Who’s the Arbiter of Your Health? Please Tell Me It Isn’t Your Doctor.

Can I share some non-news with you?

This was published in the Becker’s Hospital Review on 1/31/2023 (I subscribe to try to stay ahead of the out-of-control craziness in healthcare today since I deal daily with execs in the field.)

“The U.S. spends two to four times as much on healthcare as most other high-income countries, but the health outcomes lag behind, a new Commonwealth Fund study found.

“U.S. Healthcare from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes” is an ongoing report by the Commonwealth Fund that compares healthcare spending and outcomes, health status and healthcare usage in the U.S. with 12 other high-income nations and the average for all 38 Organization for Economic Co-operation and Development members.

The U.S. remained the only nation within the OECD that does not offer universal health coverage despite spending nearly 18 percent of its GDP on healthcare, according to the report.

Here are five other findings:

1. The U.S. has the lowest life expectancy at 77 years compared to the 80 years average for other wealthy nations.
2. The U.S. has the highest rates of avoidable deaths from causes such as diabetes, hypertensive disease and certain cancers.
3. The U.S. has the highest COVID-19 death rate among high-income countries, at 3,000 deaths in every 1 million cases between Jan. 22, 2020, and Jan. 18, 2023.
4. Physical assault, which includes gun violence, is seven times higher in the U.S. than in other high-income countries, except New Zealand.
5. U.S. infant and maternal deaths are more than triple the rate of most other high-income countries.

“Americans are living shorter, less healthy lives because our health system is not working as well as it could be,” lead author Munira Gunja, senior researcher for the Commonwealth Fund’s International Program in Health Policy and Practice Innovations, said in the report. “To catch up with other high-income countries, the administration and Congress would have to expand access to healthcare, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population.”

I bolded the last part of Mr. Gunja’s comment because it’s the same ‘ol, same ‘ol chant that we hear from everyone jumping on the “let’s fix healthcare” bandwagon.

• Expand access
• Control costs
• Invest in health equity

All valid. All doable. All sensible.

ALL DOWNSTREAM!!!

Sorry, you’ve tolerated my rant on this before, but I’m not stopping even though I’m a voice in the wilderness.

We’re not solving the problem. We’re fixing the results of the problem. And threatening to bankrupt the country.

At some point, we need to turn off the spigot instead of spending society-crippling amounts of money mopping up the water.

There’s no end to gullibility!

Here’s another example.

I read an article recently in which a board-certified pediatrician is advocating bariatric surgery and diabetes drugs for overweight children, claiming that the main cause of child obesity has a genetic origin.

Do I smell an element of “follow the money” here? Does she really think we are that naive? Couldn’t she be bold enough to shed her “drug it or cut it out” indoctrination and advocate for that ghastly model-busting concept called – wait for it – PREVENTION.

How many kids were obese when you were in grade, middle, or high school? I remember two in my high school of 95 kids. And they weren’t really even obese by today’s definition.  But then that was pre-McDonalds.

What does it say that the average American woman today weighs the same as the average American male in 1960? Or that the average American male is 32 pounds heavier that the 1960 American male?  And neither of them is any taller. Or that we are now beset with epidemic levels of overweight children?

I’m not a scientist or a geneticist but I do know enough to say confidently that genetics don’t change in a 40-50 year span to make all that happen.

We know the problem and choose to ignore it.

We let the food industry get away with murder with their deceptive practices and food-like products. We provide them with cover with senseless government policies.

We provide insane subsidies to the industries that provide the food components that are killing us.

We build massive, monolithic healthcare institutions that know only “cure” and can’t or won’t learn to spell, pronounce, advocate, or train for prevention.

This is Sisyphean

Is it too big and too late to change? I believe so.

I’m guessing this will be a pivotal and disruptive year in healthcare. The big systems are shoveling money out the door by the trainload. Major disruption is starting and will intensify. Amazon, Walgreens, CVS, Walmart, Optum – all are circling like vultures over this wounded carcass looking for a way to swoop in and intercept the incredible cash flow the government doles out by using their technologies to get to that stream faster and at lower costs. Some of that lower cost may even be passed on to the victim – er, the patient. All under the guise of providing “better patient care.”

They’ll be able to increase the convenience and lower some of the costs of mopping up the water. Count on them being able to get us in and out faster and at a lower cost to allow us to continue on our life-sapping, unhealthy habits with not a modicum of advice like “get you arse out of Whataburger and over to Planet Fitness.”

That doesn’t fit the dying model nor the emerging one.

The solution? Avoidance!

It’s unfortunate and an anomaly, but the last place to go to get counsel on how to stretch your health span across your lifespan is your health system-affiliated physician. They are not trained,  equipped, or motivated to provide advice on the metabolic processes that enable that extended health span. And, if employed in a system, they are under pressure from a financially-strapped mothership to treat you as a number with a fifteen-minute visit limit.

My primary care physician is in his early 60s, has two artificial knees, is 30 pounds overweight, and is blind in one eye from an as-yet unexplained cardiovascular event. I love the guy – I’ve been seeing him for over 25 years. We have great conversations about the industry and his photography from his twice-a-year ventures to Lake Powell. He has helped me numerous times with the right solutions to my downstream problems.

I do my darndest to avoid seeing him. It’s usually just once a year for the blood panel review, a quick look in the ears, nose, and throat, and the rubber glove bit.

He’s never asked about my diet or exercise regimen – nor would I listen if he volunteered.

It’s nice to know he’s there and competent if my wheels skid off the rails.

He’s a partner in my health when I need him – not the arbiter.

I’m counting on my immune system to do the heavy lifting by giving it what it needs to perform optimally.

Nobody’s coming to save us.

We’re left with little else but to take responsibility for acquiring the knowledge of how to protect our birthright of good health, regardless of where we are on the age spectrum.

If you’ve tracked with me for a while, you know I’m a fan and advocate of “Harry’s Rules”, the appendix in the book “Younger Next Year”  (affiliate link) that was written by the co-author, the late Dr. Henry Lodge.

It seems a good time to resurrect them.

Harry’s Rules

Exercise six days a week for the rest of your life.

Do serious aerobic exercise four days a week for the rest of your life.

Do serious strength training, with weights, two days a week for the rest of your life.

Spend less than you make.

Quit eating crap!

Care.

Connect and commit.

Can you imagine these rules hanging in your doctor’s office?

Don’t hold your breath!

Are they hanging in your office?

Thanks for reading. What are your thoughts or observations on this topic? Love to hear from you. Also, if you haven’t joined our list for this free weekly newsletter, you can do so at www.makeagingwork.com.