[Editorial] Support for caregivers in the USA

The contest to secure the Democratic party nomination for President of the USA has brought health care to the forefront of public discourse, with much of the discussion dominated by the merits of Medicare for All, a comprehensive single-payer national health-care programme. The questions raised in this debate have brought a welcome focus on specific policy options for addressing the country's myriad health-care challenges. But largely missing has been the issue of social care, particularly th...

[Editorial] Trump’s steady erosion of health insurance protections

43% of US households report that at least one family member has a pre-existing medical condition, according to a survey released by Gallup on Dec 6, 2019. 49% of Americans (156 million people) receive health insurance through employers, and before the 2010 Affordable Care Act (ACA), a change of situation, such as losing or switching a job, would have allowed insurance companies to decline coverage or potentially make people uninsurable because of chronic health conditions. Although Democrats ...

[Series] Primary prevention of ischaemic heart disease: populations, individuals, and health professionals

Ischaemic heart disease has a multifactorial aetiology and can be prevented from developing in populations primordially, and in individuals at high risk by primary prevention. The primordial approach focuses on social determinants of health in populations: political, economic, and social factors, principally unplanned urbanisation, illiteracy, poverty, and working and living conditions. Implementation of the UN Sustainable Development Goals can lead to major improvements in cardiovascular hea...

[Editorial] Prioritising primary care in the USA

Although the USA spends more on health care despite having worse outcomes than other high-income nations, one area where it underinvests is primary care. Research has shown that higher levels of spending on primary care lead to improved patient outcomes and lower overall health-care costs. On July 17, 2019, the Patient-Centered Primary Care Collaborative (PCPCC) issued the first report to look at primary care spending by state, including spending from across different types of payers: commerc...

[Correspondence] Key points to consider in the IMPERIAL trial – Author’s reply

We agree with Jim Reekers that the IMPERIAL trial,1 in both device concept and trial design, as well as in its outcome, was unique and important in the endovascular field. We also wholeheartedly support the use of supervised exercise training in peripheral arterial disease patients as a valuable primary and adjunctive tool to improve symptoms and functional capacity, and we are especially pleased at the decision in 2017 by the US Centers for Medicare & Medicaid Services.

[Editorial] Universal health care in 21st century Americas

Despite considerable progress, the Pan American Health Organization (PAHO) estimates that 30% of the population of the Americas still do not have access to the health care they need because of multifaceted barriers. On April 9, leaders, including Mexico's President Andrés Manuel López Obrador, PAHO director Carissa Etienne, and UN High Commissioner for Human Rights Michelle Bachelet, gathered with academics, activists, and representatives of social movements in Mexico City to hear the report ...

[Comment] A dark day for universal health coverage

Dec 14, 2018, was a dark day for universal health coverage (UHC). To begin with, a federal judge in Texas, USA, ruled that the Affordable Care Act (ACA) is unconstitutional.1 That same day, the new President of Mexico, Andrés Manuel López Obrador, announced his intention to abolish the country's largest public insurance programme, known as Seguro Popular (People's Health Insurance).2 The ACA and Seguro Popular have extended health coverage to millions of previously uninsured families, most of...