By Dan Carmody
Special to the Michigan Citizen
The United States leads the world in the amount invested in health care. Nearly 20 percent of our economy is devoted to health care with the next closest — the Netherlands — coming in at about 12 percent. The return from this investment is remarkably poor. Our life expectancy as a nation continues to decline in comparison to other countries ranging anywhere from 31st to 55th on a variety of recently published indexes.
In large part, this high-cost/low-results system has been driven by a focus on cure rather than prevention. We have sought exotic and expensive cures to health problems rather than improving the underlying conditions that promote wellness.
Rather than a national debate on how to improve our national wellness we are in the midst of one of the most acrimonious debates in our history, shutting down government and threatening secession, because of an attempt at reforming a system that is obviously broken.
The Affordable Care Act (ACA) begins a process to push a system from its emphasis on cure to one based more upon prevention. Honest debate about the impact of what the ACA will achieve is needed. It is extremely complicated legislation and the mountains of rules it has spawned will lead to unintended consequences that will need refinement.
The heart of ACA concerns itself with the long overdue need to extend health insurance to those who have not been covered. More fairness in how we pay our collective medical bill is important, but we need to keenly focus on how to reduce the enormous size of our collective medical bill.
We certainly can’t afford our current system, and whether the ACA goes far enough to reduce costs by incentivizing prevention is unclear.
Recent events in Washington indicate depending upon our national government to solve tough problems is not prudent. Real change is more likely within our families and local communities. A recent column by Mike Roizen, chief wellness officer of the Cleveland Clinic provides a great example from Camden, New Jersey:
Dr. Jeff Brenner was recently awarded a MacArthur Foundation grant for his work as executive director of the Camden Coalition of Healthcare Providers (CCHP), an organization that seeks to improve the quality of care delivered to vulnerable populations in Camden.
He found one percent of the patients in Camden were responsible for 30 percent of hospitalization costs. These patients have complex medical conditions and often lack social services such as transportation or knowledge about how to use the health system most effectively. CCHP has been able to lower costs in a prototype program by proactively working with these high utilizers prior to an emergency event.
Perhaps the most effective way to reduce health care costs are to reduce the stress, diet and inactivity related to chronic diseases accounting for up to 70 percent of total health care costs. In many ways, the most important contribution we can all make toward improving national wellness is to eat better.
More than finger wagging and nanny-state-ism, this is an opportunity for many of us to be more deliberate about the food we eat and for each of us to define what eating better means. This is an incremental approach, which doesn’t require completely changing our diets just taking a step or two at a time to eat better.
Oct. 24 is Food Day in the United States. Celebrate it by thinking about food and make decisions that are both delicious and nutritious.
Dan Carmody is president of Eastern Market Corporation in Detroit. He is also a member of the Detroit Food Policy Council.