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Four simple steps to health care reform
Commentator David Frum.
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TEXT OF COMMENTARY
Kai Ryssdal: The House and Senate aren't even back at work yet, but the health-care debate got kicked up a notch today all the same. The buzz around Washington -- widely reported but not yet confirmed by the White House -- is that the president will make an address to Congress next Wednesday.
Speculation is that he's ready to drop what's known as the public option. That is, a government insurance program, as part of a deal to get some kind of bill passed. Policy is often largely about the politics of an issue. But commentator David Frum suggests that for health care, it's personal too.
DAVID FRUM: How much does health care matter, really? The numbers suggest that for most of us individual behaviors matter more than anything doctors do.
The U.S. spends 60 percent more of national income on health care than the other advanced countries. Yet American life expectancy ranks below Italy's and Portugal's.
Let me suggest four simple actions to extend and improve American life and save hundreds of billions of dollars.
1: Everybody wear a seatbelt. Even now, one-fifth of American motorists go unbelted. The National Highway and Traffic Safety Administration projects that more than 1,600 lives could be saved and more than 22,000 serious injuries prevented every year if Americans wore their seat belts as often as Germans and Brits do.
2: Smokers: please quit. One-fifth of Americans currently smoke, and almost 9 million Americans suffer a smoking-related disease. We spend $75 billion per year treating those who will die from smoking. Those who live will incur costs of tens of billions more.
3. Everybody lose weight. Obesity is not nearly as lethal as smoking, but its health consequences are much more costly -- about one health dollar in nine for everything from type 2 diabetes to premature hip and joint disease.
4. Above all: If you're a woman of childbearing years, please: take extra care of yourself. Our infant mortality statistics are awful, worse than Cuba's. It's these infant deaths that pull down American life expectancy overall. Once Americans reach 65, American life expectancy ranks a respectable 9th in the world.
Why so many infant deaths? The shockingly high American incidence of premature birth: about one baby in eight. And the most important causes of premature birth are controllable: smoking during pregnancy, drinking, drugs, maternal overweight, and sexually transmitted diseases.
We all want wider health access and a more rational health-care system. But a big obstacle to a better system is our expectation that doctors, hospitals, and machines will save us from the harms we do to ourselves.
RYSSDAL: David Frum is a resident fellow at the American Enterprise Institute.
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This was the best thing I have heard on the subject so far. It needs to be played again on the air. unlike some of the other stories played over and over untill I want to smash my radio with a hammer. I has some GOOD advice. I do not have health Ins. I pay out of pocket when needed. which is not to often because take care of my body.
How about this?? There is NO answer which suits the crowd equally. Right? Fat, skinny, smoke, no smoke, drunk, sober, lazy, active... why are intelligent people wasting time with external solutions, mostly offered to "others", for "their" benefit? Health? It begins with a healthy mind, a sense of "being" that's independent of someone else's "opinion" or control. Reading all this "stuff" on here is like trying to select a box of Band Aids at Walgreen's. How can we suggest or dictate external remedies when we haven't addressed the way we see the world, the way we think, the ignorance we each suffer? Is government going to fix that for us, so we can remain ignorant? Isn't this the problem with our healthcare? Since we each came from the same "place", our mother's womb, via a true miracle, don't you think we might have a bit more intelligence when it comes to managing our lives? Are we born stupid? Do we need governments or "experts" telling us how to live, breathe, work, eat, blah blah blah?? SO SIMPLE, yet apparently too complicated. All this education we have, yet still ignorant. Get in the car, go find a farm, go pick some vegetables. Find a way to get your hands in the dirt. Climb a tree. Just go sit at the base of a tree and read! Take back your connection to nature, and stop with all this superficial self-inflicted chaos. You can start by leaving the car parked in the driveway and WALKING to the grocery store, noticing the little nuances of "earth" as you pass them. "Hey! That grass smells great!" Start simple, just START!!!
Way to stir up the rhetoric. Last I checked, inalienable rights included life (protection from the government and others, not ourselves), liberty, and the pursuit of happiness, and I certainly wouldn't call this a conservative solution.
The real problem is the "moral hazard" caused by disassociating consequences from life style choices in the form of a public insurance program. Insurance is one of the most expensive ways to buy anything. Imagine going through your car insurance every time you bought gas or an oil change, instead of only when you have an accident.
Instead of blowing >20% of our health insurance premiums on gluttonous health insurers, we should require hospitals to give quotes on demand, consolidate billing and publish regional price information. Make everyone pay the same price for the same treatment instead of the fraud prone medicare and medicaid systems.
Insurance only makes sense for unlikely catastrophic risk protection. Real fair medical pricing and real insurance with high deductibles and low priced premiums will restore responsibility and sanity to our care and our economy. And if people choose to smoke and eat poorly, then they can pay for the consequences.
David Frum's segment that aired on September 2
concerning how our healthcare system may be
improved was one of the most incredible pieces I
have ever heard on Marketplace. And I use the word
"incredible" in its original sense, i.e., "totally
not credible".
Mr. Frum starts out by noting that the US spends
much more than other advanced countries on its
healthcare and yet our life expectancy ranks below
that of "Italy's and Portugal's". You would think
Mr. Frum would follow that up with the question,
so what is the difference in the healthcare
systems of the US on the one hand versus that of
the other countries on the other that results in
lower quality of care in the US despite the higher
cost? But that is not what he does. Instead, he
launches into a tirade about how individuals in
the US should take on more responsibility for
their own health by wearing seatbelts, quitting
smoking, etc.
Wow! Here we thought that healthcare costs were
higher in the US because hospitals and doctors
have to deal with multiple health insurance
bureaucracies set up by the various insurance
companies, not to mention the enormous profits
that these companies make, and the obscene bonuses
some of them pay to their top executives.
According to Mr. Frum, everything will become
alright if we would just wear our seatbelts and
quit smoking!
Mr. Frum works for the American Enterprise
Institute so I guess it is not surprising that he
is spewing corporate propaganda but I would have
expected Marketplace to present a somewhat more
balanced picture. For example, how does Italy
manage to have much higher number of doctors per
capita than does the US despite spending
substantially less than the US?
And, by the way, a quick Google search showed that
the percentage of smokers in Italy and Portugal
are both higher than in the US. As for seatbelts?
Have you ever driven in Italy? Talk about being
irresponsible with your health! So it looks like
you were ... simply blowing smoke, Mr. Frum!
To David Frum's four points, I would add this one: Let's get guns off the street. Gun violence costs this country untold amounts in emergency treatment, long-term injury, lost productivity, not to mention the sorrow it visits on the victim's family and the fear it engenders in the community that anyone of us could be the next victim.
Talk about preventable injuries! This one is a no-brainer.
I'm surprised and disappointed by the level of negativity towards David Frum's commentary. I don't believe he meant this as the ONLY solution to our health care crisis but rather as encouragement to take charge of what's within our control. I don't know why his point that we should take responsibility for our own health is met with such hostility. Don't get me wrong; I'm about as liberal as they come--hell, I don't even consider "socialized medicine" a dirty word. But we can't expect only the government to take care of our health when we haven't ourselves. I'm sorry, but regardless of your socio-economic situation, you can buckle your seat belt, you can quit smoking, you can not eat McDonald's every day and you can turn off the "Who Wants To Be An American Idiot" and walk around the block.
I'm amazed by Mr. Frum's ridiculous "solutions". Just telling people to behave better is going to solve a systemically flawed system? What is his view on defense spending? Just tell people to get along? Behind it all though is laying blame on those whose lifestyle we don't choose to follow. I'm amazed that this man's opinion is considered worthy of any consideration at all and wonder why you allow such pandering nonsense to be broadcast. Care to explain??
While I do believe that Americans need to take greater responsibility for their actions when it comes to healthy behaviors, especially those that we embrace when young and recreational, ahem, I must point out that David Frum has left out an incredibly critical element to his blanket analysis.
It is impossible to ignore the fact that systemic socioeconomic factors influence the OPPORTUNITY (remember, we are the land of this, right?) to care for ourselves well. Access to fresh foods, the luxury of time for exercise, steady and minimal stress employment, preventative medicine and education are all very indicative of long term disease and health risks. Is David Frum suggesting that every individual in American has equitable access to these aforementioned things and thus, an even playing field of resource for self-care? Because, that sounds absolutely preposterous to me.
It is pretty broad to surmise that taking better care of ourselves is as easy as giving up vices, eating right, and mediating risks like infant mortality. These risks manifest along pretty clear racial and economic lines and are not going to change until their are responsibilities taken on higher levels to offer access to resources absent of marginalized statuses.
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