I think they predict, but don't determine.

We need to do more to eliminate such problems, to be honest. It's not right that children are being born into such a system, and that some people get trapped in it.

The health care system in this country is so messed up and upside down I'm amazed at how we manage to not have more people die every day. I've been a hospital pharmacy tech almost 40 years and I keep seeing patients who- with a little preventative care- wouldn't be in my hospital. Prevention is the key. Fresh air, exercise, and a healthy diet. Affordable access to a family doctor for everybody, no matter where you live or how much you earn, is necessary, not a luxury. Screw the minorities and the poor is just plain wrong. Insurance companies that answer to wall street and ceo's huge paychecks are also wrong The high cost of drugs is wrong. Medicine for the wealthy is wrong. We as a society have to change.

Why didn't people understand the ACA? Don't we want to be able to have affordable healthcare for all? Evidently not. And it has everything to do with socio-economic status. Those who can afford healthcare don't want any change but America is all about the Common Good, and that should include all citizens not only the wealthy.
In my own life, being forced into semi-retirement at 60, lowered my income by 2/3's. I have health insurance, but the $30 copay to see a specialist is something that I can no longer afford.

I think many parts of the U.S. system and government are set up to benefit the wealthy. Health Care, Education, Financial, they are all set up to prevent upward mobility and protect the established wealth. When leaders say they favour freedom of choice, what they really means is, I want to be able to buy the best of everything, the rest of you fend for yourselves. Fortunately, Canada has a high quality universal health care system where health care professionals make the same fixing my broken arm as they do fixing a millionaire's broken arm. The basic health of a nation's citizens should not be a for-profit industry IMO.

The wealth divide is the problem. Some countries have very low levels of health services, yet they are available to all. These people seem to have less problems. America seems to be at the other end of the spectrum. If you are wealthy enough you can have anything, if not, well ....
Here is Oz we have very good health systems available for the poor up to a point. It is also free.
We have a private health system which is a rip off.If you are too wealthy to access the free system, you have to pay private health where the doctors charge you a fortune but the health fund only refunds you a small fraction of this. So the really wealthy people just pay for what they need as they wouldn't waste their time and money with private health cover.

The culture in which one is raised and the income level of the family are large determinants of behavior. Genes and behavior determine health. I was raised in the deep south with a lot of fried food and carb-laden food, and which smoking was widespread. Systematic exercise was not. I was overweight for much of my life until I became a diabetic at the age of 45.I was also a heavy smoker.

I developed diabetes at the age of 45 and became more serious about weight control by diet and exercise. I developed high cholesterol and high blood pressure at the age of 65 I quit smoking at the age of 56. At the age of 69, I had a heart attack and had to have a pacemaker installed. The smoking has led to COPD.

Today, I eat healthy food and healthy amounts of food. I have walked 3 - 5 miles a day for years, and now am on a very heavy weight-lifting regiment. With proper diet, heavy exercise, and the proper medication, the diabetes, blood pressure, and cholesterol and are under full control, as is my weight. My heart is stronger than it was over 20 years ago and my COPD is manageable.

My point is this: One's health is largely controlled by one's personal cjoices and behaviors. Regardless of the culture, one can and should choose to live a healthy lifestyle. And, even in middle age, one can still increase quality of life and life-span by choosing to live a healthy lifestyle. If one does not, he or she will pay the piper. .

I am more concerned about our "health care" system itself than I am about access to it. American medicine is based on disease and cures instead of health and causes. We are basically just a bunch of lab rats anyway. Sure they cured some things but damn, they caused most of them first. Why are MORE people getting cancer and being born with mental health issues if we are receiving health CARE? If you have ever eaten in a state run facility you will know health care is not a priority or they would have gardens instead of garbage.

I think about this almost every day. If I get sick or hurt, I am screwed. And as a single parent, so is my daughter. It is disgusting that Healthcare in this country is so expensive.

Being self-employed, I cannot afford even ACA. I have a health issue right now and I have been looking for care for over a year without success. Unfortunately, I may not be able to work much longer due to my deteriorating condition. I have been turned down by every government agency and non-profit I have contacted. No help for me. I'm still looking and will not give up. I know if I lived in any other country with socialized medicine, I would be cured by now. The solution to this problem is not lack of insurance but lack of health care. I was having pain the other day so my daughter took me to yet another hospital I hadn't visited before. They looked at me, took my blood pressure, temperature, asked me a few questions, told me they would not help me because I do not have insurance and sent me on my way. Now I will get an astronomical bill in the mail which I will not be able to pay, and this is not the first time. I feel like they would rather not have me anywhere near the hospital because I might die on the property and they would have to get someone to clean it up. Tuesday, I'm going to another place to apply to yet another agency again (I've already applied there twice). I refuse to quit. My daughter said that if I would have just moved to Canada when I was first diagnosed, I would be cured and home living my life again now. I'm still living my life and will continue living even with this disease but it would sure be nice to be cured since it is possible. I'm not looking for sympathy, just stating facts from my point of view. I'm happy to be alive.

In the US, of course it does.
It's not likely to change either. There's entirely too much money in it for those who
are making the money off it.

When I was diagnosed with AML-acute myloid leukemia I had health insurance through my employer who had forced me to retire within 6 months. It then went to qn expensive Cobra which my hospital connected with Dartmouth Medical Center, covered generously as I went through 3 rounds of chemo, radiation and bone marrow transplant. That coverage was cancelled and I was then covered by the ACA-Obamacare. Living in NH and Obamacare saved my life.

It’s not just access to health care. It is also about diet and excersise as well. The lesser amoung us are hit with affordability of health care and healthier foods. It saddens me that this country is so far behind the curve on this. We can do better.

This is the quadruple aim: better health care, affordable, accessible, self-care for physicians, too, who are subject to cynicism and burnout.