Opinion: A change in perspective is necessary if we wish to get a handle on America’s healthcare problems.
In the wake of a 49-51 defeat of the Republican “skinny repeal” of the Patient Protection and Affordable Care Act, it is clear that healthcare remains one of the most hotly contested issues in today’s political climate. However, a large part of the problem does not lie in the absence of some complex piece of legislation (or its repeal), or the failure to add yet another entity to the alphabet soup of federal agencies. Part of the problem is how we – the public and politicians alike – view healthcare.
There’s an old saying you likely heard in childhood, “An apple a day keeps the doctor away.” Unfortunately, it seems that many of us have forgotten this simple yet useful bit of wisdom, as evidenced by the enormous amount of healthcare expenditures that go to treating preventable diseases.
According to the Centers for Disease Control and Prevention (CDC), 86 percent of the nation’s nearly $2.7 trillion in annual health expenditures in 2010 were spent in the treatment of chronic and mental health conditions. The largest portion of this spending coming in the form of direct medical treatment for cardiovascular disease ($190 billion). Another heavy hitter, diabetes, accounted for $176 billion in annual spending.
The issue becomes more clear when you consider the risk factors associated with these diseases. The American Heart Association, for example, lists 7 simple behaviors that can help one lessen their risk of CVD. These behaviors include, among others, not smoking, engaging in physical activity, and eating a healthy diet (the proverbial apple a day).
Unfortunately, around 15 percent of adults in the U.S. said they smoked cigarettes in 2015, 79 percent did not meet recommendations for physical activity, and over a third of adults are considered obese. What these behaviors all share in common other than being risk factors for CVD, is that they’re also linked to many other chronic illnesses like diabetes, which eat up even more healthcare dollars. Another thing they have in common; they are entirely preventable.
Obesity, one of the largest contributors to the conditions listed above, is at epidemic proportions in the U.S. More than two in three American adults are considered obese or overweight, which gives us the honor of being the fattest nation in the world. And make no mistake, this prestigious status comes with a cost — $1,429 more per obese person per annum to be exact.
All of this, and we haven’t even touched the medical expenditures directly associated with alcohol consumption, smoking, and cancer (which has also been linked to obesity).
But in the larger healthcare conversation, it is not uncommon to hear pundits and politicians mention that the U.S. currently outspends all other nations when it comes to healthcare. This is true. But a discussion about where these healthcare costs originate from is less common.
The impression you’re likely to get from most politicians — especially those on the political left — is that healthcare spending necessarily means life-saving care of illnesses which the patient has no control over. Even more egregious claims take the form of assertions, such as “Without good healthcare, you die.” Almost certainly in these comments, the term “healthcare” means doctor-provided services.
Other than being misleading or just outright incorrect (if without modern healthcare you really did just die, then the human race would likely not exist today), it’s a hollow platitude that carries with it much more emotional appeal than intellectual integrity. It’s also a rhetorical strategy that allows politicians to virtue signal and score political brownie points because victims that have no responsibility for their situation are much easier to sympathize with. But an honest look at the facts shows that the majority of healthcare is not synonymous with life-saving care, and the statistics on preventable diseases suggests that we may have much more control over our health than we think.
Now if you think I’m simply arguing that people need to eat more apples, then perhaps you’ve taken the phrase a bit too literally. What I am suggesting though, is that we change how we look at healthcare. This starts with understanding that healthcare isn’t something you just get in a doctor’s office, or a prescription you pick up at your local pharmacy. Anything which goes into maintaining your physical and mental health should be correctly regarded as healthcare, and there is a large body of evidence that suggests some of the most effective healthcare measures – indeed those which may reduce costs the most – are relatively free. It doesn’t cost you a dime to run a lap around the block, and the grilled chicken is likely in the same price range as the burger and fries, if not cheaper. Ditching the cancer sticks also can’t hurt.
This change in perspective is imperative if we wish to truly get a handle on the healthcare issue in America, particularly spending. No longer should hollow platitudes and political catch phrases rule the day in the healthcare debate; leave that to the lackeys in Washington. Because as it turns out, the proverbial apple may do much more than keep the doctor away, it may keep the debt collector away.