Sunday, April 29, 2012

Not As Smart As We Think

What's wrong with this picture? America is supposedly the most advanced nation in human history, but the following facts belie that assumption (from this article):

Life Expectancy: United States life expectancy is 42nd in the world.

Infant Mortality: In 1960, the U.S. had the 12th lowest infant mortality rate in the world. By 1990 it had dropped to 23rdplace, and the most recent study in 2008 estimated that the U.S. is now in 34th place.

Effectiveness of the U.S. Health Care System : We spend more on health care than any other nation in the world ($6,714 per person in 2006) but get less, according to the World Health Organization, which ranked our health care system as 37th in overall performance, and 72nd by overall level of health.

I was amazed to read a current editorial by Fortune senior editor-at-large Geoffrey Colvin that touches this subject—that America's healthcare (sickcare, actually) crisis is fundamentally a problem of how people choose to behave. I read this kind of opinion from alternative and plant-based docs and authors all the time, but rarely from a mainstream, non-medical professional. Colvin's editorial calls to mind the stunning moment in a 2008 presidential debate between Obama and McCain when the moderator asked the two candidates whether they considered healthcare a right or a responsibility.

Obama: "A right"

McCain: "A responsibility."

No one should be surprised that Obama wants to dedicate one-sixth of the U.S. economy to supporting a rights/entitlement system that has proven to be an utter failure at elevating the health of the American people. The government can't legislate health any more than it can legislate morality. Both are responsibilities.

Colvin's entire editorial is great, this being the heart:

At the beginning of the 20th century, the top causes of death in the U.S. were communicable diseases -- flu, tuberculosis, curses that could strike any of us. Today the top causes of death are noncommunicable diseases that result mostly from the way we live --coronary artery disease, hypertension, diabetes, some cancers. Medical researchers call them lifestyle diseases.

What's important from a policy perspective is not just that these diseases cause the most deaths, but also that they cause the most spending. The great majority of America's staggering $2.6 trillion health care tab (as of 2010) was spent treating lifestyle diseases. While we rightly worry about health care costs rising 8% or 9% a year, we spend well over 50% of our costs on diseases caused mostly by the way we choose to behave.

If Americans behaved just a little differently, our health care costs could settle down to a sustainable growth rate that matches the economy's growth, or could even fall further. We don't need a nation of triathletes. If we would smoke and drink a little less, walk a little more, eat a few more vegetables and fruits, and lose some weight, the effect would be far more dramatic than most people suspect. "More than 90% of type 2 diabetes, 80% of coronary artery disease, 70% of stroke, and 70% of colon cancer are potentially preventable" by that combination of moderate behavior changes, reports Harvard epidemiologist Walter C. Willett. In other words, by making realistic changes that are entirely within our own control, we could end the crisis of unsustainably rising U.S. health care costs. Which brings us to that simple question: Why don't we?

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