A Pound of Cure

Newsweek reported last week about the work Senator Tom Harkin is doing to focus the Presidential Transition Team's healthcare portfolio on preventative care and wellness. Bravo to him!

The United States spends $2 trillion (yep, "2" with 12 zeros!) annually on healthcare, more than any other nation on earth (according to the WHO). And yet the US ranks 37th among nations in citizen health, and 20th out of the 21 industrial nations.

Some reasons:

1. Americans are about the unhealthiest people in the world
2. Americans are horribly lazy and believe that pills can cure bad behavior
3. Physicians in this country are paranoid about lawsuits and over-test, over-prescribe, and over-treat
4. Pharmaceutical companies know how good a thing they've got
5. Insurance companies are mind-numbingly stupid
6. The policy and regulatory machine is embarrassingly out of touch

I'm thinking that #2-6 have caused #1.

Senator Harkin is right - something needs to be done. It's a combination of health-conscious behavior with appropriate incentives for the machine. It surprises me that insurance companies won't pay for preventative care, but will happily cover the result of bad behavior. How bizarre!

I'm sure the insurance companies realize that if people are healthy, they will still get premiums but won't in aggregate have to spend as much? Wouldn't it be better to spend a little bit on everyone (assuring preventative healthcare across the population), and then benefit from not having to spend so much on the vast percentage of the population that gets sick because of bad behavior?

It's similar to the drug problem in this country. We spend $billions on the so-called war on drugs in the name of being tough on crime (another ridiculous concept), but don't realize that if we spent those $ on reducing demand by helping and curing drug addiction, we'd end up starving the suppliers. All without having to put people in jail, and instead helping people eliminate their dependencies and lead better lives.

This is classic of a system that is not interested in cause and effect, but simply patching symptoms.

This is an endemic problem, ranging from failing bridges, levees and air traffic control systems, to starting wars without thought to how they'll end, to badly-designed school systems, to borrowing without considering financial capacity, to poor health, to crime, to everything.

Oddly the population of this country seems sanguine about all this. There's no sense of urgency about fixing any of this. Why is that?

I wrote a while ago about how breast cancer can be managed through early detection and about how we're presently governed by a stunningly short-sighted leadership. It feels like this society only lives in the present, and is completely oblivious to anything that might happen tomorrow as a result of indifferent or bad behavior today.

What does it take to open our minds to the reality that you can only paint over the cracks so many times before the walls fall down?

I think the first step is for this entire society to abandon the idea that there is a free lunch for weight-loss. This (yet another) multi-billion dollar industry preys on people that think there's a quick fix.

Let us once and for all recognize the fallacy of fried chicken, pork rinds, french fries with gravy, apple pie and a diet soda?