By Paolo von Schirach
July 13, 2013
WASHINGTON – Yes, as banal as it sounds, in health care prevention is far more cost-effective than treatment, with the added bonus that healthy people enjoy a much higher quality of life, while they stay fit and productive for many more years. And yet, here in America, the land supposedly built around the concept of efficiency, home of thousands of business school that teach about the rational use of scarce resources, we do exactly the opposite when it comes to health care. Indeed, there is no prevention, while we spend mountains of cash to treat a vast array of mostly preventable diseases that diminish the quality of life for millions of Americans who end up dying way before their time, because of preventable illnesses.
US: 18% of GDP on health care
This may sound absurd. And yet it is true. America has the dubious distinction of being the wealthy country that spends the most (18% of GDP) on health care. However, this astounding sum of money buys very little. As health care costs increase, life expectancy has barely budged. This awful data has been once again illustrated by a study recently published in JAMA, the Journal of the American Medical Association.
Bad life style multiplied by several millions
These terrible statistics about life expectancy do not imply that medical science has not improved. It has. There are new cancer treatments, new diagnostic technologies, new types of non invasive surgery, and what not. And all this is good. However, the real problem negatively affecting national health statistics is that millions of Americans have embraced a very unhealthy life style. As a consequence (especially as they get older), they develop diseases, in most cases chronic diseases that require constant (and expensive) treatment. If you combine this robust “demand” for health care services with payments to doctors based on the number of procedures they prescribe, you have the perfect formula for out of control, crazy costs that created the most expensive (and most inefficient) health care system in the world.
And yet the causes of this immense waste are plain: tens of millions of sick people require larger amounts of expensive treatments, while eager doctors are there to oblige them.
Simple changes
In all this the irony is that simple life style changes, multiplied by the millions of sick Americans, would dramatically reduce the incidence of totally preventable diseases. The necessary personal changes would have to include increased physical exercise for all citizens, young and old, and the adoption of a new diet consisting mostly of vegetables, fruits and lean proteins. This is pretty much it.
Yes, these straightforward, (mostly inexpensive, yet drastic), changes would dramatically diminish and eventually eliminate the illnesses caused by our national obesity epidemic. Cardiovascular diseases, hypertension, Type 2 diabetes, would go away; or at the very least they would go way down to manageable levels.
Big problem only because of size: we know what needs to be done
Well, these are the simple facts. We have a huge problem in our hands only because its size has gotten out of control. But it is not a complicated problem. We know what needs to be done. Health care experts know all this. Medical research specialists and statisticians know all this. And yet, most amazingly, there is no serious, large-scale action plan aimed at eliminating this national tragedy. We hear almost nothing about remedies.
It is obvious that we should start with a national education/awareness “wellness” campaign. People need to understand the long-term health consequences of a bad diet. Yes, a diet consisting mostly of processed food high in sugar, fat and salt is essentially like ingesting small amounts of poison every day. Overtime, the cumulative effect of bad nutrition is the onset of various diseases. The general public needs to get clear, easy to understand guidance on what to change when it comes to diet and exercise, and how to phase in the necessary changes.
This is a daunting task , but only because of the scale of the problem: we are talking about tens of millions of Americans. However, we are dealing mostly with simple, straightforward dietary changes. There is nothing mysterious or exceedingly complicated in any of this. We do not have to find a “cure” for an unknown illness. We know the problem and what needs to be done about it.
Health authorities say practically nothing
And when the American people will receive the information and will finally understand that what is at stake here is their life, in terms of its quality and duration, they will respond positively to simple and sound nutrition and exercise advice.
And yet, for some reasons, we hear nothing from national or local health authorities about the steps to reverse the consequences of the obesity, (plus lack of exercise), epidemic. Do they really believe that it is alright to have an unfit American population, with millions who are barely alive only because of costly medications? Sure somebody is making money in all this. But the country as a whole loses –a lot.