We don’t have a healthcare crisis in this country; we have a health crisis.
About 75% of the $2 trillion we spend annually on healthcare is spent on chronic disease, most of which could be prevented by not smoking, maintaining healthier diets and exercising.
These three lifestyle changes could prevent 40% of cancers, 80% of type 2 diabetes and 80% of heart disease. Prevention would help contain an enormous source of our spiraling healthcare costs. But much more than money is at stake here. If we continue on the path we’re on now, with our epidemic of childhood obesity, one-third of our children will become diabetics, not to mention the increased cancers and heart disease brought on by obesity. For the first time in our history, we’re looking at a generation whose members may have shorter life spans than their parents.
I know from personal experience the toll that unhealthy habits resulting in obesity can take. In 2003, I was diagnosed with diabetes. As if that wasn’t bad enough, my doctor sat me down and told me that without major lifestyle changes, I was entering my last decade of life. I was only 48! But I was digging my own grave with my knife and fork. I had tried diets before. This time, instead of focusing on losing weight, I focused on achieving true fitness and health. I lost 110 pounds, and this former couch potato is preparing for his fifth marathon.
Besides prevention, we need early diagnosis and more consistent, cost-effective management of chronic disease to save both lives and money. Right now our health system is delighted to pay $30,000 for a diabetic to have his foot amputated, but if he spends $150 for a podiatrist visit that will save his foot, his claim is denied. We have to change our coverage to avoid the catastrophic outcomes that the system now grimly dictates. We also have to waive deductibles and copayments for screenings (such as mammograms, colonoscopies and prostate-specific antigen, or PSA, tests) that lead to early detection, less-invasive treatments and achievable cures.
Americans who live healthy lifestyles should be rewarded in the cost of their health insurance (just as safe drivers get lower rates on their auto insurance). Employers should allow exercise breaks during the workday, just as smokers get time to go outside to pursue their unhealthy habit. Employers should give all workers “well leave” instead of “sick leave,” so that people aren’t rewarded for neglecting their health and penalized for staying fit and healthy.
The Democrats arguing for the disaster of socialized medicine falsely claim that the free market isn’t working. But the reality is that the free market hasn’t been given a chance. Our current employer-based system, which was originally adopted as a way around wage-and-price controls during World War II and has outlived its usefulness, doesn’t let the free market function.
The overwhelming share of the cost is picked up by the employer, while the person actually receiving the healthcare, the employee, pays a small fraction of the bill and often doesn’t even know what the total cost is. Whenever the person using something and the person paying for it are not the same, whenever something is essentially free, more of it is going to be consumed.
The employer-based system doesn’t just distort the free market our economy is based on, it makes our goods more expensive at home and less competitive on the world market. Right now, General Motors Corp. spends more on health insurance than on steel—about $1,500 a car. We have to move from an employer-based system to a consumer-based system of portable health insurance that belongs to us, not our employers, and can’t be lost when we change jobs, start our own businesses or take time off to care for children or elderly parents.
The employer-based system infringes on our basic freedoms and holds us back from living our lives the way we choose. With a consumer-based system, we have some skin in the game, some incentives to stay healthy and not take every MRI we possibly can, so that we’ll have tax-free money coming back to us from our health savings accounts.
Socialized medicine would be a disaster for the doctor-patient relationship we cherish. It would replace that relationship with a national institute that will dictate our treatment. Some procedures, such as lumbar fusion, work in some circumstances and not in others. That’s why individual determinations have to be made by patients and their doctors, why we have to be treated as individuals—not statistics.
But if the national institute decides not to cover a procedure because it doesn’t work for everyone, that determination would apply across the board. They won’t look at our X-rays and records; they won’t consider our individual circumstances. Besides lumbar fusion, other procedures likely to be refused are knee replacements and preventive angioplasty.
We must retain our personal relationship with doctors who will give us options, not be forced into an impersonal relationship with Washington bureaucrats who will take them away. We can’t own our health if we don’t own our healthcare.
We also have to adopt electronic record-keeping, which will not only reduce costs, but also reduce mistakes in our treatment.
If we focus on wellness rather than sickness, and if we move from an outmoded employer-based system to a forward-looking consumer-based system, we can maintain our state-of-the-art standard of private medical care, expand coverage and control costs.
