Long-shot candidate Marianne Williamson, a best-selling self-help author and friend of Oprah, is getting a lot of attention after her breakout performance in the second set of Democratic Party debates.
She generated the most Google searches during her two hours on stage and earned the most new Twitter followers (she already had 2.7 million).
It’s easy to make fun of her New Age flakiness. “Late Night” host Stephen Colbert joked she believed in “the goddess of light, amethyst and essential oils” after playing her opening comment that America’s “amoral economic system has turned short-term profits for huge multinational corporations into a false god.”
But during two nights of heated debate about the best way to reach universal coverage and lower costs, where moderates backing Medicare-for-more steadily attacked the liberals backing Medicare-for-all, Williamson was the only candidate on stage to address what is arguably the most important question facing America when it comes to health. Why are we so sick?
“We don’t have a healthcare system in the United States. We have a sickness care system in the United States,” she said. “We just wait ’til somebody gets sick and then we talk about who’s going to pay for the treatment and how they’re going to be treated.”
There was far more substance in her comment about the importance of preventing disease than all the other candidates offered in their plans for expanding coverage. “What we need to talk about is why so many Americans have unnecessary chronic illnesses, so many more compared to other countries,” she said. “It has to do with chemical policies; it has to do with environmental policies; it has to do with food policies; it has to do with drug policies.”
That profound insight received zero attention from pundits in the media. But if the polls are right about a large majority of Americans hungering for a leader who can bring this country together, Williamson’s message had a lot to offer.
The incidence of chronic diseases like diabetes, cancer, asthma and chronic obstructive pulmonary disease rose dramatically in recent decades. It coincided with the dramatic rise in obesity, which is now up to nearly 40% of adults, more than doubling since 1990. Last January, the bipartisan Aspen Institute Health Strategy Group, chaired by former HHS secretaries Kathleen Sebelius and Tommy Thompson, offered a detailed road map for fighting chronic disease.
One-quarter of all Americans over 18 have two or more chronic diseases and half have at least one, their report noted. Chronic disease patients account for 86% of all healthcare expenditures and their increased numbers accounted for nearly a third of the increase in healthcare spending over the last three decades.
America’s life expectancy is declining, largely because of rising deaths from alcohol, drugs and suicide. A disproportionate share of those deaths-of-despair occur in the mostly white, semi-rural communities that largely support President Donald Trump.
What’s the cure? If we want to bring down asthma rates, we need less air pollution and better housing. If we want less COPD and cancer, we need to bring down smoking and obesity rates.
If we want to bring down obesity rates, we need better food labeling, more fresh fruits and vegetables, mandatory daily gym classes in schools, more bike paths and walkable cities and suburbs. If we want to end race- and class-based disparity in outcomes, we have to lower income and wealth inequality and address the scourge of racism.
What we need to achieve any of those goals is presidential leadership—something we’re not getting from Trump with his fast-food diet and deliberately divisive Twitter feed. Relitigating the 2009-10 debate over the best path for achieving universal coverage—a necessary but insufficient condition for lowering long-term costs—won’t get us there, either.