The Compounding Demographics Of Health Care
The Baseline of Health® newsletter is not a political newsletter. It's a health newsletter. Nevertheless, politics plays a role in health. Decisions made and implemented by politicians determine our choices in health care, including how much access we have to alternative health care -- or to health care in general, for that matter. With that in mind, it is hard to ignore the presidential campaign now underway in the United States. In this one campaign, we can see the entire gamut of health care options on display. So, without endorsing any candidate, I would like to make some observations on their stated positions on health care and what those positions might ultimately mean to you. As you will see, I am totally non-partisan in believing that they are all writing checks that cannot be covered.
One thing that all the candidates agree on, and not just in the United States for that matter, but all over the world, is that current health care systems are in trouble. The one thing none of them agree on is how to fix it. All of the variations, however, fit into one of four camps.
- Some form of universal health care funded entirely by the state and taxes
- Some form of universal health care, requiring a heavy mix of state involvement and citizen and corporate mandates
- Tweaking the free market system of private health care
- Doing nothing and hoping that it all just goes away -- or at least doesn't get critical as long as you are in office
Most of the world is in the first camp -- the state takes care of everything. Most of the Democratic candidates lean in that direction, but political reality says they can't go that far. Instead they opt for a mix of state involvement, along with mandating that corporations and individuals who can afford to do so participate in the insurance pool, thereby helping to subsidize it. The Republicans, on the other hand, eschew universal health care as socialist heresy and, instead, look to refine the free market model. The intent is to lower costs so that the system can afford to cover more people, and that more people can afford to opt into the system. As for Ron Paul, the libertarian leaning Republican candidate, he believes that government should totally remove itself from health care and allow people to make their own choices -- without limitation.
In its current form, the debate, not only here in the US, but worldwide is being framed as coverage vs. cost -- in other words, who gets covered and how much does it cost (or more accurately, how do you pay for it). But truth be told, coverage and cost are largely red herring issues. As we will see, the one overriding issue (and it is the issue no politician wants to address) is "compounding demographics." But before we explore this issue, let's return to the problem at hand.
In the US, as elsewhere, the immediate problem boils down to not enough dollars to provide all of the required health care in a timely manner. The simple reality is that one of those components is going to get short changed. In the universal health care model, as seen in Europe and Canada, with everyone being covered for everything, what gets lost is timeliness. Patients often have to wait many, many months for simple surgeries. The standard answer is to throw more state money at health services -- unfortunately, with questionable results. ( Great Britain, Canada, France)
In the current United States model, you can get timely health care if you pay for it -- not so much if you can't. At the present time, there are some 47 million people in the United States who have no medical coverage. So the question remains: how do you get them covered and pay for that coverage without breaking the bank (as in the European social model) -- considering that the system is already severely in the red and already costs twice as much per person as it does in the European model? The Democrats' answer is to mandate universal health coverage and to save money by the proverbial "cutting of costs" and forcing employers and healthy individuals to step up to the plate. In other words, pass the costs down to the consumers so taxes won't have to be raised…and we'll all live happily ever after. To be fair, Barack Obama's plan only calls for mandating health care for children -- initially. Incidentally, the only state to run a universal mandate so far, Massachusetts, has seen health care costs soar. (For a side by side comparison of the leading Democratic candidates' positions, check out http://images.huffingtonpost.com/bluchart1.pdf.)
All of the Republican candidates, on the other hand, adamantly oppose the principle of mandated universal health care and, instead, look to control costs and encourage the free market to pick up the slack. Issues of fairness and of taking care of the uninsured don't enter into the equation. That would be an imposition on the free market. Instead, they all have variations on a plan to force costs lower so that more people can "afford" to purchase their own insurance. This, of course, is as silly as the Democratic plans. I mean when is the last time that you've seen the cost of health care actually go down in the last 20 years. (For a side by side comparison of the leading Republican candidates' positions, check out. http://images.huffingtonpost.com/bluchart3.pdf.)
Ron Paul, the odd man out in the campaign, instead talks about throwing it all out and not even starting again. He sees almost no role for government in providing healthcare. I'm not sure that's either practical or generous. However, his position on the use of dietary supplements is spot on and should be adopted by every politician in every country in the world. Here is an excerpt:
- The real issue is not whether supplements really work, or whether FDA drugs really are safe. The real issue is: Who decides, the individual or the state? This is the central question in almost every political issue. In free societies, individuals decide what medical treatments or health supplements are appropriate for them.
Interestingly enough, all of the above arguments are not exclusive to the United States. Tony Blair, for example, tried to increase competition and free choice in Great Britain's National Health Service to improve health care quality and reduce costs. But that approach has been overridden with the usual, let's throw more money at it and see what happens approach. In any case, when it comes to health care in the US, voters this year are being offered some very different options -- although, I submit, none of them are workable.
So what is my problem with all of these positions?
It's compounding demographics. No amount of tinkering and funding can stop the inevitable train wreck barreling towards us -- without a major paradigm shift. How can any health-care system survive up to half its population living for 20--30 years with severe diabetes (as predicted by the CDC), let alone the other half suffering from cancer, heart disease, osteoporosis, Alzheimer's disease, and MS? There isn't enough money in the world to cover it. Quite simply, the sicker a population makes itself, the more it costs to provide health care for it. And as I said, the demographics are compounding. Not only are more and more people getting sick earlier because of dietary choices and the inescapable environmental toxins they are exposed to, but in the wealthier countries, populations are rapidly aging, which means there are fewer and fewer taxpayers to support an ever aging, ever sicker, ever expanding population. Pretending that any tinkering of the current systems can produce a viable solution to this problem of compounding demographics is the equivalent of shifting deck chairs on the Titanic. At some point, our children will be left drowning in debt. (But maybe people are okay with that. Certainly most governments seem to be.) The bottom line is that the only way that health care can survive -- the only way you can survive -- is if you take back control of your health and start doing those things that allow your body to stay healthy without the need for health care. Or to put it another way, the only way to save health care is to stop using it. Start living the Baseline of Health® program.