A perfect storm has been brewing just over the horizon and is heading this way, bringing with it a torrent that has the power to ruin the lives of whomever it touches.The leaders of our nation have seen the forecasts and are wringing their hands not knowing what to do about it.This storm will wreak more havoc than any natural disaster in history, leaving millions of Americans sick and unprotected -- at least the lucky ones.The unlucky ones will not survive.
The name of this storm is not a common name like Katrina, Andrew or Wilma.It is called "America's Health Care Crisis."Most people are completely unaware of how big this storm is, but much like other disastrous events in our history, the day will soon come when the world as we all know it will end. Early signs of the looming storm have already begun to impact us.Just consider these facts:
- Every 30 seconds in the United States someone files for bankruptcy due to a serious health problem.According to a recent study by Harvard University, researchers found that 50 percent of all bankruptcy filings in the United States were the direct result of excessive medical expenses.
- Health care spending in the United States is more than $1.8 trillion, which is more than four times the amount spent on national defense and almost forty times the amount spend on Homeland Security.
- Although nearly 45 million Americans are uninsured, the United States spends more on health care than other industrialized nations, and those countries provide health insurance to all their citizens. In 2003, the United States spent 15.3 percent of its Gross Domestic Product (GDP) on health care. It is projected that the percentage will reach 18.7 percent in 10 years.By contrast, universal health systems in other countries consume much less of their GNP: Canada - 8.4%;Sweden - 9.1%; Germany - 8.2%; Japan - 6.8%; UK - 6.2%.
- According to the Kaiser Family Foundation and the Health Research and Educational Trust, premiums for employee-sponsored health insurance in the U.S. have risen five times faster than workers' earnings since 2000.In fact, most people are shocked to find out that Starbuck's Coffee spends more money on health care costs than they do on coffee, and General Motors spends more on health care costs than they do on steel!
- Experts predict retiring elderly couples will need $200,000 in savings just to pay for the most basic medical coverage17. Many others believe that this figure is conservative and that $300,000 may be a more realistic number.
The overall cost of health care -- everything from hospital and doctor bills to the cost of pharmaceuticals, medical equipment, insurance and nursing home and home-health care -- doubled from 1993 to 2004, according to a report from the Centers for Medicare and Medicaid Services.In 2004, the nation spent almost $140 billion more for health care than the year before.In fact, more than 15% of America's Gross Domestic Product is spent on medical care, or $6,280 per person1.That means that $15 of every $100 of our economy goes toward covering the cost of being sick in this country. According to the National Coalition on Health Care, the U.S. health care spending is expected to increase at similar levels for the next decade, reaching $4 Trillion in 2015, or 20 percent of GDP2!
It's important to remember that the money to cover these costs does not come from thin air.It has to come from all of our pockets.We all pay for these costs in the form of increased taxes and increased cost for all of the stuff that we buy on a daily basis.Consider this.Every time you spend:
- $1.95 at Starbucks for a cup of coffee approx. $.30 goes to cover medical costs.
- $10 for a movie ticket approximately $1.50 goes cover medical costs.
- $20 for a pizza approximately $3 goes cover medical costs.
- $50 for a tank of gas approximately $7.50 goes cover medical costs.
- $250 for an airline ticket approximately $37.50 goes cover medical costs.
- $1000 on auto repairs approximately $150 goes cover medical costs.
- $2500 on a plasma television approximately $375 goes cover medical costs.
- $25,000 on a new car approximately $1666 goes cover medical costs.
When you consider how many things you buy each month, you can see how quickly the cost of health care adds up!
The incredibly high cost of health care in this country could almost be justified if the enormous expense led to better health among the population, but this hasn't been the case.According to a study by the World Health Organization, the United States ranked a pathetic 15th among 25 industrialized nations based on a wide variety of health measures including infant mortality, the percentage of the population who have access to health care and the incidence of degenerative disease.The United States ranks behind the entire European Union and countries such as Cuba, South Korea, Singapore, Aruba, Greece and the Czech Republic.
To make matters worse, the current state of our medicine-based health care system actually contributes to an increase in disease and disability!There is a lot of talk about the devastation of AIDS, yet six times as many people die from medical mistakes as from HIV/AIDS.A recent article published in the Journal of the American Medical Association (JAMA) documented the danger of relying on medicine as the primary means to promote health.In the JAMA article, Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health listed the negative health effects of the U.S. health care system itself, including:
- 12,000 deaths per year from unnecessary surgery
- 7,000 deaths per year from medication errors in hospitals
- 20,000 deaths per year from other errors in hospitals
- 116 million unnecessary physician visits
- 77 million unnecessary prescriptions
- 17 million unnecessary emergency department visits
- 8 million hospitalizations
- 3 million long-term admissions
- 199,000 unnecessary deaths
- $77 billion in unnecessary costs
Many experts including the FDA agree that these statistics are a conservative estimate because of the "culture of secrecy" regarding medical error and the enormous malpractice risk that goes along with admitting error. The incredible cost and less than optimal outcome in modern health care is because we are spending too much money in the wrong place.We have focused far too much attention on exciting new drugs and therapies in the belief that it will lead to better health.But it has not.In fact, it has only served to divert our attention away from the very thing that can help us avoid developing most disease in the first place -- living a lifestyle that promotes wellness.That is not to take anything away from the incredible advances that medical research has brought to the treatment of disease.However, what our country needs is not more medicine, but rather more people who are less sick.
The high cost of health care, and the associated costs of being ill are responsible for half of all personal bankruptcies in this country, according to a study published by the journal Health Affairs.This was confirmed by an independent study done by Harvard University.This is true even though most of those filing for bankruptcy had health insurance when they first became sick!But because they either lost their coverage or because they had to pay for expensive treatments not covered by their policy, these people were left financially unprotected.
According to the Harvard study, most people filing for bankruptcy due to medical costs are middle class; 56 percent were homeowners, and 56 percent had attended some college.In some cases, the family's breadwinner was forced to take time off of work, which caused a loss of income and job-based health insurance, compounding the problem.
According to experts in the field, there are several reasons for this trend.Many employers no longer offer a full range of health care benefits, and most now require employees to pay more for coverage out of pocket, or costs are passed on to employees in the form of policies with higher deductibles.
With co-payments, requirements to pay certain percentages of medical bills and services that simply aren't covered, many people with insurance are having a harder time coming up with burdensome out-of-pocket expenses, and wind up in debt. A significant percentage of those turn to the bankruptcy courts for relief.
As quoted from a recent article, Jeff Morris, resident scholar at the American Bankruptcy Institute says, "there is a trend toward insurance being viewed as sort of catastrophic protection….The problem, of course, is it doesn't take a lot of hours at a hospital to generate a bill that is very difficult to pay."
Other health care and social science professionals were interviewed for that same article, and they agree."I think the message that we take away is, really, nobody is safe in our country. Short of (Microsoft Chairman) Bill Gates, if you're sick enough long enough, you're likely to be financially ruined," cautions author Dr. David Himmelstein, an associate professor of medicine at Harvard Medical School."We're all one serious illness away from bankruptcy."Carol Pryor, a senior policy analyst at The Access Project in Boston, has studied the issue of medical debt and its "ripple effect" on people's lives. It can ruin an individual's credit and make it difficult to obtain and pay for medical appointments, she says. And as more health-care costs get shifted to consumers in the form of higher premiums, deductibles and co-insurance, the problem is only likely to escalate, she added."The medical debt issue is interesting," Pryor said, "because it just points up so many fault lines in our system."
The Harvard University study mentioned earlier concluded that financial hardship caused by medical bills affects everyone; not just the uninsured.According to a recent interview with Dr. Steffie Woolhandler, a Harvard associate medical professor and one of the study's authors, "even the best policies in this country have so many loopholes, it's easy to build up thousands of dollars in expenses."
Even for those in the work force who have insurance, retirement will offer new challenges for maintaining health and insurance coverage, and for paying for health care.Acting now to promote better health and to prevent disease will pay dividends later in life.
I have seen people who have saved up and waited their entire lives to take their dream trip or to send their kids to college, whose dreams were siphoned away to pay for health care expenses. I have seen people who have had work injuries like carpal tunnel syndrome, neck or back pain, who have been unable to work, unable to drive and even unable to sleep without pain.Most importantly, I have seen family members who have spent thousands of dollars, consistently come to work late and leave work early, cancel plans with friends and cancel events with their children because they had to care for another family member who was sick and in pain. The impact this has on a family can be devastating and often becomes the central focus and cost for families. In many cases this happens to families who are already over-stressed, under-loved and already emotionally maxed out.
What Is Creating the Health Care Crisis?
According to the Kaiser Family Foundation, the three biggest expenses that we all incur due to America's unhealthy lifestyle is an increase in costs in hospital care, physician and clinical services, and prescription drugs.It is important to remember that these costs are not the cause of the health care crisis in our country.They are merely a symptom of the problem; a measure of how severe the problem has become.
Hospital care currently makes up the largest chunk of the health care pie, accounting for about one-third of the $1.8 trillion national spending on health care. Hospital spending has been rising rapidly for the past five years, contributing to the fastest rise in health insurance premiums in a decade.Charges have gone up quickly in recent years and often bear little relationship to the actual cost of services. "It's not unusual for a hospital's billed charges in a market to increase 25% to 30% in one year," says John Bauerlein, senior partner Milliman USA, a firm that tracks health care spending.
But even more important than the increase in price for services provided, the fact is that more people are having to be hospitalized for being sick!According to a report from the American Hospital Association, the most important source of growth was volume -- more people using more hospital services.In fact, the total national spending on hospital care rose a whopping $84 billion in just four years between 1997 vs. 2001 -- more than half of that increase was simply from more people being sick19.
Physician and Clinical Services
Next on the list of the biggest expenses are pysician and clinical services, which makes up about 22% of our total health costs20.These are all the times that we go to see a doctor when we aren't admitted to the hospital.Just like with the increase in utilization of hospital care, the majority of the increase in physician and clinical services is also due to an increase in the demand for services.More people are sick.
Another one of the largest contributors to rising health care costs is the price of prescription medications and our enormous appetites for these drugs.Americans comprise only 5% of the entire world's population, yet we consume one-half of all the prescription drugs manufactured world-wide; more than 3 billion prescriptions each year.Five out of six persons 65 and older are taking at least one medication and almost half the elderly take three or more, according to the U.S. Department of Health and Human Services' annual check-up on Americans' health.Drug expenditures have been the fastest growing segment of health care spending in this country, rising by more than 15 percent every year since 199820.
To put this in perspective, according to Pulitzer Prize winning journalists Donald Barlett and James Steele from the New York Times, "In 2002, New York-based Pfizer Inc., the world's largest drug company, reported return on sales of 28.4 percent. That was two and a half times better than the 10.7 percent return of General Electric Company, perennially ranked as America's best-managed business. It was nearly nine times better than the 3.3 percent return of Wal-Mart Stores, the country's largest and best-run retailer. And it was nearly thirty-two times better than the 0.9 percent of General Motors Corporation, America's largest car manufacturer."
The pharmaceutical industry has done a masterful job at convincing people that drugs are intended to save lives and cure disease.But if prescription drugs were the answer to health, then we would have the healthiest nation in the world.In spite of our immense drug consumption, however, the general population is getting heavier, the rates of diabetes, heart disease and cancer are rising, and we have one of the highest infant mortality rates in the civilized world.
This severe over-reliance on drugs is hastening the death and disability of most of the public.People believe they are "doing something" about their health issues by taking drugs when the underlying challenges " what caused the disease in the first place " are actually being ignored and therefore left to fester and expand.Simultaneously, of course, the revenues of the drug industry continue to increase, meaning ever-fatter checks for all who are directly and indirectly on their payroll, and ever-more money spent on marketing and lobbying efforts.
And those marketing and lobbying efforts are worth it. The top selling drugs are consistently manufactured by the drug companies who invest the most on marketing. Lobbying efforts have been so effective that Congress allows pharmaceutical companies to charge Medicare whatever they want; Congress willingly forfeited its right to negotiate drug prices for Medicare recipients.
The pharmaceutical industry continues to do whatever it can to protect its profits by prohibiting importation of drugs from foreign countries including Canada, claiming that importation of drugs may be dangerous. When asked about why Canada is able to receive such favorable rates compared to America, they explain how Canada has negotiated better rates and how it is America's duty to continue paying such exorbitant fees for supposedly life saving medications because otherwise, drug companies would not be able to afford to continue research and development efforts to search for the next miracle cure.Their emotional appeal to the public has worked and so have their vast lobbying efforts.But if you know better, you can help stop the insanity, help save money and help save lives.
It is certainly fair to say that there are times when traditional medicine can do amazing things, especially in treating trauma and infectious disease.America has the world's foremost experts at high-tech interventions and there are certainly many well-intentioned, honest medical professionals.But for promoting health, traditional medicine is ineffective and extraordinarily expensive. As wellness expert Dr. Mercola states: "It is indisputable that our current system has enormous benefit and value in the treatment of acute medical emergencies that require the use of trauma centers, skilled surgeons, and intensive care units to help repair us when we are injured. When this system is applied to chronic degenerative health conditions that comprise more than 95% of the health problems it becomes a miserable failure."
Soon, this brewing health care crisis will be worsened by a flood of retiring Baby Boomers whose medical expenses, if current trends continue, will be large enough to bankrupt the country.The conventional medical paradigm has been a destructive influence in our culture, promoting disease by pinning all focus on treatments to combat the symptoms of existing illness, while virtually ignoring prevention and wellness.
Why Current Health Care Solutions Won't Work
There is no longer any disagreement among policymakers, government officials, corporate executives and business owners that the cost of health care must be brought under control.But there is much disagreement on how to best address the problem.Some favor price controls and imposing strict budgets on health care spending.Others believe free market competition in the private sector is the best way to solve the problems.But these so-called "solutions" only focus on rationing the availability of health care to the average person, and have no affect on improving the health of the population as a whole.
Among policymakers and opinion leaders, there's little dispute that the nation's employer-based health insurance system is flawed and vast agreement that something needs to be done to help the more than 45 million Americans who lack insurance coverage.But that's where the consensus ends and philosophical divisions begin. To ameliorate the problem of medical bankruptcy, the authors of the new research argue for a national insurance system divorced from the existing job-based insurance model.
Others favor targeted, incremental fixes. The Bush administration, for example, proposes making greater use of health savings accounts and allowing businesses to band together to offer health insurance coverage through "association health plans."
"That's part of the solution," agreed Grace-Marie Turner, founder and president of the Galen Institute, a research organization that promotes free-market ideas in health care. She also endorses the Bush plan to allow people to buy insurance across state lines.
"It's just so important that people have more choice to buy the kind of insurance they know protects them,' she said.
Former House Speaker Newt Gingrich also has a vision for reforming health care. In Saving Lives & Saving Money: Transforming Health and Healthcare, he and co-authors Anne Woodbury and Dana Pavey propose, in part, a national reinsurance pool to spread the risk of insuring people who incur extremely high medical costs.
"It's another something to try that is more aligned with the American value set,' said Woodbury, chief health advocate of Gingrich's Center for Health Transformation in Washington.
But proponents of a national health system disagree. Health savings accounts, which are tied to high-deductible health plans, have the potential to skim away affluent, healthier individuals, leaving sicker people in traditional health plans and putting them at risk of higher premiums, Pryor said.
Meantime, Himmelstein suggests Canada's low rate of medical bankruptcy is the result of a better medical and social insurance system. Every other developed nation has solved the problem, he asserted.Why should Americans have second-class health care?
We Need More People, Less Sick
While all of these numbers are big and impressive, it's important to remember that these health care costs are not the cause of the health care crisis.They are merely a measure of how severe the health care crisis really is.The reason why the health care crisis exists is simple, there are too many sick people.
As simple of a statement that is, it communicates a real truth about the source of the problem.Any proposed solution to the health care crisis that does not specifically lead to more people being less sick is doomed to failure.Just like changing seats on the Titanic, it can only, at best, delay the inevitable.
There is an old saying that nothing good in life comes free.This is true when it comes to your body as well.Living a wellness lifestyle requires you to be a proactive agent for your body.You need to treat it well and not wait until you hurt before you decide to take care of it.Health is not merely the absence of disease any more than wealth is an absence of poverty.Health is not simply "feeling fine," for we know that problems may progress for years without causing any symptoms whatsoever.For example, heart disease often progresses unnoticed for many years before it rears its ugly head.In fact, the first symptom that many people experience with heart disease is a heart attack or death.
I work hard to get people to understand that it is much better to prevent disease from happening in the first place than try to treat it once it occurs.By creating a state of optimal health within your body, you will feel better; have more energy and an increased quality of life.You will also reduce your risk of the expense and pain associated with getting hooked into the downward spiral of disease and dependence on more and more prescription medications.
The main ideas that I really want to drive home in this book are: 1) illness causes bankruptcy in every way -- financially, emotionally, professionally;2)there is not enough money in the world to cover the expenses for treating the illness of a population that makes poor lifestyle choices;3)we don't need more or better treatments to solve our current health care crisis, we need more people less sick;4) each of us has a responsibility to ourselves, to our families, and to our nation to take care of ourselves by making healthy lifestyle choices every day.
Each of the book's sixteen chapters covers important topics that are relevant to your health.You will learn how the major diseases -- heart disease, cancer, diabetes, and obesity -- are largely the consequence of poor lifestyle choices, as well as the pillars of health that will lead to a lifetime of wellness -- alignment, nutrition, exercise,healthy thinking and other critical components to your overall health.Finally, you will learn about the importance of having your own hand picked wellness team to help you build up a rich reserve of health to carry into your future.
In this book I want to share with you the best and latest information on creating a life that can provide you the ability to make choices to help you age gracefully and to look and feel your very best. It has been my experience that people who are free from chronic pain, are active and feel their best are the people who tend to be happiest with themselves, nicest to others, are best able to contribute to their employers, families and communities. They have the most rewarding relationships and spend the least on medical expenses. It is this combination of factors that I have seen makes people RICH.
1. Smith, C., C. Cowan, A. Sensenig and A. Catlin. "Health Spending Growth Slows in 2004." Health Affairs 25:1 (2006): 186-196; Zhang, X. et al., "Cost of Smoking to the Medicare Program, 1993,' Health Care Financing Review 20(4): 1-19 (Summer 1999); L. Miller, et al., "State Estimates of Total Medical Expenditures Attributable to Cigarette Smoking, 1993' Public Health Reports 113: 447-58 (September/October 1998); Office of Management and Budget, The Budget for the United States Government - Fiscal Year 2000, Table S-8, "Tobacco Legislation,' at page 378.See, also,
CDC, "Medical Care Expenditures Attributable to Smoking -- United States, 1993," MMWR 43(26): 1-4 (July 8, 1994).
2. Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006.
U.S. Bureau of the Census data re 101.04 million households in the United States,
http://www.census.gov/population/www/estimates/housing.html.U.S. Internal Revenue Service re portion of all U.S.
federal tax revenues paid by households, http://www.irs.treas.gov. Economic Research Service, U.S. Department of
Agriculture, Tobacco Briefing Room, http://www.econ.ag.gov/Briefing/tobacco. Leisticow, B.N., et al., "Estimates of
Smoking-Attributable Deaths at Ages 15-54, Motherless or Fatherless Youths, and Resulting Social Security Costs in
the United States in 1994," Preventive Medicine 30: 353-60 (2000).
17. Fidelity Investments, Press Release, 06 March 2006.
18.Bernard, D. and Banthin, J. Out-of-Pocket Expenditures on Health Care and Insurance Premiums among the Nonelderly Population, 2003. Statistical Brief #121. March 2006. Agency for Healthcare Research and Quality, Rockville, Md. http://www.meps.ahrq.gov/papers/st121/ stat121.pdf
19.American Hospital Association News. February 24, 2003.
20. National Center for Health Statistics Health, United States, 2005 With Chartbook on Trends in the Health of Americans.Hyattsville, Maryland: 2005