Tuesday, April 29, 2014

May, 2014 The Unfolding Disaster That is Obama Care, Part 2: What Should Have Been Done Vs. What Obama Did

Yesterday we laid out all of the Obama Care operations, strategies, and tenets that have already gone wrong and which are highly likely to go wrong in the coming months and years. Identity theft, higher deficits, higher national debt, higher insurance premiums, higher deductibles, loss of privacy, IRS harassment, failing government websites, millions of Americans losing access to their preferred doctors, hospitals, and insurance plans, millions of Obama Care policy holders being denied access to the top medical facilities and doctors in the country, etc. The list seems endless.

We also explained how the legislation never had a chance of successfully reducing our ever escalating health care costs in this country since those that wrote it never understood the true root causes of our increasing health care costs: Americans smoke too much, Americans eat too much of the wrong kind of food, Americans do not exercise enough, the government restricts insurance company cost reducing competition across state lines, much needed medical tort reform never happened, etc.

Since Obama, Pelosi, Reid and other Obama Care architects never understood the root causes, we ended up with 2,500 pages of legal mumbo jumbo that created a Rube Goldberg-like subsidized government insurance program that will ultimately fail. The problem is that we have a public health crisis that is causing our higher and higher health care costs, we do not have a lack of insurance problem. High insurance costs are a symptom of the root causes, they are not the cause themselves.

Starting in two days, we will again start reviewing the unfolding disasters still coming out of the Obama Care legislation, much like we have done on a monthly basis since last August. Today and tomorrow, however, we have gone back through our blog posts over the past few years and gathered up all of the suggestions that subject matter experts and informed, logical people have put forth to identify the true root causes of our high health care costs. That information leads one to the needed public health initiatives which should be put forth to resolve those root causes. We have also added some additional information and reports that we have not previously covered which also make our point.

I maintain that if we were successful in attacking the true root causes, as proposed below, the cost of health care would drop dramatically as would the cost of health care insurance, making it affordable for all who wanted it. The Obama Care approach, raising taxes to cover everyone with health care insurance without eliminating the underlying root causes is a fallacy solution.

The following observations, government and independent reports and analysis, success stories, and realities are in no particular sequence. However, at the end of the two posts I think you will agree that the Obama Care approach to the problem has missed the mark completely by focusing on health care insurance rather than health care solutions.

1) Several years ago, a report from the National Research Council had some very interesting findings, findings that continue to prove that Obama Care got the whole approach to solving the nation's escalating health care costs. The National Research Council is part of the National Academy Of Sciences, an independent organization of the Federal government. It is chartered by Congress to advise the government on scientific matters. Thus, the government did not even listen to itself when it cobbled together the unfolding disaster know as Obama Care.

According to the report:
  • The United States spends more on health care than any other nation in the world but has worse life expectancy than many other nations who spend less.
  • The U.S. average life expectancy at birth for women is 80.8 years and 75.6 years for men.
  • In France, women's life expectancy is 84.4 years and for men it is 77.4 years.
  • In Japan, women's life expectancy is almost 86 years and for men it is 79.2.
  • The report concludes that smoking and obesity are the primary drivers of the U.S.'s poor performance since, according to the findings, over the years, the U.S. led those unhealthy trends of eating too much of the wrong kinds of food and smoking too much.
  • The report found in countries where women's life expectancy was high, there was a strong correlation with low smoking levels and in those countries where women's smoking levels were comparable to U.S. smoking levels, life expectancy was about the same as in the U.S.
Smoking and obesity are the primary drivers of the U.S.’s poor performance. Interesting, a possible set of root causes of bad BEHAVIOR for our high health care costs in this country? Note that the report did not find that lack of health insurance was the primary driver of poor health or high healthcare costs.

2) According to a March 25, 2010 Associated Press article, recent studies have shown that the incidence of breast cancer (190,000 new cases and 40,000 deaths every year in the U.S.) can be reduced by 25-30% through the modification of BEHAVIOR as it relates to smoking, diet, and exercise. “Modification of behavior” sounds like a need for a public health initiative, not a massive government health insurance initiative.

3) A March 28, 2010 article in Parade magazine reported that the New England Journal of Medicine found that reducing the daily intake of salt by just three grams by every American would "reduce the annual number of new cases of heart disease by 60,000-120,000, stroke by 32,00 to 66,000, heart attack by 54,000 to 99,000" cases. This would reduce annual health care costs by up to $24 billion a year. 

Another vote for the changing of BEHAVIOR, not the implementation of a government insurance bureaucracy. 

4) In a Fortune article in the March 1, 2010 issue, an interview of the head of the Cleveland Clinic asserted that smoking, poor diet, and exercise BEHAVIOR was the cause of 40% of the premature deaths in this country every year. Obviously, reducing the amount of premature deaths would significantly reduce health care costs.

The same article reported that these same bad habits and BEHAVIORS are responsible for 70% of the chronic diseases in this country such as heart disease and diabetes. Imagine how much health care costs and health care insurance costs would come down if you could eliminate 70% of the chronic diseases. 

Consider the other assertions made by the head of the world renowned Cleveland Clinic, Dr. Delose Cosgrove:
  • In our current health care industry there is no incentive for staying well. 
  • Obesity in America accounts for 10% of all health care costs. 
  • At the Cleveland Clinic facility, all deep fryers were removed from the cafeterias, the menus were made healthier, the candy and soda machines were removed, free exercise programs were initiated for Clinic employers, free Weight Watcher memberships were made available.
  • In the first year of this transformation, Cleveland Clinic employees lost amazing 120,000 pounds of weight, 60 tons. 
  • From a smoking perspective, smoking was banned on the entire grounds of the Clinic, free smoking cessation classes were offered to both employees and the entire county where the Clinic is located, a lobbying push was made to ban public smoking everywhere in Ohio, and the Clinic stopped hiring smokers. In four years the smoking rate in the county went from 28% to 18%, a little less than the national average of 20%.
Smoking reduction and better eating habits, imagine that as a way to reduce disease and health care costs vs. getting everyone an expensive insurance policy.

5) Consider an article in a past issue of AARP's magazine. The article focused on the residents of Albert Lea, Minnesota which was a participant in the AARP/Blue Zones Vitality Project. This program started in May, 2009 and focused on lessons learned in so-called "blue zones" - regions in the world where people have a long life span. 

The lessons learned in these zones focus on exercise, good eating habits, connecting with others, and finding purpose in life. Outputs and activities from this towns efforts included fifteen healthy initiatives, among which were the following:
  • Cooking classes to help people learn to eat healthier. 
  • Formation of walking groups to get people more active and connected to others. 
  • Construction of pedestrian-friendly paths. 
  • Creation of community gardens. 
  • Two thirds of the city's restaurants began serving health food options.
Within just five months, town residents participating in the program had lost three pounds on average which had added about three years to their estimated life spans. One resident, used her participation in dance classes to lose thirty pounds. Another resident has lost 55 pounds and has increased his life expectancy from 52 years to 78 years by eating smaller portions at meal time, walking daily, and doing community theater work.

A year later, according to the article, more and more people were walking, dancing, and bicycling. Residents had accumulated over 42,000 miles in distance traveled via exercise. Twenty two town employers now offer work-site wellness programs to their employees, which has resulted in over 1,000 free health assessments. 

These Americans are living healthier, living longer, and not contributing to our rising health care problems since they took personal responsibility for their health, not nameless and numerous government agencies

6) A December 24, 2010 article from The Week magazine reported on how Americans take in too much salt in their diet. The article reported that just a small reduction in that amount could save upwards of 100,000 lives a year that occur as a result of excess salt (a 13% decline), and the incidence of new heart disease and stroke cases would decrease by 11% and 8% respectively.

7) On October 17, 2013, the health.com website ran an article based on the latest obesity results and research from the Centers For Disease Control (CDC). The CDC reported that about one in three U.S. adults are obese from a body weight perspective. 

This obesity epidemic costs the nation’s economy an estimated $270 billion a year due to health care costs and loss of productivity associated with obesity and overweight, according to a 2011 report produced by the Society of Actuaries. This cost burdens every U.S. household with an average cost of almost $2,400 a year.

That will do it for the first half of our theory, what should have been done vs. what Obama did, in the crisis of high health care costs in this country. Rather than making Americans healthier via a public health strategy of diet, exercise, and reducing smoking, his administration and supporters created a massive insurance apparatus that is expensive, inefficient, and ineffective. Why? Insurance plans and strategies do not resolve the undelrying public health care issues of obesity, smoking, and the government programs that encourage both. 

Tomorrow, we will conclude our analysis and theory that other, different steps should have been taken, based on a root cause analysis, vs. the wrong path that the Obama administration took, making a bad siutation worse.

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