If you mean short term impacts that may be true, but I wonder if the medicaid, aca and likely medicare cuts will have material impacts on mortality. It will not be as easy to attribute, and therefore it’ll be hard to quantify (you might say that’s “convenient”), but the number of people impacted will be well into the tens of millions.

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bonsai_spool 8 hours ago | parent [-]

> if you mean short term impacts that may be true, but I wonder if the medicaid, aca and likely medicare cuts will have material impacts on mortality. It will not be as easy to attribute, and therefore it’ll be hard to quantify (you might say that’s “convenient”), but the number of people impacted will be well into the tens of millions.

I think these can't possible be commensurate - just consider how many more HIV cases there will be without US funding for overseas HIV prevention.

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harmmonica 8 hours ago | parent [-]

I’m not so sure. 630,000 total HIV deaths annually. What percent are impacted by USAID and then how much growth in HIV deaths without USAID? My tens of millions comment is the people whose health care will potentially be impacted short term (medicaid and aca changes; Medicaid is currently 70 million people. ACA is 24 million) plus potential aggressive efforts to move medicare people to medicare advantage and you have another 68 million potentially exposed (that number isn’t actually that large today because a majority of those people will likely pass before the medicare changes have a negative impact, but over time, as people enter the system with worse coverage, the deaths will climb).

Please understand I’m not saying I’m right about this but just that the vast number of people impacted by the admin’s policies re domestic health care makes me think it could be greater than USAID.

edit: grammar and spelling

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bonsai_spool 8 hours ago | parent [-]

I am very genuinely interpreting all of this and I recognize you are just reviewing the data.

HIV deaths are a lagging indicator, so any effect of today's policy will be delayed - as a general matter. But HIV in newborns will lead to death within a year if untreated, and adults with untreated HIV/AIDS will die from other communicable disease sooner than if they were treated.

Since US hospitals public obligation in the US to treat people who are gravely ill, we're 'only' going to see a marked increase in deaths attributable to chronic disease, and I don't think the Medicaid cuts will survive in their current state.

But it's true I don't have numbers on this and won't have a chance to get them this morning. Please share if you have a sense of comparative DALY/QALYs lost through USAID funding cuts vs Medicaid changes.

	▲	harmmonica 6 hours ago \| parent [-]
		I really don't have a concrete sense. My comment was very much predicated on the sheer number of folks who would be negatively impacted by the changes to existing domestic healthcare programs. And to put a fine point on my own comment in case you think I'm attempting to downplay USAID impacts, both of these things are materially negative from a healthcare perspective. It will be impossible to effectively quantify the impacts on mortality of the medicaid/medicare/aca changes, but they are (if implemented) going to impact great numbers of people and their health. USAID absolutely the same as you're pointing out and those impacts will be much more measurable. You're going to have about as good a linear test as you can get given how abruptly that funding will disappear (abrupt in contrast to the long, drawn out medicaid/medicare/aca changes (though the initial aca changes, assuming they do happen, will likely be the most abrupt of the three domestic programs because they will happen cleanly on January 1, 2026)).