Wednesday, February 18, 2009
First, improve our health
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Alice Louise Kassens
Kassens is an assistant professor of economics, specializing in health and labor economics, at Roanoke College.
Pressure is ever increasing to address the issue of the provision and financing of health care in the United States, and the answer many vocally support is a government-run and mandated universal insurance program. This is an extremely expensive venture, costing at least $100 billion to $200 billion per year. Before such a burden is placed upon our country and future generations, we should ask what is its purpose and if it will achieve its intended goal.
One would think that the overall goal of any health policy reform would be to improve health outcomes in America. To determine if universal coverage will, and to what degree it will, improve health outcomes, we need to know what is making us sick and what is killing us.
Cause of death differs substantially across age groups, gender and race, thus health policy must look to these disparate causes. For the sake of brevity, only male mortality will be addressed here.
Young males (15-24) are predominantly dying at their own hands. Death by violence and suicide account for more than 75 percent of all deaths in this group, with half of white male deaths from accidents, largely of the motor vehicle variety; half of black male deaths are listed as murders.
These statistics constitute a collection of many personal tragedies, but not ones that can be solved via universal coverage. Violence and poor decisions are killing young American men. Pouring billions of dollars into providing them with access to health care will not make a dent in their mortality rates.
For males aged 35-44, accidents are still the top cause of death, but heart disease and cancer (primarily lung) hold the next two spots. By the time we reach the 55-64 age group, these diseases become the top two causes of death, far surpassing any other cause. These diseases are largely preventable.
Two-thirds of adults are overweight or obese, and about 21 percent are regular smokers. Being overweight or obese increases the risk of heart disease and death by raising blood cholesterol and blood pressure and triggering diabetes, in addition to many other health problems. Obese diabetics are at an enormous risk for heart attack and heart disease. It is well known that smoking is the predominant cause of lung cancer, which has a 90 percent mortality rate.
While increased access to health care will aid in the treatment of trauma, heart disease and cancer, changes in behavior and lifestyle could prevent many of these diseases from happening in the first place. Instead of spending an exorbitant amount of taxpayer dollars to address the health problems caused by poor choices, Americans should be implored to serve their country by changing their ways and saving all of us a tremendous amount of money.
Rather than mortgage our children's future with a health care program that has bankrupted states that have tried it, why don't we at least couple any coverage with a cheaper and healthier approach that will improve society as well? Lawmakers should not falsely lead Americans to believe that any health care program or policy that they promote will be able to improve the health of the people without facing and addressing the true causes of many of our problems.
Put down the cigarettes, stop drinking and driving, stop killing each other, start exercising, and start eating moderate portions of healthy foods. We can all enjoy some simple pleasures on occasion, but should not make a regular habit of overindulging our personal wants to the detriment of our health.
We should all understand and act upon the notion that when we take care of our own health, we do a service to ourselves, our children and our community.
We may need to incorporate incentives for healthy living and disincentives for unhealthy lifestyles into any heath care policy if it is to have any hope of improving the health of our people. Such changes will go a long way to improving health outcomes in the U.S., something that universal health care coverage alone will never achieve.
