Changes must occur in America over the next several years in the way healthcare is administered and in how it is funded. The Affordable Care Act represents a start, but it does not begin to address the problem. Costs are excessive but at the same time the general health of the populace requires that more healthcare needs to be administered. We eat poorly, excessively, and we don’t exercise enough or take care of our health in other ways.
Americans are increasingly in poorer health because of the way they eat. Eventually they gain weight and exercise diminishes. They eat excessive amounts of high density caloric foods, too many carbohydrates and often not enough protein. They are increasingly overweight and obese and their diet pushes them toward high blood pressure and high cholesterol both of which lead to cardiovascular problems. The obesity and high carbohydrate diets gradually leads toward insulin resistance and eventually to type II diabetes. In general, this group within the population uses a higher and higher fraction of the healthcare dollar, but it’s not a death sentence because medicine increasingly knows how to keep these people alive in spite of their tendency toward chronic illness. Continuing excessive use of tobacco products, alcohol and both legal and illegal drugs make additional contributions to ill-health and add to the costs of medical care.
Children are at particular risk as they are goring obese as well. They eat insufficient fruits and vegetables and as a result do not get the vitamin and mineral nourishment they require as their bodies and minds develop. This can not only lead to the kinds of problems noted above but also to neural deficits affecting both intelligence and affect. Hyperactivity, emotional difficulties may also result in part from nutritional deficiencies. Not all of these problems may be easily treated by the physicians as the loss of neural function at a particular stage of development may not be completely retrieved by subsequent changes in diet or by medical treatments including drugs.
Reversing these troublesome habits in the population will not be easy. Highly processed foods with additives that may improve flavor and other elements to enhance their desirability are in fact popular and are not given up easily. People also somehow believe that it is their right to overeat and to produce increasingly costly medical conditions. Recently the state of Mississippi enacted a law that would prohibit municipalities from disallowing the selling of large carbohydrate concentrated sodas as had been previously tried by Mayor Bloomberg in New York City. What makes this interesting is that Mississippi is one of the top five states in the country in the proportion of the population that is obese. Still, many of us are libertarians that do not want to be told how to behave when there is a choice.
Here are some choices to think about. First, let’s consider the obesity issue. Some state agencies and companies who pay all or most of worker’s health insurance have seen their costs rise as greater percentages of their employees enter the obesity category. Some have taken to weighing in their workers and passing on their losses to those who are taking the wrong path. To be fair some of these same agencies and companies have provided gyms or other work out facilities and nutritional counseling services. For those who are retired and obese the federal government may gradually reduce medicare payments to states consistent with the average lower healthcare costs associated with citizens who are not obese. Thus, states with higher percentages of obese citizens may find that the increased costs of medicare they have will have to be borne by the states themselves. There may be other ways to address this problem, but it is certain that change is in the wind.