Cheaper Health Care
Posted by Tom Naughton in Bad Medicine, Bad Science
(I’ll be posting this on both of my blogs, since it’s partly about health, partly about politics and current events. Pretty convenient for me, since I’m in play rehearsals and don’t have as much time to write.)
There are a lot of proposals to “fix” health care floating around, all with various cost predictions - most of which are probably about as accurate as the predictions provided by a magic 8 ball. Whatever price tags you’re seeing now, just triple them in your mind. That way, the actual cost will only be double what you expected.
I have my own proposals to address the rising costs of health care. And unlike the proposals coming out of Congress, I don’t need thousands of pages to explain them. Better yet, my proposals aren’t based on the theory that the best way to bring down health-care costs is to spend another trillion dollars or so. In fact, my proposals would actually save the taxpayers money.
Seriously, they would. And I’m not talking about the kind of pie-in-the-sky “We’ll spend billions on this program now, but it will save money in the long run” nonsense that usually comes out of Washington. (If just half of the “save money in the long run” predictions I’ve heard in my lifetime had come true, we’d be running huge surpluses right now.) Nope, I’m talking about real, spend-less-money savings.
Here’s how the federal government can realize those savings:
* Stop telling us what to eat, and admit that the earlier attempts to tell us what to eat were a mistake.
* Stop subsidizing corn and other grains.
These proposals would produce both short-term and, more importantly, long-term savings. The short-term savings are based on a principle of economics that’s so stupidly simple, even the average congressman can grasp it: if you stop spending money, you end up spending less.
For decades, the federal government has been employing people whose job is to tell us what they think we should eat. In addition to their salaries, taxpayers also pay for the dubious research they conduct and the mountains of literature they produce and distribute. I say “dubious” because the primary purpose of the current research seems to be to prove that their previous advice wasn’t actually wrong … which it was. We don’t need these people. And for reasons I’ll explain shortly, we would’ve been better off without them.
The taxpayers also foot the bill for billions of dollars in annual farm subsidies. These subsidies were enacted in the 1930s as a “temporary” solution to the price shocks and instability of the Great Depression - which apparently never actually ended. In our continuing efforts to lift ourselves out of the Great Depression, we now provide wealthy corporations like Archer Daniels Midland with subsidy payments. Same goes for “farmers” like Scottie Pippin, the former star forward for the Chicago Bulls, who without government checks would no doubt have to strap his trophies to the top of a rusty old truck and seek work in California.
But even as the country struggles to escape the effects of the stock market crash of 1929, it’s probably time to end those subsidies. And we’d be healthier if we did, again for reasons I’ll explain shortly. In the meantime, we’d save billions - instantly. Once again, for the benefit of any federal policy-makers out there: if you stop spending money, you end up spending less.
The long-term savings are based on another economic principle that’s not stupidly simple, but merely logical, so at this point we’ll probably lose any government policy-makers who happen to stumble across the blog. But here it is anyway: When lots and lots of people get sick, health-care costs go up.
I know, I know … you probably thought we’re just as healthy as ever, but the insurance companies keep jacking up their rates simply because nobody’s had the political will to stop them. The fact is, the profit margin in the health-insurance industry is pretty much what it’s always been: around 3%. (Actually, a report I saw recently said it’s dropped to about 2.2% in recent years.) Insurers aren’t creating the spiraling cost of health care; they’re just passing it along to us in the form of spiraling premiums.
We can sit in town hall meetings and shout all we want about pre-existing conditions, levels of reimbursement, co-payments, deductibles, portability, public versus private competition, and the true number of the uninsured. None of that changes the simple fact that when people get sick enough to require medical care, someone is going to pay for it.
Shifting the cost of being sick from one group of people to another doesn’t reduce the cost; it just sticks someone else with the bill. The only way to reduce to the real cost of medical care (aside from refusing to treat sick people, which isn’t a good idea) is to require a lot less of it.
We require much more medical treatment than we should largely because the federal government told us what we should eat, and by gosh, we listened. As you already know if you’ve seen Fat Head or read Good Calories, Bad Calories, the only macronutrient we consume more of now than in previous generations is carbohydrates. (We’ve actually cut back on fat, especially men.)
This didn’t happen by accident. It was the result of a senate committee on nutrition, headed by George McGovern, who believed everyone should switch to a low-fat, high-carbohydrate diet to prevent heart disease. Plenty of researchers and scientists, including the head of the National Academy of Sciences, tried to tell the committee they were wrong - but McGovern knew he was right because his own doctor said so. (With that kind of authority backing you, it’s just a waste of time to wait for actual scientific proof.)
And so, with a big push from the McGovern committee, the FDA and the USDA, the low-fat, high-carb diet became the rage. We became a nation of fat-phobic grain and sugar eaters.
Meanwhile, the federal government made it cheaper for us to eat sugar and starch through massive grain subsidies. As the old farmer told the stars of King Corn, “You couldn’t make any money growing corn if not for the government payments.” Those government payments are the reason we feed cattle corn instead of letting them eat grass as nature intended. Subsidies are the reason high-fructose corn syrup is in half the products you’ll find in the grocery store, including bread. Dirt-cheap subsidized corn is the reason for Big Gulps and endless refills at the soda dispenser.
And here’s the happy result of all that government involvement in food and nutrition: Nearly one-fourth of all senior citizens have type II diabetes. Just think of the impact on Medicare expenditures. Diabetes isn’t just a disease; it’s a driver of many other ailments, including kidney failure, blindness, heart disease, cancer and Alzheimer’s. Diabetes puts senior citizens in wheelchairs. It puts them in assisted-care facilities. And as a harbinger of health-care disasters yet to come, type II diabetes is even showing up in adolescents now. That never used to happen.
You are paying the toll for the diabetes epidemic even if you’re in fine health and have private insurance. Your taxes, of course, pay for all those diabetes-related Medicare costs - but so do your health-insurance premiums, whether you realize it or not.
You’ve probably seen media stories about hospitals charging $10 for an aspirin. Perhaps you were even outraged at the very idea. But there’s a reason hospitals put $10 aspirins on your bill: Medicare, expensive as it is, doesn’t actually cover the full cost of many treatments hospitals are required to provide. So they make up for the Medicare deficits with $10 aspirins and other exorbitant charges - all billed to your insurance.
Much, if not the majority, of our ever-increasing health-care costs are driven by chronically high blood sugar and diabetes. But diabetes isn’t like the swine flu. We aren’t catching it from each other. We don’t need to spend billions of dollars to develop a type II diabetes vaccine.
What we need is for officials in Washington to stop beating up on the health-care industry, and instead call a giant press conference to make an announcement like this:
Ladies and gentlemen, the nutrition advice we’ve been handing out since the 1970s was clearly wrong. You could even say it was dead wrong. Saturated fats are not and never have been the cause of heart disease and cancer. And let’s face it, fat is delicious. We scared you away from a taste your body loves, and we feel really stupid about that. We especially feel stupid about recommending corn-oil margarine. It tastes awful and it promotes inflammation. It’s not a natural food, despite the picture of the hot-looking Native American lady on the box.
It turns out we should have been warning you about sugars and starches all along. Those are the real problem. So please, embrace your fatty foods. Enjoy your meats, your eggs, your cheeses, and be sure to drizzle lots of butter on your vegetables. We were at least right about the vegetables. But we were totally wrong about grains. They’re not a natural food for humans, and you should try to cut back on them as much as possible.
And to encourage you to do so, we’re going to cease all farm subsidies so the price of grain-based foods will reflect the actual cost of production. We suspect a lot of corn farmers will choose to retire or grow other crops, and we wish them well.
Again, we’re very sorry, and we have all turned in our resignations. Thank you, and enjoy your dinners.
No, this wouldn’t solve the problem overnight. Millions of people are already sick. Somebody is going to pay to treat them. But we could at least prevent future generations from developing the same diseases. That alone would stop the spiral.
Then, with the cost of health care held in check by actual health, we could resume debating about who’s going to pay for the costs of treating injuries and illnesses that aren’t caused by metabolic syndrome and diabetes.
I have a feeling it would be a much more civil discussion. Lower bills tend to have that effect on people.
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