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Baloney! It's not your fault

Fri, May 23rd, 2008
Posted in Commentary

Last week a politician in a radio interview said unless Americans change their ways the cost of health care would soon consume 20% of the GDP. The inference was our unhealthy life style is responsible for the rise in costs.

He was the second politician I had heard make this claim. The other politician, thank goodness, lost her election. A local citizen claimed his nurse wife and her coworkers often joked they would be out of a job if not for the dissolute ways of Americans. These people, apparently, believe if you and I live a good clean life we will live to a ripe old age and drop dead suddenly without ever using the "health care system".

Besides being nonsensical this is similar to the religious fundamentalists claiming AIDS is Gods way of punishing lasciviousness. It is really like blaming the victim of rape for being too attractive and causing the problem. You can't put enough lipstick on that pig to make it pass.

If these people are basing their remarks on the Center for Disease Control Study of the National Institute of Health they should analyze the data. Spurious risk factors in the study included whether the patient had annual mammograms, dental care, eye exams, pap smears, colonoscopy after age 50, ate fresh fruits and vegetables, had up to date immunizations and other factors requiring large out-lays of cash.

These things have nothing to do with life styles. Are they risk factors? Sure they are. Risk factors generated by being too poor to pay for life's little extras. These preventive measures are not covered by insurance (even if one can afford the insurance) and are beyond the means of many people.

But, you say, what these folks mean is the smoking, drinking, over eating/obesity, and loose morals of Americans are causing increased costs over other countries. Sorry, according to an American Medical Association Journal article quoting the World Health Organization, accessible on the internet, Americans were not mired in the muck of sin and excess. According to WHO Americans, among the people of the developed nations, were 5th best (least) for smoking among women and 3rd best for men.

We are 5th best for alcohol consumption per capita. We were 5th best in consumption of animal fat and 3rd lowest for total cholesterol for men 50 to 65 in the 13 nations with serum levels for cholesterol.

Are we too fat and lazy? Possibly, but you cannot drive around even a small town without seeing multiple people wind-milling themselves down the middle of the street at all hours. Obesity statistics are pretty iffy in any case.

If anyone tells you it's your fault health care costs too much or your fault because you are sick, you should be out raged. There are many reasons people get sick, family history, environment, job related factors, just plain luck and many others.

In any case, all of these arguments are straw dogs. It does not explain why we spend over $6000 per year per capita and are rated number 37 by the World Health Organization for health care. Or why we lag 12 to 25 countries in infant mortality, life expectancy, healthy life expectancy, death before age 5, and many other measures of health. Apologists and xenophobes quibble over the methods of collecting the statistics, but death is a pretty clear cut end point.

We are paying for a lot and getting relatively little for the money and it is not your fault. There are multiple reasons for the excessive costs. If this was simple even the cranky distracted politicians would have solved it by now.

There are many constituencies who have a vested interest in the status quo who will fight any change. It amazes me how an entrenched idea can be maintained by these folks in direct contradiction with their own best interests. The insurance industry is the only faction that stands to lose by fixing this problem satisfactorily. Their underwriting policies assure they will insure only people not likely to use the policies. When possible they do not reissue policies at anniversary dates to those who do use their policies.

We don't have to reinvent the wheel or copy another country's methods whole cloth. All other advance nations provide basic medical care, usually paid by general taxes, for all their citizens and by all accounts, more efficiently with much lower costs and better outcomes.

Dr. Sauer lives in Preston. He can be reached at r.sauer@mchsi.com

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