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Editorial MAY
2009
Health Care Crisis: Another Bailout
Patricia J. Sulak, MD
It seems like we are currently in “crisis” mode with “bailout” as
the answer: housing crisis, banking crisis, unemployment crisis, and, yes,
a health care crisis. We hear the often quoted
“47 million uninsured.” In fact, my son (who is in graduate school)
recently turned 25 and had to be taken off our family insurance plan. He wanted
to
go without insurance for a few months until he was able to get a job that
offered health insurance as a benefit, but we convinced him that was not a
good idea.
I just read that economists estimate it will cost $1.5 trillion to “fix” health
care. Now, understand: I’m old enough to remember when a million dollars
was an amazing amount of money, so a trillion is pretty mind-boggling. I must
admit, though, I am becoming desensitized to multiple trillion dollar bailouts,
just as teens have become desensitized to sex and violence in the media (but
that’s a topic for another editorial).
Yes, the cost of health care is a significant percentage of the GNP, but from
where are those costs arising? No one at the “bailout” level in
our government seems to be focusing on the fact that some of the major money-consuming
health issues are self-induced: obesity, dietary indiscretion,
sedentary lifestyle, tobacco use, multiple sexual partners, and adolescent
sex.
Heart disease and stroke are major killers, and their greatest risk factors
are obesity (caused by sedentary lifestyle and dietary indiscretion) and tobacco
use. The incidence of obesity in this country is downright disgraceful (as
my father would say). What percentage of degenerative joint disease is worsened
by obesity?
To most people’s surprise, the number one cancer killer of women is
not breast cancer—it’s lung cancer! The majority of lung cancer
is, of course, caused by tobacco use, which is also linked to other cancers,
including bladder and cervical cancer.
Multiple sexual partners and
teen sexual activity are costing billions due to the consequences of unintended
and/or teen pregnancy, sexually transmitted diseases, and associated socioeconomic
ramifications that are often long term, if not lasting a lifetime. The benefits
of healthy lifestyles, such as routine exercise, Mediterranean-type diets,
maintenance of ideal body weight, and delayed onset of sexual activity for
adolescents, cannot be ignored or argued.
It seems today that everyone wants a “bailout.” Let’s bail
out the banks that made poor lending decisions; the insurance companies (AIG)
that tried to redefine, unsuccessfully, the accounting balance sheet; the
people who bought more than they could ever pay for; and yes, those who would
rather try to fix the problems induced by their unhealthy behaviors than lead
a healthy lifestyle in the first place. When is disease prevention going to
be the response to our current health care crisis? It seems the health care
bailout is not much different than the current economic bailout. There are
those who worked hard, made money, paid their bills, saved, lived within their
means, and denied themselves many luxuries, rather than financially overextending
themselves. There are also many people who do try their best to eat healthy,
exercise, and abstain from health risk behaviors. Those who have “done
it right” will have to bail out those who have not.
Now, please understand, I
realize bad things can happen to good people. There are many health disorders
that have no connection to unhealthy behaviors and occur in people who seem
to lead the healthiest of lives. Unfortunately though, if
we add up all the people in the United States who are overweight, smoke, do
not exercise, and participate in indiscriminate sexual activity (particularly
adolescents), then we are talking about millions of US citizens and yes, trillions
of dollars over time.
While there are other problems that can be debated, such as costly diseases
that need enormous expenditures for research and treatment, and problems with
the distribution of health care, the potential cost savings from reducing
health risk behaviors is a given. I think this is
definitely the time for “change” and implementation of programs
that will benefit our children, rather than add to the enormous financial
burden being placed
on their shoulders. The often quoted “Just Say No” advice needs
to extend to more than
just drug use, but also to overeating, smoking, indiscriminate
sex, and physical inactivity. It is not our “right” to participate
in these activities: it’s our responsibility to avoid them for a better
future. Let us respond to the health care crisis with responsible ideas that
will actually lead to a healthier America.
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Patricia J. Sulak, MD, Associate Editor |
