When it comes to the healthcare debate in Congress and the Senate, the main questions practically always relate to insurance. The cost of insurance, the difficulties in attaining it, and the issues relating to government spending:they are important questions right now, but are they the right ones?
As important as having the right insurance is, factors that are even more crucial are at play. Everything from the food we eat to the way we drive affects our health, yet Washington ignores these problems, or so it seems.
The Public Health Crisis
In “The American Health Care Paradox,” Lauren Taylor and Elizabeth Bradley point out that per-capita spending in the U.S. is well above that of any other nation in the world. Yet, despite this level of expenditure, America falls well short in terms of results; notable areas of underachievement include maternal and infant mortality, infant birth weight, and life expectancy.
The key question is,”What are the lowest cost public health interventions capable of improving the health and lives of Americans?” The great anti-smoking campaigns remain one of the greatest examples of “bang for your buck” public health initiatives of all time. In 1964, Luther Terry, then the United States Surgeon General, concluded that there was overwhelming evidence to support the idea that smoking caused lung cancer and a variety of other illnesses.
In the half century since, the anti-smoking program has prevented the premature deaths of up to eight million Americans. In fact, tobacco control efforts added up to 20 years to the lives of one-time smokers who quit. The campaign included advertising limits, age restrictions, cigarette taxes, and a cut in advertising time. Going forward, here are four other areas that could benefit from a similar crusade.
1.The Obesity Epidemic
The issue of obesity is now an “epidemic,” and it is now technically an illness, which might not help matters one iota. The stats published in 2016 by the CDC are frightening:
- Over 36.5% of adults are obese
- Conditions related to obesity include type 2 diabetes, several types of cancer, stroke, and heart disease
- As of 2008, the average medical cost of obese individuals is $1,429 more than someone of “normal” weight, per annum.
- In 1960, the average weight for an American male was 166.3 pounds; today, it is 195.5 pounds(the average weight for an American female today is 166.2 pounds, practically the same as it was for men in 1960)
- Over 2/3 of adults are either obese or overweight.
There are many reasons for the problem: the dependence on automobiles, the lack of exercise, and most pertinently, the issue of what we eat. The biggest problem is not the relative expense of healthy food; it is the low cost, easy availability, and convenience of junk food.
The CDC looked at statistics surrounding subsidized food from 2001 and 2006. It determined that when compared to groups of people that ate the least amount of subsidized food, those who ate large amounts were 37% more likely to end up obese. These foods include soybeans, corn, and rice,but not in their whole food form. Instead, they are refined and converted into sweeteners. Back in the 1930s, we spent 25% of our disposable income on food. Today, that figure is just 10%, and cheap, mass-produced processed foods are to blame.
There are different ways to tackle the issue. Perhaps the introduction of a sugar tax will help. Another good idea is to provide families with the means to provide their kids with healthy, nutritious foods. After all, good eating habits begin from an early age.
If you even have a cursory interest in national news, you’ll know all about the lead crisis in Flint, Michigan. The Flint Water Crisis began in earnest in 2014 when high levels of lead in the drinking water affected over 100,000 residents; low-quality water treatment was the culprit. While the water quality has returned to acceptable levels, the crisis resulted in the deaths of 15 people.
Unfortunately, Flint is not an isolated incident. The EPA says that 41 states have had higher than the acceptable limit of lead in their water supplies in the last three fiscal years. According to Reuters, over 3,000 communities have lead rates over double the level in Flint at the height of its crisis. In 2015, dangerous levels of lead exposure affected over 3.9 million Americans.
According to Casey Dinges of the American Society of Civil Engineers, failure to increase investment in affected areas will risk $400 billion in the nation’s GDP, 700,000 jobs, and $500 billion in personal income by 2020. One of the best ways to tackle the problem is by removing lead paint and lead from water lines, soil, and houses. Lead paint hazard control alone will cost at least $11 billion but would save the economy anywhere from $17 to $221 for each dollar we spend.
3. Better Housing
The United States is among the richest nations in the world, but in 2011, 874,000 people died from “poverty.” According to Science Daily, over 4.5% of all deaths in America relate to deficiencies caused by poverty, including poor housing. This figure is higher than fatalities related to cancer or heart disease.
People that live in homes with no air conditioning are at greatest risk from heat stroke, asthma, allergies, heart disease, and heat exhaustion. The CDC says that 675 people die annually because of an inability to get out of the heat for even an hour. Better quality homes with improved ventilation and air conditioning can reduce asthma attacks and help individuals suffering from chronic asthma. It also greatly helps the nation’s homeless population.
4.Reducing Automobile Accidents
Although cities across the U.S. are desperately trying to change driving rules and redesign streets with the goal of cutting down on traffic accidents, they are not yet succeeding in this fight. Last year was the worst year on American roads in almost a decade with 40,000 deaths, a 6% increase on 2015, and a 14% increase on 2014. One way to reduce deaths on the road is to increase penalties for DUI, speeding, texting, and other dangerous traffic offenses.
All of the public health interventions described above will significantly improve the lives of Americans. While every solution requires a significant upfront investment, America’s health care spending is inefficient to the point where there shouldn’t be a trade-off. One idea is to allow Medicare to negotiate drug prices and spend the savings on anti-obesity measures.
Another idea is to increase and properly enforce the fines given to insurers that fail to provide adequate insurance and use the money for better social housing. The point is that there are many ideas capable of raising funds for these worthy programs; instead of arguing about insurance, perhaps our government officials should look at public health instead.