health care crisis

Health care spending and health insurance are favorite topics for presidential elections and this year is no different. Once again the spotlight is on spending, insurance, and insurance coverage. Suffice it to say that the US is doing very poorly in this sector compared other civilized countries. Here we are on par with the Third World except when it comes to spending. We spend more than any other country on the planet but our return on investment is decidedly poor. Life expectancy in the US is ranked 27th in the world, just ahead of Cuba, a country that spends just $186 per person per year. We need $4,800, the most of any nation. The second biggest spender, Switzerland at $3,300 per person, can at least boast of a much better life expectancy, where it ranks 4th.

We are constantly told that our health care system is the best in the world, and while some may disagree, it is for sure the one that is the most out of reach. US healthcare is virtually off-limits to most citizens. I am sure that is not much of a concern to many as they seem to believe that they have access and that is what matters. Access to the best of the best. Surely, the US healthcare system is big on tech wizardry and stitching skills. We excel at procedures nobody else will do. To go where no man has gone before. Unfortunately, anyone with a bit of clinical know-how and experience will tell you that such flashy stuff often amounts to nothing much in the scheme of things. While the record shattering twenty bypass operation is front page news, the same patient dying a few days later in the ICU from a nosocomial infection goes largely unnoticed.

Furthermore, as any centenarian will tell you, the key to longevity is to stay away from hospitals and medical practitioners. Iatrogenic deaths run close to a million per year according to some studies. Iatrogenic morbidity is many times higher. Clearly prevention is better than cure. And the best prevention is the one where you don't see a doctor. Prevention of the type advertised by doctors, hospitals, and drug companies only serves to provide these do-gooders with another source of income.

It may sound far fetched but preventive healthcare is closely linked to global warming. Suburban living with its huge, isolated mansions and perpetual need for driving not only causes excess greenhouse gas production, it also leads to social isolation, and lack of exercise. Hence our epidemic of obesity, a key factor in many illnesses. Obesity rates are much higher in suburbia than in urban populations.

Many of the "diseases" that consume our health care budget and make our citizens ill are easily preventable. That is not to say that all cases can be prevented, as genetics surely plays a role. However, the vast majority of cases are. Heart disease, stroke, cancer and other ills will always be with us but they need not affect so many people or strike so early in life.

Lack of exercise, endless hours spent in traffic jams or watching TV, social isolation, fast food, ubiquitous sodas, sugar-rich diets, are but some of the factors that are making people sick. Some studies have argued that whatever savings we as a society made against infectious disease have been nullified by our new illnesses due to lack of exercise.

It appears our life-style is unsustainable in more ways than one. Our key problems are intimately connected. Before the subprime crisis, 25% of housing loss and foreclosure were linked to lack of health insurance and soaring health care bills. We have just added another factor to that list. The housing problems caused by the lending crisis are added on top of those due to inadequate health care coverage.

Recent studies have shown that for the first time since world war two, life-expectancy is dropping in some areas of the country. The finding was isolated and it could be a fluke, but it is also possible that we have another canary in the coal mine situation. Rather than blame the health care industry -which is already more bloated than healthy- we should look in the mirror and face the problem. We are getting fatter, we are exercising less, we are isolated in our mansions and our cars, and despite our "enhanced connectivity" promised by cell phones and the internet, we are more often alone and lonely. To fill the void we do our patriotic duty and go shopping. We are busily consuming our way out of existence.