Neither Trump nor Clinton Are Really Addressing Healthcare

Instead of picking who should pay, let’s admit who should be responsible.

Posted Oct 27, 2016

If your thirty-something neighbor who drinks too much really got hammered one night and accidentally burned his house to the ground while trying to light his cigarette, would you be willing to chip in and help pay to rebuild his home?

If the women in the cubicle next to you routinely fails to set her alarm and eventually gets fired for always showing up late to work, would you send her some money weekly so she can sit at home watching daytime television?

My guess is that with few exceptions, in all likelihood you answered the questions at the end of both scenarios with a resounding “No!” (or something stronger).  But why not?  You know why:  Because these negative outcomes were entirely preventable, and your drunken neighbor and irresponsible co-worker should be accountable for the consequences of their poor behavioral choices.

Whether you're “for” ObamaCare or angrily oppose the Affordable Care Act (the legislation’s official name), whether you support Donald’s plan to gut the healthcare law or Hillary’s proposal to salvage it, you're allowing the presidential candidates and all politicians and the media to distract you from one of the real issues at the foundation of our healthcare crisis.

But first…is it a crisis?  From a purely financial/economic perspective, absolutely it is a crisis.  More than 17% of our Gross Domestic Product (GDP) goes towards healthcare.  In simpler terms, out of every $100 spent to buy products or pay for services in the United States, over $17 are spent on medical products or healthcare services.  By any sensible economic measure, such spending is not viable if a nation wishes to continue to function.  That enormous amount spent on healthcare is money that therefore cannot be used for education, shelter, defense, school lunches, or (if you are so inclined) for building a wall along our southern border.  It is simply too much.  Far too much.

But, you might protest, ours is the best healthcare in the world!  Sadly, there are numerous studies of various conditions that demonstrate ours is often not the best care in the world.  Thus, we’re paying for a sports car but driving a station wagon.

But let's avoid any argument over the quality of U.S. healthcare.  Even if our healthcare is the best, at current spending levels (which continue to accelerate), we simply cannot afford to care for the health of our population while also paying for all of the other things for which we as a society must pay.

Hence, the ACA. ObamaCare. The government’s first major foray into the healthcare reform swamp.  There is no need to debate the success or failure of the President’s key legislation here, as like Donald’s and Hillary’s healthcare plans, ObamaCare also completely fails to confront one of the foundational failings of American healthcare:  Americans.  Or rather, many Americans’ lack of acceptance of individual responsibility and accountability for their own health and healthcare.  This is one of the major drivers of our financial healthcare death spiral.

Like your drunken neighbor standing in the ashes of his once beautiful home, tens of millions of individuals suffering from Type II diabetes, COPD, lung cancer, and dozens of other medical conditions refuse to accept personal responsibility and accountability for their illnesses.  Illnesses which are entirely preventable.

Today, more than 29 million Americans carry the diagnosis of Type II diabetes (and 25% of diabetics are unaware that they suffer from this condition).  More than a quarter of Americans over age 65 are diabetic.  And 86 million more Americans are pre-diabetic, meaning that without behavioral changes, they’ll likely advance to true diabetes.  Type II diabetes can lead to kidney failure, stroke, heart attack, blindness, circulatory and nerve damage to the legs and feet, and a number of additional life-impairing complications…Not only are these complications life threatening or severely damaging to a person’s quality of life, they’re damn expensive.

But shouldn’t we all open our wallets with a smile?  Willingly chip in our hard-earned cash?  Happily help pay for the emergency room visits, hospitalizations, hemodialysis, heart bypasses, kidney transplants, stroke care, cardiac rehabilitation, leg amputations…?  After all, just because your neighbor got drunk and burned his house down, why should he be held accountable?  Why shouldn’t you help pay for the damage which resulted from his own poor behavioral choices?

The Type II diabetic is your drunken neighbor.  Harsh, I know.  So harsh, in fact, that no politician is willing to say it, let alone legislate it.  But as harsh as it is, that’s how true it is.  Type II diabetes, COPD, smoking-related cancer and heart and circulatory disease, and dozens of other conditions are man-made.  A result of "human progress," or, more accurately, our successful culture which allows for us to make dangerous behavioral choices.  Neanderthals didn't get Type II diabetes.  They didn't sit on their stone couches in their caves watching t.v. while wolfing down fists full of nachos.  They didn't have fast food.  They didn’t have tobacco.  They had to exercise simply to survive.

And not only are these man-made illnesses costly (not only in terms of quality and quantity of life, but also in real dollars), these conditions are entirely preventable.  Avoidable through appropriate behavioral decisions.  Through individual choices.

So don’t be fooled by the political distractions.  Instead of simply trying to figure out who should pay for the out-of-control healthcare costs, let’s dig deeper.  To the core of the problem.  Let's have the courage to demand that each us accept personal responsibility for our own health and healthcare.  I’m not talking money, here.  Because the reality is, if people truly owned their health, accepted the need to control their weight, take a walk, reduce their smoking, get a colonoscopy, then the overall cost of healthcare would decline, making healthcare much less of a political hot potato.

Yes, it is a slippery slope.  Many conditions aren't as clear cut as Type II diabetes or COPD. Many diseases are the result of both behavioral factors and genetics (and other biological factors) which are not under our direct control.  But come on, people, there are enough illnesses that clearly are preventable through behavioral changes in diet, mild exercise, smoking cessation, and other actions.

And I, for one, would rather have my tax dollars used to support such behavioral changes aimed at actually improving the health of my fellow Americans than to pay to treat or control the avoidable health damage resulting from these preventable diseases.

Universal care.  Two system care.  Health Savings Accounts.  Distractions (albeit important distractions).  What we should demand is that, just like paying our bills, overseeing our children, obeying the laws, every individual should own his or her health.  We’ll all be healthier and happier, and the politicians will have more money to spend on building that wall...