The health care dilemma

For better or for worse, health care reform is here. With some of the debate over, and with Congress having debated the issues more on party lines than on the merit, we must ask ourselves: are we addressing the real issues?

Here is one man’s opinion:

It has been said by many that, despite its many deficiencies, the US has “the best health care in the world.” There is not much argument about the quality of care, certainly for those who can afford it. After all, people come to the US for medical care; they don’t usually leave the US to get better care elsewhere. But, surely there are tremendous deficiencies.

A large number of Americans are still without medical insurance. Others, who became unemployed in the recent economic downturn, may still have Cobra insurance, but when this runs out, they too may become uninsured.

Yet, if you need an urgent procedure (cardiac catheterization, an MRI), you are more likely to get it with much less delay in the US than in other industrialized countries, insured or uninsured (hospitals accepting Medicare will lose their funding otherwise).

There’s also no question that we have the most expensive healthcare system in the industrialized world.

Despite our presumed best health care and the enormous expense, longevity and infant mortality in the US lag behind many industrialized countries. We are #37 in longevity, sharing an “honorable ranking” with Cuba, and way behind Andorra, Canada, Israel, Norway, Germany and Jordan… A similar picture holds for infant mortality.

Why is there such disparity between “best, most expensive health care” and longevity?

I’ll briefly make the case that it’s lifestyles, not healthcare reform, that’s going to keep us healthier and make healthcare less expensive. There’s a whole lot more to health than health care reform.

Faulty lifestyles, mainly smoking, lack of physical activity and overeating, account for more than 40% of premature deaths in the US. They undoubtedly account for much more than 40% of the medical expense associated with faulty lifestyles. Combine this with the tendency of Americans to run to the doctor for minor issues not requiring care, such as simple colds or minor anxiety, and the willingness of the system to accommodate these demands, you have written the script for a healthcare system that is destined to bankruptcy. But there’s another aspect to lifestyles, not completely the fault of each person individually.

Much of the fault for our relatively poor health lies with industry, especially the food industry. It is not my intention to write a treatise about it here, but suffice it to say that in the last few decades Americans have been exposed to progressively increasing amounts of processed foods devoid of nutritional value, or outright dangerous, especially corn-derived sugar, salty canned foods, and bottled drinks (the plastic ones are generally worse).

So what’s the answer? Sure, there’s a lot to be corrected with the present health care system. Open competition for HMOs and commercial insurers, taking away limits on HMO payments (now restricted to no more than 65 cents on the premium dollar), decreasing the enormous obstacles the FDA places in new drug approvals, and many other measures will help. But all of this will be of limited value.

The biggest effort has to come in educating the public to change its lifestyles, and make sure that these changes are adopted by the young children. It could be very easy to make changes in the way food is processed in the US. If the demand for processed food is diminished, then the manufacturers will respond to market demands and make more acceptable foods available. If you give incentives to people who keep acceptable lifestyle (for example, reduce their insurance premium), the people will respond.

We can each contribute to the solution of the healthcare problem by taking the right steps and improving our lifestyles. With our actions, industry will respond, and we’ll help the economy, healthcare, and, most importantly, ourselves.