A Prescription for Our Health Care System

Our health care spending is out of control. Worse still, it’s not buying the outcomes we want. Prevention is the common-sense approach we need.

Why is it that we have spent years wrangling over how to fund our staggering health care costs, yet paid so little attention to how we can lower them?

Interviews with the experts featured in my new documentary film, The Art of Aging Well, cemented my conviction that our health care system must be reinvented to prioritize prevention—not just for the sake of our national budget, but to help all of us live healthier, longer lives.

“Most of our health care dollars are spent on treating things that have already happened to people. We wait for people to get sick, we figure out what’s wrong and we try to fix them,” said John Peters, Chief of Strategy and Innovation for the Anschutz Health & Wellness Center in Denver. “Prevention is really not a priority. There’s no business model for it right now.” As James Finck, CEO of the YMCA in Austin, put it, what we really have is “a sick-care model.”

Spending more, getting less

The trouble is, this legacy approach isn’t working very well. The U.S. spends a higher share of our economy on health care than any other developed nation; in fact, our spending is twice that of the average OECD country.

We’re a rich country, and all that spending wouldn’t be so bad if it yielded terrific health outcomes. But it doesn’t. We do score well on some metrics, like heart attack mortality and breast cancer screening. But on broad measures of well-being, like life expectancy and chronic disease burden, we rank at or near the bottom among the 11 OECD nations.

That phrase, “chronic disease burden,” sums up a big part of the problem we’re facing. When it comes to chronic conditions including heart disease, cancer, diabetes, chronic lung or kidney disease, stroke, and Alzheimers, the numbers are stark:

  • Six in ten adults in the U.S. have a chronic disease—that’s more than 150 million people—and four in ten have two or more, according to the CDC.

  • The direct costs of treating these chronic conditions total $1.1 trillion annually, based on a 2016 Milken Institute study. (The Milken analysis included high blood pressure, osteoarthritis and back pain.)

  • The total costs of chronic disease, including economic impacts, add up to a stunning $3.7 trillion annually, found the same Milken Institute study—an amount equivalent to nearly one-fifth of the U.S. economy!

These statistics don’t even begin to describe the deeper toll of so much pain, suffering and premature death on our lives. And with the aging of America, the crisis will only escalate. Between now and 2060, the U.S. population over 65 is expected to more than double.

A look in the mirror

Why are we, as a nation, in such poor health? The chronic diseases that plague us are strongly linked to lifestyle, said Dr. Michael Roizen, Chief Wellness Officer Emeritus at the Cleveland Clinic, and one of the authors of the popular YOU book series. You could say our way of life is killing us.

Obesity, in particular, has skyrocketed, and is now “by far the greatest risk factor contributing to the burden of chronic diseases in the U.S.,” the Milken Institute has found. According to the latest CDC data, more than four in ten Americans are not just overweight, but medically obese, a big jump from the 30% obesity rate less than 20 years earlier.

Toward a new model

Is it possible that we can shift the health care industry’s business model to one where doctors are paid to keep us well, and not only for treating our illnesses? The political obstacles alone are daunting, to be sure, and it may not happen in my lifetime or yours.

But there’s nothing to stop any one of us from making meaningful, personal changes right now. And, because we’re social creatures, our individual choices tend to reverberate with our families and friends, and ripple into the culture at large.

I myself was a 70-year-old couch potato when I decided I was tired of being in pain and having no energy. Clearly, it was going to take some time to reverse decades of a sedentary, overfed way of life. At first it was all I could do to go for a walk. But I went, putting one foot in front of the other, and I went again the next day, and walked even farther the day after that. From then on it was one small change and one small increment of progress at a time.

After a couple of years, I was in the best shape of my life, and as energetic and confident as I’d been at my peak. Now my wife is on a similar track, and so are a number of other people who say they’ve been inspired by my fitness guide, Just Move!, and my new film.

My only regret is that I didn’t get on this bandwagon sooner. But I’m glad I discovered my new way of living. As James Finck put it, “Prevention is the best medicine, and it always will be.”