Opinion Today: How do we fix the scandal that is American health care?

We can start by expanding access to care, but we also need to look beyond medicine. 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They shame us. Partly because of diabetes and other preventable conditions, Americans suffer unnecessarily and often die young. Sandra Stringfellow after an exam at Greenwood Leflore Hospital. [Author Headshot](~/AAAAAQA~/RgRmwzWHP0TIaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vY29sdW1uL25pY2hvbGFzLWtyaXN0b2Y_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyMzA4MTkmaW5zdGFuY2VfaWQ9MTAwNDE5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE0MjQyMiZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZNuHsOBko4oFxFIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) By [Nicholas Kristof](~/AAAAAQA~/RgRmwzWHP0TIaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vY29sdW1uL25pY2hvbGFzLWtyaXN0b2Y_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyMzA4MTkmaW5zdGFuY2VfaWQ9MTAwNDE5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE0MjQyMiZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZNuHsOBko4oFxFIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) Opinion Columnist Readers regularly ask how a columnist finds topics to write about. That’s easy: Columns find us and nag us to write them! In this case, I came across a statistic that staggered me: Life expectancy in Mississippi is a hair shorter than in Bangladesh. Huh? How can that be? In a nation that is arguably the richest in the history of the world, where we have every diagnostic machine, where we spend far more than other nations on medical care, how can outcomes be so dismal? So I went to the poorest parts of Mississippi and tried to understand what goes wrong. And what shook me wasn’t just the early deaths. It was the amputations: so many people with poorly managed diabetes, which leads to a wound on the toe that refuses to heal, requiring the removal of the toe and later the foot and finally the leg. It’s a journey of unnecessary suffering and disability that both reflects and amplifies poverty. One aspect of American exceptionalism: We are a leader of these avoidable leg, foot and toe amputations, 150,000 or so a year. One surgeon in Mississippi who performs these operations, Raymond Girnys, sighed and told me has nightmares of “being chased by amputated legs and toes.” But it’s not enough to know what’s wrong with our health and health care. I wanted to understand how America can fix these problems, for similar challenges can be found to some degree across the United States. This column is the third in a series I’m writing about “How America Heals,” aiming not only to explore problems but also to seek solutions. And I think I found some. I hope you’ll check out my column. READ NICK’S FULL ESSAY HERE [How Do We Fix the Scandal That Is American Health Care? We can start by expanding access to care, but we also need to look beyond medicine and address harmful behaviors and poverty. By Nicholas Kristof and September Dawn Bottoms](~/AAAAAQA~/RgRmwzWHP0TsaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wOC8xNi9vcGluaW9uL2hlYWx0aC1jYXJlLWxpZmUtZXhwZWN0YW5jeS1wb3ZlcnR5Lmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyMzA4MTkmaW5zdGFuY2VfaWQ9MTAwNDE5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE0MjQyMiZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZNuHsOBko4oFxFIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [Article Image](~/AAAAAQA~/RgRmwzWHP0TsaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wOC8xNi9vcGluaW9uL2hlYWx0aC1jYXJlLWxpZmUtZXhwZWN0YW5jeS1wb3ZlcnR5Lmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyMzA4MTkmaW5zdGFuY2VfaWQ9MTAwNDE5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE0MjQyMiZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZNuHsOBko4oFxFIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [Continue reading the main story](#a11y-skip-universal-0) ADVERTISEMENT [Ad](~/AAAAAQA~/RgRmwzWHP0SXaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9NTk3ODUmbGk9VFkmbT1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkNyZwPVRZXzIwMjMwODE5JnRlPTEmbmw9b3Bpbmlvbi10b2RheSZlbWM9ZWRpdF90eV8yMDIzMDgxOVcDbnl0Qgpk24ew4GSjigXEUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) THE WEEK IN BIG IDEAS Editors’ Picks [[Article Image] Damon Winter/The New York Times](~/AAAAAQA~/RgRmwzWHP0TwaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wOC8xNS9vcGluaW9uL2VkaXRvcmlhbHMvdHJ1bXAtaW5kaWN0bWVudC1yZXB1YmxpY2Fucy5odG1sP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjMwODE5Jmluc3RhbmNlX2lkPTEwMDQxOSZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xNDI0MjImdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmTbh7DgZKOKBcRSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~) [THE EDITORIAL BOARD What if, Knowing What They Know Now, Republicans Don’t Vote for Donald Trump? 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