So Where’s the Money?
The election is over. Who will now pay for health care?
There’s a simple answer – you will.
Where Will You See Increased Costs?
First through higher co-pays. The Affordable Care Act does little to control health insurance pricing or capriciousness (we paid for it last week but we decided against that this week. You’re not happy? Spend twelve hours repeating the same information with 3-7 customer representatives – after that you can sue us.) Co-pays will rise inevitability, as will many bills for the many uninsured or poorly insured who find themselves stuck visiting Emergency Rooms. Medicaid in many states will follow private insurance practices of providing coverage in name only. State legislatures that want “smaller” government are very capable of sending poor, auto-less pregnant women to a single obstetrician 60 miles away – who also has a long wait list.. Of course, on paper the women are “fully covered.”
Ultimately the nation will pay far more due to our lack of virtually any incentive to promote health. Globally, national health systems generally are heavily incentivized to keep their populations healthy. It saves money and helps grow their economy. A healthy economy requires a healthy population. Healthy people are also more productive.
The US spends about twice as much on health care per person as does Germany, creating an enormous and continuing tax on the competitiveness of American business. Plus Germany has far better health indices across the board thus us. They even have public, non-profit, and profit arms competing with each other in ways that make a mockery of our “market” system.
If we had health systems as efficient as Germany and Britain, where they acknowledge lifestyle as important to health, we might see our Federal Budget deficit shrink away.
Why Does the US Spend So Much for Such Little Result?
Because health is not heavily impacted by health care – particularly if you look at lifespan as a measure of healthiness. The US ranks 50th in the world in lifespan, according to the CIA World Fact Book, and pays out more in health than almost anyone.
Money will buy you health care. It won’t buy you health. That’s true for individuals and societies.
In the twentieth century, lifespan doubled in developed countries primarily through changes in nutrition, sanitation, education and vaccination. Let’s go through what’s happening with them now:
Nutrition –enormous sums promote supersugared foods to kids. One doctor friend of mine watched a two year old at a wedding reception sample everyone’s drinks as they went off to dance. Finding a sugary soda provoked a big smile – and a long draught.
You find high fructose corn syrup in children’s Tylenol. Want to make any guesses about future American rates of diabetes and obesity?
Sanitation – The Clean Air and Water Acts meant a lot to the nation’s health. What will happen as global climate change degrades water and sewage infrastructure? What will happen to aquifers if controls on fracking are not enforced? Why are all those drugs showing up in the water supply? Hopefully the rise of “smart cities” and cheap sensors may make it easier to quickly close off pollution sources.
Education – If global comparisons of American science and mathematics ability are any indicator, we have lots of opportunity to improve people’s health just through teaching them how to analyze and think.
Vaccination – As a nation we are still protected by herd immunity to a fair degree, and vaccines like those for influenza should improve. They will need to, as many refuse necessary vaccination and bugs get smarter as we overuse antibiotics and transform the environment.
As for our collective lifestyle, have you been to the mall recently?
What Will Get Americans Better Health?
Lifespan doubled over the past century primarily due to what we now witness as lagging improvements in sanitation, nutrition, vaccination and education. Presently populations are living into their nineties through the added lift of lifestyle changes. In the Kungsholmen data from central Sweden, lifestyle modifications can add four years of life at age 85. At that age, medical care essentially adds zero.
Where Will We Get the Biggest Bang for Our Buck?
By changing attitudes towards health and medical care.
Health is about how you live. Health is well-being – physical, mental, social and spiritual well-being. It does not come out of a pill bottle.
Health can markedly improve when you recognize your body survives by constantly regenerating itself. We don’t know precisely what biological factors make people live long. We do know that how you eat, move, rest and socialize may add a decade or more to a population’s lifespan, and make people more productive.
In the information age, recognizing the body as information – constantly updating itself as it rebuilds – can have great benefits for individual and population health.
But that will mean looking at systems rather than single items or factors – including our national obsession with weight. It will mean fighting entrenched political and economic powers. It will mean understanding that well sited parks and walkways improve people’s health more cheaply and effectively than building new hospitals, and that how you advertise foods to kids will affect long term national economic health.
Things are connected. Having a Regeneration Health perspective highlights what connections give you the best results.
But getting people to think differently is not easy. In a world struggling with economic, ecological, and political crises, it’s simply necessary.
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