states to check their rolls frequently for ineligible Medicaid recipients. For the sake of fairness and accountability, the GOP will make it easier to find and remove those who don’t qualify.

The Medicaid cuts Republicans are proposing will help stop the government from wasting Medicaid dollars that low income, elderly and disabled Americans need. Those who oppose these cuts are either playing politics with the issue or benefiting from ineligible payments; they’re not looking out for the country or the people who really need Medicaid.