Our healthcare spending is killing us, but is our healthcare system healing us?

Per CMS, (the center for medicare services), The United States spent $11, 582 per person for healthcare in 2019, which is the highest in the world. 

 

Large companies, on average, spend at least 10 to 15 thousand dollars on health care per year for each worker. Small companies may pay even more than that.

 

But despite this high spending, the US has the worst health outcomes compared to other developed nations, with the lowest life expectancy, 79 years in 2017.  This is 5 years less than Switzerland, which has the longest lifespan on average.

 

Compared to these same developed countries, the US also has the highest rates of Obesity.

 

And the US has the highest rates of Chronic disease.

 

In the US healthcare system, the COVID-19 pandemic has revealed a deep crisis in our health care system, highlighting substantial racial and ethnic disparities, leaving people of color, and people with higher rates of chronic disease, more vulnerable to the devastation of the virus.

 

The US also uses expensive technologies such as hip replacements and MRI’s at a higher rate than most of these other countries.  And spending on end of life care and the care of chronic diseases makes up a large proportion of our medical spending.

 

In the US healthcare system, The prevalent belief is that pharmaceuticals, supplements, and interventions are the key to health and longevity.

 

Direct to consumer marketing is legal, and the advertising of expensive brand-name drugs is often cited as a factor for rising health care costs.  This increased demand for pharmaceuticals and interventions significantly contributes to driving up medical costs.

 

And in the US Healthcare system, despite years and decades of fierce debate and controversy regarding health care reform, most all of the reforms concern access, and are still just modifications to our “sick care system.” None of the reforms truly address the root causes of our problems, and would reverse the skyrocketing rates of chronic diseases like diabetes, which will continue to make our system unaffordable and unsustainable.

 

For anybody who has worked on the front lines of our healthcare system, in the ER, the dysfunction of our healthcare system is obvious.  Throughout my career in the ER, during every shift, all day long, I have seen people suffering with conditions that could likely have been prevented.

 

But with all of that said, there is actually good news and hope. 

 

There is a way to transform our health care system, and drastically cut our healthcare spending, while we  actually truly heal our population.

 

80%, or more, of all healthcare spending in the US is on chronic diseases that are almost completely preventable, (and often even reversible).  These chronic diseases such as high blood pressure, type 2 diabetes, heart disease, strokes, obesity, and some cancers plague our population, causing unnecessary disability and premature death.  But they are also the source of our surging healthcare spending, as these conditions are among the most costly to treat.

 

According to the World Health Organization, 80% of heart disease, strokes, and type 2 diabetes could be prevented with improvements to our diet and lifestyle.  Not only that, they estimate that 40% of our cancers are also preventable.

 

Lifestyle Medicine is the relatively new medical specialty that focuses on the underlying root causes of disease, and uses evidenced based lifestyle interventions to prevent, treat, and often reverse chronic disease. It was after years of practicing in the ER, that I discovered this specialty, and I continued my training by becoming board certified.

 

The 6 main tenets of lifestyle medicine are relatively simple.

1. Eat more whole plant based food. (Choose nutrient dense foods like fruits, vegetables, whole grains, nuts, seeds, beans, lentils).

2. Increase physical activity. (Aim for 30-60 minutes of moderate physical activity at least 5 times a week).

3. Improve Sleep. (Prioritize sleep to ideally get at least 7-8 hours a night).

4. Better Manage Stress. (Learn to recognize negative stress responses and identify better coping mechanisms and stress reduction techniques).

5. Avoid Risky substances. (Quit smoking and drink alcohol in moderation).

6. Nurture relationships. (Recognize that being socially connected is essential for both physical and emotional health).

 

There is a vast amount of research that supports that these lifestyle changes will not only help to prevent disease, but will also improve quality of life, and increase longevity. 

 

But yet, despite the overwhelming evidence that addressing these lifestyle factors is the key to our wellness, this is not the focus of our current healthcare system. 

 

 

In latin, doctor means “teacher.” And knowledge is power.  It is only when we are aware of how much power we have over our health, and how much our lifestyle and diet choices affect us, for better and for worse, that we can truly realize our potential.

 

If we all individually focused on improving our lifestyle, we would lose weight, prevent disease, optimize our physical and emotional health, and increase our longevity.

 

If we as a society focused on lifestyle, we could collectively decrease our rates of chronic disease by 80%, and relieve this unaffordable and unsustainable burden on businesses, on employees, and on our federal government. 

 

It is only by addressing our lifestyle first, that we could create true health reform, and this is the key and only real solution to heal our healthcare system.