HEALTH: What’s Missing in the HealthCare Debate
By Karden Rabin of the Center for Structural Wellness
Nearly everyone agrees that some manner of healthcare reform is necessary in this country. The prevailing healthcare system is expensive, inefficient, exploitive and seemingly designed to provide as little “care” as possible. Healthcare costs in this country accounted for 16.5% of GDP in 2007. That’s $2.26 trillion or $7,026 per American, a price tag that most Americans can ill afford, as reflected in the fact that, health related issues account for nearly half of personal bankruptcies in the United States. The bill[s] being reviewed by Congress are estimated to cost a staggering $856 billion, and the future costs of the system are estimated to reach 19.5% of GDP by 2017. The present and projected costs of healthcare in the United States, already beyond the quantitative sense of most Americans, arise within the disgraceful reality that 15% of Americans are completely uninsured and substantially more are underinsured.
Stepping back in an effort to comprehend the madness, one can only conclude that the healthcare system is completely out of control. When a national discussion becomes as complicated as our healthcare debate and the solutions are more expensive than the recently passed stimulus bill, it cries out for a different approach. From my standpoint as an alternative healthcare provider, that approach is concerned with a legitimate reform focused on keeping Americans healthy in the first place.
The heart of the matter is that 133 million Americans (45%) have at least one preventable chronic disease. Chronic disease is responsible for: 7 out 10 deaths; 81% of hospital admissions; 91% of all prescriptions filled; and, 76% of all physician visits. The U.S. Centers for Disease Control and Prevention estimates that eliminating poor diet, inactivity and smoking would prevent 80% of heart disease, 80% of type II diabetes and 40% of cancer cases in the United States.
The awful fact is that we’re eating and lounging ourselves to financial ruin and death. Instead of taking on the underlying challenge of making Americans healthy, healthcare reform proposes to spend another trillion dollars on revamping a broken system. That strategy compares to repaving the surface of a decaying bridge and claiming that it can support 18-wheelers. Sooner or later, that bridge and every vehicle on it is going to come crashing down. Like the bridge, the healthcare problem is structural, but the proffered repairs are merely cosmetic.
Rather than throwing another trillion dollars on a facelift for a disintegrating system, we should try to reduce the burden under which the system is expected to function. We’ve known how to do it for decades; the formula is simple: eat well, exercise and don’t smoke tobacco. In a triumph that altered the cultural habit of more than a century, we’ took on the tobacco industry. We raised and expanded our awareness of the risks of tobacco use; we made cigarettes expensive; and we use the taxes levied on cigarettes to help pay for the medical care of the people cigarettes have sickened.
But, on the other factors, healthy eating and exercise, we’ve failed miserably. As for eating well, few people do. It can’t be done in a country that awards subsidies and concessions to a food industry that makes bad food cheap and healthy food expensive. For some, it’s a matter of ignorance and for others it’s a matter of apathy. For yet others, the choice to eat poorly is an expression of their right to life, liberty and the pursuit of happiness. But for most, it’s simply a matter of cost. Healthy food is expensive and can take time to prepare. How can brown rice, a chicken breast and broccoli which costs as much as $10 bucks compete with French fries, a hamburger and soda for $4 bucks? Healthcare reform must hold the food industry to account for the damage it is doing to American health in exactly the same way that anti-smoking legislation addressed the tobacco industry, Otherwise, no system of healthcare will be able to care for a population where two-thirds of the population is overweight.
Exercise and fitness are extremely popular and present in the media, but hype is far from implementation. Our public school system makes a mockery of physical education and our business culture sees no profit in it. Exercise needs to be made an important and rigorous aspect of education. Perhaps then, our children won’t suffer from type-II diabetes at alarmingly young ages. As for business, if fitness were made a standard feature of the American workday, then we’d have a far healthier and more productive citizenry.
For Healthcare reform to be effective, it must not only reform the system of providing care, but guarantee access to a healthy lifestyle for all Americans. To do that, we need to enact laws that regulate and tax the food industry in order to create a new American diet based on health and not profit. We have standards for quality and sanitation across the industry, now its time to add an additional layer of health standards. This shouldn’t mean the elimination of indulgence foods, but requiring warning labels for unhealthy foods would guide consumers to better choices. Mandating better physical fitness and education standards in public schools would shape a more vital and conscious citizenry. Encouraging small business and corporations with tax credits and lowered insurance premiums for making fitness available to their employees would go a long way towards empowering working Americans.
The reality is that we cannot debate these issues any longer. It’s a critical matter of national interest to preserve both the financial and physical health of our citizens. By legislating on the side of keeping people healthy, rather than saving them when they are chronically ill, we would not only save this country from a financial disaster, but improve the quality of life for all Americans. That’s what real health-care does.
