22 Jun 2011
We hear a lot about health care costs these days. Expect to hear a lot more of it.
We live in a country with a rapidly aging population. In 2010, the median age increased to 37.2 from 35.3 in 2000. The proportion of people between the ages of 44 and 64 increased by 31.5% over that time period, and those over 65 grew by 15.1%. The administration on aging (part of the US Department of Health & Human Services) is forecasting that by 2050, 25.5% of the population will be 60 and older. With this aging, health care costs rose by 7.32% at a rate in 2010 – above the 1.1% overall inflation rate. According to the OECD, the United States spent $7,538 per capita on health care – double the average of OECD countries, and compares to $5,003 in Norway and $4,079 in Canada. As a percentage of GDP, the United States spends 16.0% on health care – compared to an average of OECD countries of 9.0%, and a rate of 10.4% in Canada. In the United States, there were 46.3 million uninsured people as of 2008 – that’s 15.4% of the population who had no health insurance.
The trends are not good. The population is aging. Health care costs are rising dramatically. And, the United States spends the most on health care of any country in the world – and concentrates that spending on relatively fewer people, as compared to countries that offer socialized medical care like Canada. Extrapolating those figures into the future presents a very bleak picture. It is clearly unsustainable.
Ironically, 95% of medical care is spent on treating medical disease – ¾ of which is devoted to preventable chronic problems. Which begs the question, why not focus on prevention as a cure? Incentives, of course. On a macro level, it’s much easier to sell a pill to treat a problem, rather than one to prevent something from ever occurring. As a result, R&D is less commonly invested towards prevention. On a micro level, there is virtually no short term cost associated with eating a high caloric and sugar laden beverage – nor for a high-fat, high-processed fast food meal. In fact, our bodies are trained to seek out sugar and fat to store in our bodies for when that deadly lion chases us across the urban jungle. Food costs for fresh fruits and vegetables can be many times more expensive than a fully prepared fast food meal, and are often not as readily available in many parts of the country. Cigarettes provide near term satisfaction which is easier to react to than the potential long term disease that may or may not affect any individual.
How to fight the incentives problem is tricky, but the body does provide many cues to help reinforce the idea of prevention. Anyone who is a runner knows about runner’s high. There is a euphoric and positive feeling associated with exercise. Similarly, that feeling of doing good that comes after a whole grain, unprocessed, home cooked meal is a satisfying pat on the back from your body. A diet rooted in those principles will help you feel naturally energetic without those spikes throughout the day, help you look better from a weight perspective, and leave you feeling your best. Your health is a function of diet, exercise, and genetics. You’re not going to change genetics today, but you can change your diet and exercise habits. Those two things are the principal way to use prevention as a cure. Remember the triggers and cues, and use your body as the ultimate reinforcing mechanism. Preventing disease is the ultimate cure for good health.
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