By Dr. Mercola
The cost of health care in the U.S. jumped to over 17 percent of the GDP in 2015.1 However, even though the U.S. tops $3 trillion in spending on health care each year, it is the worst performing system ranked by multiple aspects of care.2
Americans spend, on average, over $9,500 per capita on healthcare. This is the highest amount spent over 11 developed countries, but the U.S. ranks 11th in terms of health. The most glaring difference is that the last ranked U.S. per capita expenditure is more than double that of the first ranked expense in the U.K.
Not only is healthcare in the U.S. more expensive, less effective and performs poorly when compared to other countries, recent research demonstrates half of Americans are living with chronic illness.
Although the study included only a particular group of physical illnesses that create chronic problems, results show half of the population is living with a continuing health problem.
Research Demonstrates Rising Numbers of People With Chronic Illness
Researchers from Emory University scrutinized public health records to determine the number of individuals living with a chronic health problem, substance abuse problem or mental health disability, and how these conditions may be related to living in poverty.3
They found more than half of Americans are living with at least one chronic illness, a substance abuse problem or a mental health condition.
According to study authors Elizabeth Reisinger Walker, Ph.D., assistant research professor and Dr. Benjamin Druss, professor at Rollins School of Public Health at Emory University:4
"The health of individuals in the U.S.A. is increasingly being defined by complexity and multi-morbidity, the co-occurrence of two or more chronic medical conditions.”
Overall, the study revealed 18.4 percent of adults have suffered with a mental illness in the past year and 8.6 percent of those have reported a substance abuse or dependence during the same time. Nearly 40 percent of the records studied had one or more chronic medical conditions.5
The researchers acknowledge some limitations to the study, but point out overlapping conditions contribute to multi-morbidity and poor health in the U.S.6
According to the report, the study included only the following chronic conditions in their calculations. If other chronic health conditions were to be included, it would likely increase the percentage suffering from chronic disease.
✓ Heart Disease
✓ Lung Cancer
Prenatal Toxic Exposures Impact Future Health
Exposure to environmental factors that may cause chronic illness may begin even before birth.7 In a unique study published in the Journal of Environmental Science and Technology, researchers tested the blood of 77 pregnant women and umbilical cord blood from 65 women once their babies were born.8
Researchers sampled women living in San Francisco between 2010 and 2011. The study is the first to measure exposure to 59 different environmental pollutants and toxic chemicals.
Many of these chemicals have been detected in 99 percent of pregnant women in the U.S., according to National Health and Nutritional Examination Survey results.9
Some of the chemicals measured included polybrominated diphenyl ethers, (PBDEs), polychlorinated biphenyls (PCBs), perfluorinated compounds (PFCs), organochlorine pesticides (OCPs), lead, mercury and other chemicals. In this study the median number of chemicals found in maternal blood was 25, and 17 in cord blood.10
Almost 80 percent of the chemicals found in maternal blood were also found in the infant cord blood, with concentrations of mercury and some PBDEs higher in cord blood than maternal samples.11 These chemicals are linked to developmental problems and long-term chronic illnesses.12,13,14,15
However, one-third of the participants potentially had much less exposure to environmental toxic chemicals as they had been born in Mexico where these chemicals are not as widely used, meaning the percentage of exposure in the study is likely lower than the overall population of the U.S.
Americans Continue to Struggle With Access to Medical Care
In this portion of my lecture at Harper College, I outline some of the problems with our current health care system. The latest report from the Commonwealth Fund has not changed appreciably in the past 15 years despite the recent overhaul to health care access under the Affordable Care Act, colloquially referred to as Obamacare.16
Americans continue to pay far more for health care than other countries, but with little to demonstrate for the outlay. Key findings from the most recent Commonwealth Fund report include:17
• Comparing adults in 11 countries, Americans are sicker and more economically disadvantaged, which is subsequently magnified by higher health care costs and low spending on social services.
• Americans ranked last, with 41 percent experiencing multiple chronic conditions compared to France’s 23 percent.
• Of the chronically ill people in the U.S., 14 percent said they didn’t get needed support from providers to manage their health conditions. This was twice the rate of Germany, the Netherlands, Switzerland, New Zealand and Australia.
• American adults were more likely than adults in 10 other countries to go without health care for reasons of high cost.
The number of adults who went without care, failed to fill a prescription or did not see a doctor when sick improved from 37 percent to 33 percent since 2013. However, only between 7 and 8 percent of people in Germany, the U.K., the Netherlands and Sweden experienced an issue with affordability.
Commonwealth Fund president Dr. David Blumenthal commented on the results from the latest report:18
"The U.S. spends more on health care than any other country, but what we get for these significant resources falls short in terms of access to care, affordability, and coordination.
We can learn from what is working in other nations. If we're going to do better for our patients, we need to create a health care system that addresses the needs of everyone, especially our sickest patients, and those who struggle to make ends meet."
Cost Burden of Chronic Illness Impacts Families, Business and Politics
The cost of providing health care in the U.S. is staggering, and individuals are suffering under the burden. In 1960 health care was 5.1 percent of the GDP, but now is expected to be greater than 20 percent by 2020.19 Those costs are not all related to your care.
Hospital administration eats up 8 percent of health care costs, while comparatively those same costs are 2 percent in Finland.20 And the care inside hospitals doesn’t appear to have gotten safer. Ten years after a report released in 2000 from the Institute of Medicine, researchers did not find evidence of widespread improvement.21
The cost of health care is driving many people into bankruptcy. Unpaid medical bills affected nearly 2 million people in 2013.22 Of the total number of bankruptcies filed in 2013 for health care costs, the majority of individuals were between 35 and 54 years old.
NerdWallet analyzed data from Commonwealth Fund, U.S. census and the Centers for Disease Control and Prevention (CDC) and estimated that 10 million adults who carried insurance year-round would accumulate medical bills they couldn’t pay. NerdWallet Health Vice President Christina LaMontagne said:23
"With an average American family bringing home $50,000 in income, a high medical bill and a high-deductible insurance plan can quickly become something they are unable to pay. If you have an out-of-pocket maximum of $5,000 or $10,000, that's really tough.”
While the Affordable Care Act has increased the number of low-income people who are insured, it is not a panacea. The incoming U.S. president has promised to make changes to the Act, and possibly completely repeal it. However, in an interview with The Wall Street Journal, president-elect Donald Trump said he is considering keeping two popular provisions, an indication he’ll possibly compromise on his campaign promise.24
Is Access to Health Care the Answer?
Whether access to health care is the ultimate answer or not, the reality is that health care in the U.S. is financially out of reach for many, causes a financial burden for others and the return on the investment is not paying dividends for the users.
The research published by Emory University demonstrates that health issues are multifactorial and complex. Poverty, availability of social services and poor lifestyle choices are contributors that a strong hospital system can’t solve. While the Affordable Care Act increased the number of people who can access health care, it has not made a difference in the health of Americans.25
Cost continues to be a barrier to seeking care from physicians and filling prescriptions, as does a growing number of people suffering from heart disease, asthma, diabetes and other chronic illnesses. Big Pharma is fueling the opioid epidemic and society continues to shun people with mental illness.
It is highly improbable that addressing just one aspect of health and wellness will make a significant impact on the whole. Making changes to the health of American people will require significant changes to lifestyle choices as our current health care system is more about managing diseases than promoting health.
Disease Management Versus Promoting Good Health
The current health care system is dependent upon a pharmaceutical economy and invasive surgeries without much attention paid to healthy living choices and preventive care. The system is rooted in maximized profits as opposed to helping people maintain or regain their health.
The majority of the diseases we're trying to "manage" in this manner are lifestyle-related, and if you don't address this root cause, you'll never get better. You're just paying for overpriced bandages that do absolutely nothing to fix the underlying cause and create long-term health and wellness.
I promote integrative medicine (IM), as it offers a combination of conventional medicine and complementary or alternative therapies. IM places a greater emphasis on preventing problems rather than treatment once a problem arises, using conventional drug and surgery approaches sparingly or as a last resort.
Our current system does the exact opposite. Drugs and surgery are employed first and, then, when the patient has exhausted all conventional avenues, he or she will sometimes turn to alternative therapies or nutritional interventions out of sheer desperation, frequently on their own and at their own expense. Often this is what ends up saving that person's life. Unfortunately, many have been financially ruined by the time they've worked their way through the conventional system.
Reducing Prevalence of Chronic Illness 1 Decision at a Time
Incorporating healthy lifestyle choices will increase the potential you’ll enjoy optimal health and will give you the best chance to live longer without disease. Remember, it is never too late to take control of your health. It’s clear the American health care system is flawed and in need of a serious overhaul to reduce cost and improve health.
At the present rate the current system is not sustainable. However, I suggest you don’t wait for a miracle, but start focusing on simple, inexpensive lifestyle changes that can help prevent some of the most common health problems plaguing the U.S. today. The majority of deaths today are due to chronic disease, such as cancer, heart disease, diabetes and obesity — all of which are largely preventable with simple lifestyle changes.
The bonus to making healthy choices is that you’re less likely to need conventional medical care, which is one of the leading causes of death in the U.S. In my previous article, “It’s Time to Change American Disease-Management into a Health-Fostering System,” I provide you with a short list of basic choices that are part of my nutrition plan, designed to dramatically improve your health.