The real problem with healthcare in America

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For years, Democrats and Republicans have struggled with the politics (and business) of healthcare in America. The focus has been on health insurance — and nothing has been done to address the actual cause of high insurance costs.

The real problem starts with the root of the issue, namely health. The solution is simple. Eat right, exercise and don’t smoke.

I can see you, sitting behind your screens, laughing. You’re saying, “Troy, if it was that simple to get people to put down the cheeseburger, throw away their cigarette and actually do those workout videos they're watching on YouTube, why hasn’t it happened yet?”

Perhaps the root of the problem is all the dialogue around other ways to motivate Americans rather than address these very easy, tangible solutions to improve health.

If we can get back to basics and repeat over (and over) again, “Eat right, exercise and don’t smoke,” we can move the needle.

It’s expensive to ignore prevention. We all know health insurance is expensive because healthcare is expensive. Healthcare is expensive because as a nation we don’t eat right, we don’t exercise, and some people still smoke.

The fiscal impact of poor diet and exercise in America is staggering. The Center for Science in the Public Interest reported that in the last 30 years, obesity rates have doubled in adults, tripled in children and quadrupled in adolescents.

What were the two leading causes of premature death in 2010? Diet and tobacco.

If we ate better and exercised, our nation’s financial problems would be solved. Most of the money we spend on healthcare goes to cardiovascular disease and type 2 diabetes — “most” being a cool $245 billion. This expense is almost always associated with bad lifestyle choices (diet and inactivity) made by the individual.

Freedom is great, but people should pay for their decisions. If a car driver received multiple speeding tickets, his insurance premium would go up. This is common sense, but health insurance premiums (for the most part) do not follow this logic.

Two single people of the same age, living in the same zip code, will likely pay the same medical insurance premium even if one chooses to smoke, eat poorly and never exercise. The person who chooses to take care of their body is in no way rewarded with a lower insurance premium.

Incentivizing incentives
Some companies choose to incentivize and reward their employees with lower insurance premiums for weight loss, smoking cessation, etc. Those companies should be applauded, but there is no real incentive for better health at the national level.

The Affordable Care Act tries (operative word: tries) to cultivate a nation of better health with provisions such as the “smoker’s premium penalty.” It’s designed to enforce higher medical insurance premiums for smokers relative to non-smokers.

On the surface, this appears to make economic sense: associate the risk cost with the price. It fails because it’s simply a Band-Aid and an act of showmanship.

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In it’s first of year of implementation, a Yale School of Public Health study found that the “tobacco surcharge resulted in lower enrollment among smokers, without an increase in smoking cessation.”

The ACA smoker’s premium penalty will have no impact on saving lives or saving money. Without significant support and incentive, many states simply opted out of the smoker’s premium penalty or capped the 50% surcharges substantially lower (between 10%-40%).

Other options allow a smoker to say they are trying to quit, thereby avoiding the premium increase altogether.

The government is making us fat
The U.S. government is a major contributor to the obesity and poor health of today’s Americans. By offering subsidizes on tobacco, dairy and meat products, the Government offers a window of opportunity for these producers to lower their prices and increase consumption.

As a result, they’re perpetuating a generational cycle of poor health and increasing the damage with every generation.

The government launched national dietary guidelines and a food pyramid in the 1980s. In an article by husband and wife team Drs. Jack and Heather Wolfson on the government’s role in our nation’s health crisis, they write,

“Despite overwhelming evidence, the food pyramid advised Americans to eat the things that made them sick and to avoid the things that made them healthy. On what planet of delusion could the creators of this pyramid be from? The grain category is twice the size of the vegetable category! This planet could only be controlled by food manufacturers.”

This cycle shows no sign of changing. Our policies on scientific studies, the Wolfsons say, continually “allow studies concerning practices and health impacts to be funded and conducted by the very corporations that created them and profit from their sales.”

Within the last eight years, the most prominent and political voice on better health is Michelle Obama. When the former First Lady suggested we occasionally skip dessert or eat more carrots she was told by Republicans, “Stay out of my kitchen” and, “Don’t you have something better to spend your time on?”

The Republicans should have embraced some, but not all, of Obama’s ideas. The Republicans should have distanced themselves from some of the misguided school meal programs, but totally embraced her core message of better diet and exercise.

Overall diet education is also a problem. For decades, most television and print ads for food and drink are extremely unhealthy. Milk doesn’t do a body good. Beef should not be what’s for dinner. Do not hanker for a hunk or a slab or chunk of cheese.

The Vox article “How big government helps big dairy sell milk” explains how the dairy industry has spent billions of dollars to convince consumers that milk is the only way to get their best recommendations of calcium, potassium and protein — even though you can get the same amount from fruits and vegetables.

As a positive, popular TV shows are making attempts to debunk this misinformation and take jabs at America’s poor diet. In a Family Guy episode, Peter Griffin’s solution to cooking is to consume obscene amounts of butter. and he’s met with an instant stroke, followed by a heart attack, stroke, another stroke, heart attack — you get the picture.

Small steps forward
We have a reactive, not proactive, healthcare delivery system in America. When HSAs were first introduced, they were slow to be accepted. Most private insurance in America is sold through health insurance brokers. Initially, brokers offering HSAs were asked to do twice as much work and make half as much money.

Now, HSAs are more commonplace and have some excellent features. A free annual checkup is always part of the plan. If a person improves their health and doesn’t spend as much on medical care, they pocket the savings.

There is no fountain of youth and there is no magic pill. As Dr. Leonard McCoy said in Star Trek episode “The Omega Glory,” “… it might eventually cure the common cold, but lengthen lives? Poppycock! I can do more for you if you just eat right and exercise regularly.”

As the Ayurvedic proverb goes, “When diet is wrong, medicine is of no use. When diet is correct, medicine is of no need.”

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