For Release Sunday, September 21, 2008
Citiwire.net
Health care reformers are celebrating the fact that both presidential candidates listen to the poll data and promise, if elected, to fix the issue of peoples’ access to health care coverage.
The Republican and Democratic plans have clear differences. But they’re together on one point: they only address access to formalized health care — the doctor-hospital-prescription-medical side. Neither party’s plan recognizes mounting, compelling evidence that the most effective strategies to further peoples’ health are common sense measures we as a nation could undertake.
What are those measures? They’re hidden in plain sight. They include making neighborhoods safer, streets more walkable, and reducing contaminants so that we can have more safely breathable indoor and outdoor air.
A huge factor is good nutrition — local food systems that provide equitable access to the required fruits and vegetables for disease prevention. And then steps to reduce adults’ and children’s exposure to violence — whether it’s real or popularized/legitimized in popular media.
It’s easy to say personal behaviors, like not smoking or eating sensibly to avoid obesity, are a key. And in some respects, they are. But there’s a grim fact: collectively, as a society, we’re paying a gruesome cost for a treatment-after-the-fact health culture.
We spent a mind-numbing $2.1 trillion on health care in 2006. That’s 16.2 percent of our Gross Domestic Product. It’s projected to reach $4.1 trillion, or 19.6 percent of GDP by 2016. That’s a huge toll on our national economy and well-being. This is a critically important issue for all of us, as a society.
Indeed, such experts as the noted public health authority J. Michael McGinnis estimate that if one adds up all the factors that contribute to health, only 10 to 15 percent of preventable deaths in the United States could be avoided by better availability or quality of health care.
How backwards can we be, to spend all our money on the medical model, potentially bankrupting our country, and still come out with all these the poor outcomes we see today!
Let’s face the reality: America could finally enact universal, single-payer, health care reform, and yet continue to perform abysmally in comparison to other developed nations in health status indicators such as infant mortality, life expectancy, death and debilitation from diabetes and other chronic degenerative diseases. And we’d still be “leading” the world in per person health care dollar outlays.
So let’s stop blinking at realities. A top example: poverty is fast emerging as the leading predictor of lifelong health status. Yet more than 13 million children lived below the federal poverty line in 2006 — 5 million in extreme poverty. Eleven states have child poverty rates of over 20 percent. Many urban school systems graduate less than 25 percent of the children who enroll in high school.
On top of all that, racially-based discrimination abounds in housing, job opportunities, and law enforcement practices. These factors help to perpetuate racial disparities in disease and health outcomes. Black babies die at two to three times the rate of white babies during their first year of life in America. And men of color still have the lowest life expectancies.
It’s heartening to note that some 15 states have recently set up bipartisan commissions to see how to narrow the yawning income gaps that leave so many Americans in destitution.
But we need national leadership to inspire action across all states and communities. The next president needs to marshall the resources of his entire Cabinet and engage all government agencies in creating a health agenda for America.
David Walker, former director of the Government Accountability Office, continues to sound the alarm about runaway entitlement expenditures, reminding us that Medicare and Medicaid will overwhelm all other domestic spending if current trends continue. But Walker’s proposed solutions are limited to a financial paradigm.
The real solution to the approaching the medical care, cost-driven fiscal crisis is on the demand side of the equation. Perhaps the solution lies in engaging our nation in “creating health” instead of just “fighting disease.”
What if the next president were not only to talk up health and physical fitness but move aggressively toward a “post-medicalized” America by appointing a health adviser, a person charged with monitoring and encouraging health-promoting activities across the government, reporting directly to the president?
Such a White House officer could keep his or her finger on each relevant agency — not just Health and Human Services but Labor, Housing and Urban Development, Commerce, Transportation, Environment, Education, Defense, and Treasury. Each would be held accountable for promoting health in all its operations, including rule-setting that impacts, states and local communities.
This type of coordinated, focused, visionary leadership would mean real change for America. The benefits, physical and fiscal alike, would be almost too great to measure.
Gail Christopher’s e-mail is gailcchristopher@gmail.com
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