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The coming decision by the Supreme Court on the Affordable Care Act likely won’t make much difference to the future of America, regardless of how the justices rule. That’s because, no matter what they decide, the whole healthcare law itself doesn’t address the nation’s real health problems.
This is not a partisan position. Let me explain.
At $2.5 trillion annually, healthcare costs are America’s single biggest national expense, by far. Nothing even comes close, not the war in Afghanistan, not the Wall Street bailouts, or various entitlements. America’s healthcare bill is three times the size of the nation’s defense bill and the same size as the entire economy of Russia and India added together. The size of America’s healthcare bill is staggering and much larger than anyone knows.
We spend an average of $8,000 per person while countries like England, Canada, and Germany spend an average of just $4,000 per citizen. And their citizens live longer than we do.
It gets worse. At the current annual 6% growth rate of healthcare costs, our total healthcare bill will go from $2.5 trillion to almost exactly $4.5 trillion in 10 years. If you add the stubs of the increases over the 10-year period, above the running $2.5 trillion our debt-burdened nation already lacks, we’ll see $10 trillion in surprise new tax costs. To put this in perspective, our coming healthcare costs are three times the size of the subprime meltdown that brought America and the world to our knees. We may have survived the subprime mess, but health costs will honestly break the republic.
Here’s what blows me away: Our government reports that 70% of all these costs are for preventable diseases. Bluntly, we’re eating ourselves to sickness and death and seeing epidemic rates of diabetes, according to government studies. The Gallup-Healthways Well-Being Index finds that two-thirds of Americans are either overweight or obese. And we’re all paying about $1 trillion per year to respond to these problems rather than prevent them.
In the middle of this deadly crisis, the whole healthcare debate is focused on exactly the wrong things: on how to pay for insurance and now also on the constitutionality of a law, rather than how to prevent killers like obesity and diabetes in the first place.
I know it sounds too simple, but eating and obesity are the nation’s biggest health problems, not “Who pays for insurance?” and “How does all of this relate to the Commerce Clause?”
If our elected officials, from both parties, attacked the cause rather than the effects, they could save America. If they understood what Gallup knows -- that a focus on wellbeing will put any nation on a path to economic prosperity -- they could improve not just America’s health, but everything from jobs to the GDP. But I’m afraid we’re going to continue debating irrelevancies like how nine justices will rule…which is just shifting deck chairs on an undeniably sinking ship.
Tuesday, April 10, 2012
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8 comments:
"How does all of this relate to the Commerce Clause?" You do realize that's a debate about the constitutionality of the individual mandate and not a debate about how to be healthy right? You accurately identify obesity and preventable diseases as our problem, but dismiss the constitutional case against Obamacare, why? Those are two different questions.
Spot on Sir. Trying to make sure that everyone can see the doctor *after* they have been allowed to screw up their health sounds good, but in fact, only makes the problems worse. And one argument made in front of the SCOTUS to support Obamacare is actually a reason *not* to support it for this reason. We all, one way or another, *do* pay for even the uninsured.
Honestly, I think we are fostering a culture that not only allows such self-destructive behavior as over eating and poor nutrition (naming only a couple of our collective bad behaviors) but actually *encourages* it, since it seeks to minimize the personal consequences. Far better would be to *completely* do away with mandatory healthcare where those sub-cultures that are delusionally expecting someone else to make it "all ok" would self extinguish, while the sub-cultures that promote healthly lifestyles would thrive, thus changing the entire culture by Darwinistic Social Survival. Those that did not change would actually die and not propogate the problem to another generation, while those that woke up and changed would survive.
"At $2.5 trillion annually, healthcare costs are America’s single biggest national expense, by far. Nothing even comes close, not the war in Afghanistan, not the Wall Street bailouts, or various entitlements."
Actually, government is our biggest cost. The Federal Government will spend at least $3.7 trillion this year, with state and local governments spending at least a couple trillion more. Together, they are close to 40% of GDP, or about 2 out of every 5 dollars.
One significant thing that government and the medical industry have in common is that they are spending other peoples' money, and they have little if any incentive to economize. Given that the government controls about half of health care spending, you can expect more of the same over the foreseeable future.
It is government that will bring us to our knees.
I'm surprised that no one has commented on this yet.
You seem to be advocating a bottom-up approach to health care reform where each of us takes more personal responsibility for our health.
I'll add one more thing, something that Obamacare has completely missed. If we want to control costs and have more health care we need more health care providers. More doctors and nurses. The current approach is driving many doctors into early retirement instead.
Michelle Obama has received criticism from many on the right, like Sarah Palin, for promoting healthy eating for kids. Her critics say that she is trying to force food choices upon children and we all have the right to eat whatever we want to, without government interference.
It's also interesting that the "broccoli" analogy was used during the recent Supreme Court discussion about the individual mandate in Obamacare. The argument, used by the right, says that if you allow an individual mandate, it opens the door for Congress to pass mandates for things people should eat, like broccoli. The right is essentially saying - government, keep your hands off my cheeseburger.
The answer is the same answer that we currently have for things like alcohol and cigarettes - you have to tax bad behavior. Pass a tax on soft drinks and certain types of fast food. Put a surcharge on products that contain fat, sugar and sugar-like substances. Give people the freedom to eat anything they want, but make it more expensive to buy unhealthy food.
85% of all heath problems and strengths are inherited. In the countries you mentioned and most countries like them, the way they have children tends to gradually, over decades, cut down on these problems. In this country that is not so. We are a country where the survival of the the unfit just happens to be the way of things.Believe me this is one thing I know.Ask any knowledgeable person in genetic research. In our country a statement like this, for some reason, is thought to be somehow racial, when it is just a fact. that's why I'm anonymous. We are getting so screwed up politically we can't even hear the truth
I profoundly disagree with the priority the writer assigns to the underlying costs escalation of health care costs. As a 72 year old retired person who lives on Social security and uses Medicare, my experience leads me to conclude that the rapid increase in costs is tied directly to the ability of providers such as drug companies and equipment and services suppliers to influence the reimbursement levels the government pays. Since the governments set levels also are the basis for regular insurance company payouts the whole system is being inflated.
An example: I have sleep apnea and use a CPAP nightly. For years the mask and hose could be replaced every six months. Suddenly the frequency has changed to once every three months. You can bet I get a call from my equipment supplier every three months on the dot.
Not to mention the outrageous charge for this replacement. As a retired manufacturing manager I am very familiar with the costs to make these products. It is an absolute crime how the system is ripping off our tax dollars. This is not the only example of huge charges for equipment and drugs.
We pay the costs for government to manage and monitor the cost reimbursement system. In my opinion they are way to influenced by suppliers and do not look at actual costs and reasonable profits. I have no faith that anything will get better until we recognize the real problem and apply pressure to "get real”.
Seems the system has the profit incentive of a free market - equipment suppliers motivated to call on the dot every 3 months to sell another CPAP, whether the user needs one ofr not. But the system does not have the competition incentive of a free market, which would motivate the consumer to puruse the best price. As we can see, a system with a profit inventive but no competition incentive is a disaster. Why can't this be fixed before it is too late ?
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