Our nation’s chief governmental leader, President Barack Obama, believes firmly that, “making sure every American has access to high quality health care is one of the most important challenges of our time.” (1) Never have I heard anyone make a more accurate statement regarding the deficiency of health care in the United States today. The high costs of medical care do make it unattainable to many of our nation’s citizens, but the greatest threat facing the health of our nation today is not the cost of the goods and services provided by physicians, hospitals and pharmaceutical companies. If we dig deeper into the real issues we will discover that the biggest threat facing the health care system today is that these goods and services would not necessarily provide “high quality health care” even if they were made available free of charge to all citizens.
The president is correct in his claims that this broken “health care” system is bankrupting our country with skyrocketing costs.(2) In 2007 our nation spent $2.4 trillion dollars on health care, the highest of any nation in the world. This equated to about 17 percent of our nation’s gross domestic product. What is worse is that if we look to the future, the absurdly high cost of “health care” today is only the beginning of our financial woes. The National Coalition on Health Care states that the total national health expenditures were expected to increase 6.9% this year alone, over two times the rate of inflation.(3) With these staggering costs hitting us in such tough economic times, it should come as no surprise that 50% of people in our nation who file bankruptcy do so, at least in part, as a result of medical expenses.(4)
This high cost of medical care is seen by the majority of the population as a serious weakness, but most of us tolerate it based on the assumption that we are getting better health results from a system that boasts the highest medical expenses in the world. Unfortunately, that assumption is absolutely untrue. If we are honest with ourselves, we will see that we are not even close to having the best healthcare system in the world.
A recent study looked at sixteen available health indicators and ranked thirteen of the leading industrialized nations according to these health indicators. Upon averaging the ranks of the scores of those nations for all of the health indicators, it was found that the most expensive health care system in the world did not rank first amongst those thirteen countries in the results it produced. In case you wondered, we didn’t rank second either. Even worse, there was not even a third place trophy given to us to be displayed at the office of the U.S. Surgeon General. Indeed we ranked next to last, crossing the finish line in twelfth place out of thirteen nations in the race for the best measures of health.(5)
Lest we convince ourselves that this research is biased or merely a statistical anomaly, we must also know that in 2000 the World Health Organization did a similar study of 25 nations using different health indicators. Again, the robust network of hospitals, physicians, researchers and pharmaceutical companies of the United States did not come in first, or second, or even third, but rather we ranked 15 out of 25 nations in an average of health care indicators.(6) Our insanely expensive health care system has failed to deliver the goods by almost anyone’s standards.
Not only is our broken health care system failing to help us to be healthier, but medical research has shown that it often contributes to our poor health through its adverse affects. In recent years, an article in the Journal of the American Medical Association stated that 225,000 deaths a year occur as a direct result of our health care system (complications of unnecessary surgery, medication errors, adverse reactions of medications, etc.). The journal article itself states that these numbers may be lower than the actual deaths caused by our “health care” system because they only take into account hospitalized patients (not those who may have died at home as a direct result of our failing health care practices). It also tells us that other researchers estimate that as many as 284,000 people die each year as a direct result of treatments provided by our “health care system”. The author of the peer-reviewed article, a medical doctor writing to other medical doctors, concludes this section of her article by informing her peers that even this low estimate makes our American “health care” system the “third leading cause of death in the United States, after deaths from heart disease and cancer”, without even taking into account adverse effects that are only associated with disability or discomfort.(7)
In light of such staggering statistics, the answer to our problems is not for the government to simply take over the current system and make this same care available to all people. Our American “health care” system is broken, and I believe history has demonstrated that government control of an institution is seldom a CURE for high costs and mediocre results. Indeed, the bureaucratic red tape associated with such a takeover is often the CAUSE of even higher costs and worse outcomes. Countries like Canada, France and England that have government health care plans similar to the one that we are considering in our nation today are the evidence that government controlled health care is MORE COSTLY and provides LOWER QUALITY care for all of the citizens, even to the point of “rationing” healthcare services.
Still, I will leave the politics to the politicians, because there is an even greater point to be made here. Regardless of who has the ultimate control of our health care system in the future, the true origin of this system’s ailments is that we mistake it for a true “health care system”, when it is actually a “disease care system”. The emphasis of the vast majority of our research is placed not on the prevention of disease, but rather on the management of disease with medicine, surgery, and other therapies. These methods are a great means of reducing symptoms and perhaps stopping the progression of disease, but they are only “disease care” and should not be mistaken as true “health care”. Health care, in the truest sense of the word, includes any and all practices that promote health in a group of people, not just those that decrease the impact of disease in that population.
The vast majority of the steps that could be taken to put an end to our true “health care crisis” are not things that can be controlled or provided by the government, by insurance companies, or even by health care professionals. There is no doubt that the role of health care professionals in treating serious diseases, traumatic conditions, and many degenerative changes in the body over time is essential and does contribute at least minimally to overall health, but recruiting more health care professionals of any kind will not cure our ailing “health care” system as long as the American diet and exercise habits remain unchanged. In a similar way, our government could undoubtedly be a vital force in a “health care” system by educating the public about a healthy lifestyle as the surgeon general has done with the dangers of smoking. However, the benefits of the role of the government, and perhaps even insurance companies, in providing "disease care" is debatable, because it takes the personal responsibility for a person’s health out of his or her hands and places it in the hands of another. The third party systems that many of us so freely embrace are in many ways in opposition to the goals of a true “health care” system because they can unintentionally enable our citizens to drown themselves in a sedentary lifestyle, an unhealthy diet, and other habits that contribute to the health care crisis that we face without those people having to worry about bearing all of the financial consequences of those decisions. Again, I affirm that the true solution to our health care crisis lies not in any institution, but in the will of the American people, and if that will remains unchanged our current "health care crisis" will always be with us.
It is interesting to note that the only two things that cause more death than our broken “health care" system are cancer and heart disease, both of which can be drastically reduced by healthy living. Medical research has demonstrated that cancer risk is severely impacted by lifestyle choices of individuals more than by any other factor. More than one third of the 500,000 cancer deaths that occur in the United States each year can be attributed to exposure to tobacco products, and another third of the cancer deaths are attributable to diet and physical activity habits.(8) A similar statement could be made about the impact of lifestyle choices on heart disease. A Harvard Medical School study demonstrated that “in a population of middle-aged women, those who did not smoke cigarettes, were not overweight, maintained the healthful diet, exercised moderately or vigorously for half an hour a day, and consumed alcohol moderately had an incidence of coronary events that was more than 80 percent lower than that in the rest of the population.” The researchers concluded that “closer adherence to a more healthful lifestyle might reduce the risk of coronary heart disease still further.” (9) When one considers how moving from a system that promotes “disease care” to one that promotes “health care” could have such a significant impact on the top three causes of death in the United States, it is easy to imagine how such a paradigm shift could lead to longer, more productive lives for a large portion of our population.
As intriguing as this concept of a true “health care” system sounds, we must remember again that when all is said and done the ultimate responsibility for correcting the ailments of the virtually non-existent “health care” system of the United States today lies in the hands of individual citizens, like you and me. We must respond to this call to action to take a stand for own own health and for the health of those we love by incorporating exercise, a healthy diet and other healthy habits into our daily lives. These changes will be hard to come by, but today you and I have the power to have a significant impact on the health care crisis in our nation by embracing a healthy lifestyle ourselves and by encouraging our loved ones to do the same. Embrace health today, because the American health care system will be neither healthy nor caring until it is embedded in the hearts of the American people. Today is your chance to make it a reality.
(1) http://www.barackobama.com/issues/healthcare/
(2) http://www.barackobama.com/issues/healthcare/
(3) Keehan, S. et al. “Health Spending Projections Through 2017, Health Affairs Web Exclusive W146: 21 February 2008.
(4) Himmelstein, D, E. Warren, D. Thorne, and S. Woolhander, “Illness and Injury as Contributors to Bankruptcy, “Health Affairs Web Exclusive W5-63, 02 February, 2005.
(5) Starfield, B. Primary Care: Balancing Health Needs, Services, and Technology. New York, NY: Oxford University Press; 1998.
(6) World Health Report 2000. Available at: http://www.who.int/whr/2000/en/report.htm. Accessed June 28, 2000.
(7) Starfield, B. “Is US Health Really the Best in the World?” Journal of the American Medical Association, 2000;284:483-485
(8) Bridget M. Kuehn. Guidelines: Community Support Vital to Promote Cancer-Preventing Lifestyle
JAMA. 2006;296(15):1829-.
(9) Stampfer MJ, Hu FB, Manson JE, Rimm EB, Willett WC. Primary prevention of coronary heart disease in women through diet and lifestyle. N Engl J Med. 2000;343:16-22.
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