America is sick. Two-thirds of the population is overweight or obese, one in eleven people have diabetes, and someone has a heart attack every 42 seconds.
We as U.S. citizens pay for this dearly, both in dollars and in lives. Every year, more than two and a half million people die, in large part from preventable diseases such as heart disease, cancer, and respiratory illness. Four out of every ten Americans visit the hospital annually, and each citizen visits a physician an average of three times per year.
(Note: the above statistics are available on the Center for Disease Control website under FastStats.)
The yearly price tag of our healthcare is a staggering 3 trillion dollars, or $9,523 per person. And for all that we spend, we have little to show for it. Long wait times and poor service plague our treatment centers, and we are sicker, and die sooner and more frequently than in other developed countries. It is deeply troubling that our healthcare system, the most expensive in the world, consistently finds itself among the worst performing of the major countries.
What’s to blame for America’s high cost, low performance healthcare? The answer begins with a breakdown of our healthcare expenses. Administrative costs—those associated with billing, coding, and related activities—account for a whopping 25% of our healthcare spending. The United States’ administrative costs are among the highest in the world, attributable to the complex facilitation that must take place between patients, doctors, medical companies, and insurance providers under our current system. These costs have little to do with actual care, going mostly toward the business end of facilities, and have no apparent link to healthcare quality. Indeed, other developed countries, whose transactions are more standardized, have significantly lower administrative costs, yet manage to provide better care for their citizens than the U.S.
Prescription drugs are another culprit in our bloated healthcare bill. Among the many superlatives of U.S. healthcare, we are the country with the most expensive drug prices in the world. Unlike other countries, the United States prohibits the negotiation of drug prices between government entities and pharmaceutical companies, which begets price hikes and over-charging. Two recent examples of this are the raising of toxoplasmosis treatment drug Daraprim from $13.50 per pill to $750 per pill by America’s latest supervillain Martin Shkreli, and the 400% increase in the price of EpiPens by pharmaceutical company Mylan. Our patenting laws also encourage price gauging; the difficulty of getting approval for generic versions of drugs results in government-protected monopolies of certain medications—and their unjustifiably high prices.
The exorbitant costs of healthcare indicate a need for reform. In 2010, the Affordable Care Act, otherwise known as Obamacare, made some progress, but fell short of its goals of universal coverage and affordability. A more systemic revamping of our healthcare system has been proposed by various public figures, most notably by Bernie Sanders during his 2016 presidential campaign. Sanders advocates a national, single-payer healthcare system; in plain terms, a system covering all Americans, that derives its funding from a single source: the government. In doing so, the United States would join dozens of countries that already provide its citizens with affordable, universal coverage, including virtually every developed nation on Earth.
What are the benefits of such a system? For one thing, it would reap substantial savings, by virtue of cutting administrative waste, lowering hospital and physician fees, and reducing the prices of drugs and medical supplies. An analysis by economist Gerald Friedman suggests $5 trillion in savings over the next ten years, and PolitiFact projected the average family would save somewhere between $505 and $1,823 a year. This system would also guarantee comprehensive coverage, to all 318.9 million people living in the U.S. Other benefits include across the board coverage, from emergency care and medication to mental health and substance abuse treatment; easy access to all healthcare providers, without having to worry about whether or not your health insurance covers a given provider; and a much-needed separation of health insurance from employment, which would increase job mobility and allow business owners to focus on running their businesses. Most importantly, we’d improve our ability to care for people in need, offering vital treatment to all Americans regardless of age or socioeconomic status.
Overhauling our healthcare system is crucial to achieving better health in the United States. That being said, there is another piece of our health puzzle that must be addressed: the causes of our sickness. The most obvious of these is our diet. Excessive intake of sugar and fat elevates one’s risk of developing one or more chronic illnesses, such as diabetes, cardiovascular disease, and cancer. Low physical activity is also a major contributor to disease prevalence, increasing one’s risk of heart attack and stroke. Additionally, lifestyle factors, such as excessive drinking, smoking, and insufficient sleep have been linked to poor health.
Solutions exist on a personal level. Eating more fruits and vegetables, exercising, and cutting out bad habits can significantly improve one’s health and longevity. Doctors can encourage these practices, by providing nutritional information and guidance to patients before resorting to medication. Government can help in this process, too. For one thing, it can implement educational measures, such as mandatory nutrition classes to instill in kids the importance of living well. It can also upgrade its school lunch programs to include healthier options, such as more fruits and vegetables (and no, French fries and pizza sauce should not count). Finally, it could end its lopsided subsidies to unhealthy crops, such as corn, soy, meat, and dairy. Currently, each American taxpayer pays for the equivalent of twenty Twinkies a year, and only one half of an apple over the same period. If we want to address illness in America, we need to stop subsidizing junk food, and start making healthy eating more affordable.
Diet and lifestyle are at least partially in our control, but there’s another cause of sickness that largely is not: pollution. Air pollution alone is responsible for a host of health problems, including headaches, respiratory illness, and even cancer. An estimated 6.5 million people a year die from air pollution, 200,000 of which occur in the United States. Water contaminants, from heavy metals to pharmaceuticals, also jeopardize our health. In Flint, Michigan, in Newark, New Jersey, and all across the country, kids and adults are suffering from an array of problems, from ADHD to cancer, due to contaminated water. Land pollution also poses major problems, where storage facilities, waste sites, and landfills introduce toxic substances into the surrounding environment. These sites bring with them a litany of negative health effects, including nausea, birth defects, and, once again, cancer. Our government, at all levels, ought to address these problems—and it can, by implementing stricter environmental regulations on all forms of pollution, encouraging clean energy production, and increasing funding for Superfund, our federal waste site cleanup program.
To tackle America’s healthcare crisis, we must take a holistic approach. This means addressing everything from our providers and patent laws to the way in which we encourage—or discourage—health. My prescription for a healthier America is as follows: first, switch over to a national, single-payer system that treats healthcare as a right and not a commodity. Secondly, make it easier for Americans to educate themselves about, and engage in healthy eating, exercise, and lifestyle practices. And thirdly, enact policies to curb the air, water, and land pollution that contribute to America’s sickness. Implementing these measures would lessen the burden on our healthcare system, and save us time, money, and, most importantly, lives.