Americans spend boatloads of money on medical care — roughly twice as much, per capita, as other industrialized democracies. And what do they get in return?
Shorter lives and poorer health.
According to a recent study by the National Academy of Sciences, when the United States is compared to 16 peer countries, Americans have the lowest probability of surviving to age 50. What’s more, “Americans who do reach age 50 generally arrive at this age in poorer health than their counterparts in other high-income countries, and as older adults, they face greater morbidity and mortality from chronic diseases.”
But the times, they are a-changing.
And the changes mean baby boomers still have an opportunity to revitalize aging bodies.
A new generation of physicians is making its way through medical school, where the latest public health research is urging less emphasis on whiz-bang technologies, and more emphasis on guiding patients toward healthier ways of living.
The Affordable Care Act of 2010 is adding impetus to the trend. It requires health insurance, including Medicare, to begin paying for prevention — with no deductibles to deter patients from going ahead with a potentially lifesaving test, such as a mammogram or colonoscopy.
What’s more, it funds medical coverage for those who couldn’t afford it before. And it improves reimbursement rates to primary care physicians who treat Medicaid clients — making it more likely that low-income Americans can find a clinician willing to help them when disease is in an early stage and costs less to treat.
Dr. Matt Hollon applauds the move toward expanded coverage and prevention. At a clinic in Spokane, he practices internal medicine and teaches third-and fourth-year medical students from the University of Washington School of Medicine.
“About a third of what we spend on health care is probably just waste,” Hollon said. Some Americans get little care, until it’s too late. Others get too much care, he said, sometimes using medicines and undergoing procedures that feature high cost, risky side effects and questionable value.
Professional organizations, such as the American Board of Internal Medicine, he said, have begun to tackle this problem; that organization’s “choosing wisely” program urges medical specialties to identify treatments that are overused or unjustified by outcomes research.
Meanwhile, some of the most effective treatments are also the simplest.
“All of us have stories. An ounce of prevention is worth life,” Hollon said.
Screenings catch skin cancer when it’s a removable speck; sunscreen stops it sooner. Immunizations block flu, pneumonia and the agony of shingles. For diabetics whose nerves have deteriorated, daily foot checks are essential.
Dr. Glen Stream, a family physician at Rockwood Clinic in the Spokane Valley, remembers a diabetic patient who accidentally stepped on an insulin syringe at home. The needle broke off in his foot, unfelt due to the nerve damage diabetes can cause. By the time it was discovered, the simple injury had become a crisis.
Hollon, too, recalls a patient with diabetes. Fifty pounds overweight, the man faced serious risks including kidney disease and heart disease. He needed medication, but the medication came with side effects. —MCT