15 Jan From Health Care to Health

So, who wants to be sick? No one. At least no one I know, and probably no one that you know. However, we sure seem to spend a lot of time, money, policy-making, money, legislative work, money, lobbying activity, money and more money on health care, much of which seems to be spent on taking care of those who are ill. Little of which seems to be spent to keep people well. And did I mention that this involves a lot of money?

How much money, you ask? As I learned in business school, the quantifiable number can be best described as “a whole bunch.” U.S. health care spending is over 17% of GDP these days. And U.S. GDP is estimated by the government folks (http://www.bea.gov) to be almost $18 trillion in 2014. As I said, a whole bunch of dollars. And 17% of a big number is itself a big number.

As an aside, I remember 25 years ago or so, a lot of people I knew or heard speak at health promotion conferences would argue for more government spending on wellness and health promotion. They would invariably say something like, “If we bought one less B1 bomber, or one less aircraft carrier, we could provide prenatal care for all and immunize all the kids.” I wonder now if at the defense industry conferences some speaker says something like, “If we eliminated some hospitals and their CEO salaries we could buy more bombers.” But I digress.

Anyway, at 17% of the aforementioned GDP estimate, U.S. health care spending would equal $3.06 trillion. Holy cow. I mean holy mackerel. Or, holy guacamole (you pick).

Speaking of food, we are entering an era where the leading causes of death in the U.S. have moved from infectious disease to chronic disease. Much of these are preventable and caused by obesity (OK, that was a gratuitous trick to get a jump, I admit). And, we have moved the average life expectancy in this country from around 45 years of age in 1900 to around 75 years of age today. The second part of that statement is good news, but not if people live longer but spend a lot of time sick. Now, I’m not saying everyone who lives longer is sick, but I am saying that one’s quality of life will not be optimal if much of it is spent in ill health. Not to jump to conclusions, but I don’t think many people want to be ill for a long period of time, especially from a preventable condition.

Speaking of jumping (OK, I did it again), preventable conditions as mentioned above are also often a result of lack of exercise in addition to poor nutritional habits. Such habits are often “learned” in childhood. This is reflected in the alarming increase in the rate of childhood obesity over the past decade or so. Most of us could stand to heed the expression, “Eat less, move more.” Of course, it’s not that simple, but proper nutrition and exercise throughout one’s lifespan tend to help one have a better chance of delaying or avoiding certain illnesses (heart disease and diabetes are two of the big ones).

And maybe, if we can get the incentives in better alignment (see here), we’ll spend some of that big money on health, rather than just health care.

Be well.

Ed

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