The U.S. healthcare system ranks dead last when compared to nine other high-income nations with greater rates of death and disease and lower life expectancy. Our system achieves this dubious distinction at twice the cost of healthcare per capita in those other countries.
The structure of the U.S. healthcare system can claim a large share of credit for this predicament. Somewhere between 25% and 33% of health care providers are ‘for profit’ entities. Their financial bottom line is their top priority. More than 80% of providers in the rehabilitation and long-term care markets are ‘for profit’ entities. However, non-profit health care providers, an estimated 60% of the market, are also dedicated to revenue generation via treatment of patients with various illnesses.
There is an alternative model. Intermountain Health of Salt Lake City demonstrated that healthy lifestyle habits can reduce the utilization of medical services by half. The Utah model would rationally seem to be the goal if U.S. health providers prioritized health and wellness above profit and revenue.
It is unfair to accuse health care providers with greed. They operate in a system that has evolved over decades without deliberate design. In December 2024, UnitedHealthcare CEO Brian Thompson was murdered in midtown Manhattan. The CEO of Thompson’s parent company lamentably remarked, “We know the health system does not work as well as it should, and we understand people’s frustrations with it. No one would design a system like the one we have. And no one did. It’s a patchwork built over decades. Our mission is to help make it work better.”
Work better, indeed! The public and millions of individual citizens must deal with the consequences of a chaotic system that often denies coverage for needed treatment. There are, however, other grave consequences to manage. If healthcare providers are not going to fill the role of champions for prevention, who will?
Advocates for prevention have other problems to confront. The U.S. has 4.5% of the world’s population but contributed 17% of global deaths due to the Covid virus – almost four times our proportionate share. Ichiro Kawachi, Chair of the Dept of Behavioral Sciences at Harvard Chan School of Public Health made this observation: “Many public health theories assume that humans are rational, and we’re not. Our thought processes are automatic. And our behaviors are ruled by emotions, including the emotional states that advertisements create.”Many communities across the country supported a culture in which people believed that the Covid vaccine was more dangerous than the virus itself. And some of those people bid a tearful good-bye to their children through a glass panel.
Most people in the U.S. know that regular physical activity can prevent many chronic illnesses. The Pointer Study sponsored by The Alzheimer’s Association concluded that 45% of Alzheimer’s cases are preventable. Regular exercise plays an important role in that equation. Yet only one in four U.S. adults meet the recommended standard for physical activity.
Readers need to take away one primary lesson from this article. There is no current champion for prevention. Individuals must step into the role of health advocates for themselves. Public health schools and state and local health advocates must recognize that they are the best institutional candidates for promoting the prevention agenda.
Our cardiovascular and endocrine systems derive tremendous benefit from healthy lifestyle behaviors. However, the most important reason to stay active and eat well is our brain. Recent assessments peg the risk of contracting dementia at 42% for adults over 55. We must tilt the odds against that predicted outcome.
Given the current state of our healthcare system, it’s important for individuals to create and embrace a prevention strategy themselves.
Dr. Richard Houston is an active and curious ‘senior’ who strives to get outdoors for a brisk walk daily. He is a graduate of Brown University and earned advanced degrees at Clark University. He was licensed by the Massachusetts Board of Psychology in the early 1980’s. Personal consultations are available via Resilient-Aging.net.
This article was originally published in CHOICES For Fifty Plus, a Dubuque area magazine for people that are 50 and older. Single copies are available at Dubuque area newsstands or click here to read the digital version of the latest issue.
Read Julien’s Journal, CHOICES For Fifty Plus and Tri-State Home TRENDS from the Comfort of Your Home!
Click Here or call 563.557.7571 for convenient delivery to your home or business by mail of all three magazines for one low subscription price.
Comment here