Friday, July 21, 2017

Health care could use a dose of responsibility

A report was issued last December by the Center for Disease Control (CDC) noting that the average life expectancy for Americans dropped for first time since 1993. For those born in 2015 it was estimated that a woman could live to 81.2 while a man could live to 76.3 years of age. The previous report showed expectations of 81.3 and 76.5.

While the changes might seem small (we’re talking a couple of months or less), it’s an entirely unwelcome and unexpected situation. Unwelcome in that everyone wants to live as long as they can and unexpected given that Americans spent a mind-numbing $3.2 trillion on health care in 2015, which was 6% more than 2014.    

The reason behind outcomes not matching expectations is a marked increase in death rate not attributed to old age. Eight of the top ten leading causes of death saw increases in 2015, some of them reversing years-long trends. The usual culprits were front and center: heart disease, stroke, diabetes, respiratory diseases, etc. 

How could this happen? After all, shouldn’t all that money we’re pumping into the health care system through insurance, Medicaid, Medicare and more lead to longer, healthier lives?

Not necessarily. Expenditures continue to grow because we are managing those afflictions rather than preventing or inhibiting them. Americans make themselves sick rather than healthy.

That’s the reason why we rank a pitiful 26th in the world in life expectancy.

The nations that lead us in that regard (such as Japan which comes in at just under 84 years of good living) eat less fat and processed sugars and consume much healthier foods. The standard American diet has become calorie-rich and junk-heavy (just look at how ubiquitous the deadly high-fructose corn syrup has become).

That bad dietary behavior, coupled with a growing disinterest in physical activity, has caused two-thirds of all American adults to be considered overweight and staggering third of our population to be labeled as obese.

Their kids are following their lead as approximately one-third of children and adolescents ages 6 to 19 are considered to be overweight or obese. That’s frightening, given that many of us have fond memories of energetic childhoods with time spent outdoors or playing sports.

Despite society’s deep knowledge of the cause of our problems we continue to pursue excess with food and drink and pass on the gym or getting out into nature. This is because we have a healthcare system that rewards bad behavior and causes individuals to always think and act in the short-term.

There’s always a quick fix to health problems, be it through medications, surgeries, or equipment. It’s so much easier for people to rely on a crutch rather than make the minimal personal sacrifices necessary to maintain a health way of life.

Since all the education levied upon this problem – be it through schooling of our youth, public service announcements, or scolding from doctors - has done nothing to suppress this behavior the most efficient way to address this dire trend would be to attack the thing that people value more than their health…their pocketbooks.

To do so, we need a wholesale reform: Health insurance must truly become health insurance. By any definition of the word, it is anything but "insurance". It is more appropriately designated as "health coverage" since all individuals investing in it pay the same rates, regardless of their situation. It is quite unlike the real insurances of the world (automobile, liability, life) that require higher-risk individuals to pay much higher fees than low-risk individuals.

If the industry and laws were they applied a risk assessment to each individuals’ investment in their health care, then and only then, can we limit poor choices and promote good behavior.

The current way of doing things is counter-productive since a relatively healthy and safe person is not rewarded for his or her approach to life, paying just as much as people who smoke, have been arrested for questionable actions (DWI, hard drugs, gang activities), get infected via unprotected sex, don’t exercise, and eat grease or sugars.

If a high-risk individual had to pay 10 to 30 percent more than a health nut (which would amount to thousands of dollars per year), then chances are very good that they would change their ways and pinch pennies by pinching the fat (or ditching their vices). This would set off a welcomed domino-effect that would lessen our nation’s pervasive need for expensive medical services and pharmaceuticals.

Money drives the American economy and, sadly, our personal and societal cultures. Leveraged properly, it could also drive heath care. Were it taken away from those who want good health care but not good health then we could change the overall healthiness of our nation, righting our sinking ship and preventing further reckless and unwarranted investment in a system that is currently buoyed by stubbornness, disinterest, and, in many case, a lack of personal responsibility.

Health insurance must become insurance by action -- and not just by name.

From the 24 July 2017 Greater Niagara Newspapers 

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