Monday, July 13, 2009

Health Costs and Common Sense

“The greatest threat to America’s fiscal health is not Social Security,” stated President Obama, “It’s not the investments that we’ve made to rescue our economy during this crisis. By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care. It’s not even close.”

How can we reduce these costs without reducing the quality of care?

In our last issue, we promised a look at India's cost-reduction health system.
If India can afford health care for its citizens, why not a wealthy nation like the USA?

India's health care costs amount to 5% of so of India's gross domestic product.
But, because of a "tiered-pricing" system, only a fraction of that 5% is private pay.

Wealthy patients typically pay more. The scale of health care pricing slides downward, as patients earn less and less.
The "tiered" system automatically enables the poorest citizens to be subsidized by the wealthiest.

Information Technology (IT) is an inexpensive yet powerful resource, resulting in cost reduction and improved care.
About 60% of Indian hospitals utilize Health IT, compared to only 20% use in USA hospitals.

Health IT brings instant knowledge to a case, including certified electronic health records and specific exchanges of other health data.

In India, few are insured, resulting in resourceful innovation (and often surprising strategies) to reduce per-case costs.
For example, many operating procedures have been adapted with success to lower costs.

But, we all know, an ounce of prevention is worth a pound of cure.
Prevention is a much better way than any other to reduce health care costs.
Vaccinations, nutrition, sanitation, are all important factors. Clean food and clean water are at the top of the list.

But other dangerous factors are threatening world health. One is malnutrition, as decaying economies affect the world's poor.

Starvation devastates marginal economies, with disease and fatalities rising daily.

Neither nations nor global charities can keep pace with food depletions and birth rates.

At the other end of the telescope, bizarrely so, is the worldwide trend toward morbid obesity.
In the wealthier countries, such as the USA, normal body weight among the rapidly-enlarging obese population would drastically reduce health costs. But obesity--- once thought the image of prosperity--- is also rising at an alarming rate even in historically "lean" countries as India and China.

Obesity damages cardiovascular systems.
Obesity directly causes diabetes.
Obesity cripples those who bring such levels of weight to bear upon their joints and skeletal structure. Their hearts struggle to oxygenate such a mass of flesh. Often at a very young age they can no longer work, and are given "disability" status.

No national health plan can likely afford to permanently assist the sufferers of fat-bound bodies. Many doctors consider obesity a self-afflicted condition. It remains to be seen whether the obese will form political action groups, seeking to label themselves a minority victimized by prejudice. They may be food addicts, in many cases, and need counseling as do heroin or nicotine addicts. The fact that millions are starving elsewhere is a terrible irony, when so many overindulge constantly.

Cigarette smokers bring another abnormal weight to bear upon national health systems.
Non-smokers typically feel it unfair that they should be required to pay equally into a plan that allows others to smoke, to overeat, or to damage themselves willfully in other personal ways.
Obesity and smoking are "voluntary" afflictions. Any national health plan would need to address these on a case-by-case basis.

Very expensive high-tech medical devices are saving many lives worldwide.
But, as Stephen Ubl, head of the Advanced Medical Technology Association, said, reducing health costs is "really dependent in some part on improving the overall health of the population."

Which takes us back home, to prevention by diet and exercise.
By eliminating voluntary disease-causing habits, we prove the wisdom of sheer common sense.

No national health plan can save those of us, so fortunate to have adequate food and shelter, from ourselves.

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