State of Health in The United States

Updated: Jan 7, 2019


The United States spends about $10,000 per person on health care, which is 30% higher than the next highest country. Moreover, the gap in health care expenditures, between the United States and other similar industrialized countries has continued to widen dramatically over the last 50 years. 


In 2014 alone, the United States spent $3 trillion dollars on health care, which was a whopping 17.5% of our gross domestic product. Considering how much we spend on healthcare, we would expect citizens of our country to be getting healthier rather than sicker. Unfortunately, this just isn’t the case. 


One study of medicare patients nationwide showed that the more health care people received in the form of procedures, hospitalizations, and specialist referrals, the worse they did in quality outcomes. That’s right! The less money a state spent on healthcare, the better the outcomes. The four states with the highest Medicare spending, Louisiana, Texas, California, and Florida, rank the worst in quality. We also cannot ignore the fact that 400,000 people die every year from hospital errors and complications, a figure that dwarfs deaths from auto-accidents and rivals the amount of deaths of the number one killer, heart disease. 


In this article, we will explore the reality of the state of health both in the United States and around the world. 



As long as the field of medicine has existed, humans have managed to increase the life expectancy of the average individual. As medical technology, hygiene, and sanitation have advanced, life expectancy has increased dramatically. One of the early examples of this occurring is in the development of anesthesiology in 1799 when Humphry Davy observed the pain relieving properties of nitric oxide. Nitric oxide is now commonly known as “laughing gas.” The use of chloroform and other anesthetizing and pain relieving agents, such as morphine, allowed the field of surgery to prosper, thus ushering in a new era of modern medicine. 


The discovery of microbes and the study of bacteriology advanced significantly in the 19th century when the Hungarian physician Ignaz Semmelweis observed that birthing mothers suffered from significantly fewer postpartum fevers and subsequent deaths in the hospitals that did not have a morgue, in which doctors would dissect cadavers for research purposes before assisting with child births. Upon making this observation, Semmelweis introduced hand disinfection standards in obstetrical clinics. The field further advanced through the work of Louis Pasteur, who created a method to kill microbes with vigorous heating, a process now known as pasteurization. Joseph Lister, for whom the famous mouthwash has been named, pioneered the process of antiseptic surgery by using carbolic acid to sterilize all surgical equipment before surgery. 

Perhaps the most significant advancement in the field of bacteriology and microbiology came in 1922, when Sir Alexander Fleming accidentally discovered the first antibiotic, which became known as penicillin. Penicillin can be credited for saving millions of lives since it’s discovery, allowing humans to effectively treat bacterial infections, which before this point were commonly fatal. 


Improved health care, understanding of sanitation and hygiene combined with further advancements of the modern scientific era have successfully expanded an average life expectancy of 35 in the early 1800s to 75 years old today.


While all these medical advances deserve applause, the unfortunate reality in today’s world is that for the first time in human history, life expectancy of the human being is expected to decrease at the hands of chronic diseases of epidemic proportions. In other words, for the first time in human history, children born today are expected to live shorter lives than their parents. 



The statistics are staggering: 


Today, about a billion people around the world suffer from the combination of diabetes and obesity. Obesity in adolescence has quadrupled in the last 30 years alone. At the time I am writing this article, 1 out of every 5 children between the ages of 6 and 11 are obese. If the current trend continues, in 20 short years, 95 percent of Americans will be overweight and one in three will have diabetes. 


1 in 2 Americans has a chronic disease, and 1 in 4 has multiple chronic diseases. 27 percent of kids now have a chronic disease, up from just 13 percent in 1994. 1 in 5 Americans struggles to pay medical bills, and 3 in 5 bankruptcies are due to medical expenses. 50 million Americans have an autoimmune disease. Almost a third of adults take two or more drugs. 


600,000 people in the US die of a heart attack each year. One in four women and one in six men now suffer from an autoimmune disease. Shockingly, over half of adults in the US take prescription medication. Forty percept of the elderly take more than five medications, and 90 percent take over-the-counter drugs. Most people — over 75 percent! — will die prematurely of strokes, heart attacks, congestive heart failure, cancer, or the consequences of diabetes.



“The Truth is that the overwhelming majority of diseases threatening you and your loved ones are preventable, but not effectively treatable.”
-Douglas J. Listle, The Pleasure Trap. 

Sadly, medical intervention is barely helpful in treating complications from these diseases. For example, the treatment of breast cancer, a disease that claims the lives of one in eight American women, is barely more successful today than it was 50 years ago. Heart disease, which takes the lives of nearly half of our citizens, is similarly a poor candidate for medical intervention.


The New England Journal of Medicine published a review documenting the correlation coefficient (r) between certain modern medical interventions and the consequent increase of survival. As a reference, a correlation of r = .10 would mean that the treatment was only weakly associated with increased survival. The review found that the treatment of breast cancer with chemotherapy has been shown to have a survival correlation of r = .03. The results for coronary bypass surgery are similarly unimpressive. In a statistical review published in Lancet, the correlation between bypass surgery and survival at 5 years post operation was a disappointing r = 0.08. 




What is the problem with the current healthcare system? Modern healthcare stands on 2 flimsy legs:

  1. Disease management

  2. Symptom suppression

In other words, we generally wait until we develop signs and symptoms of a disease, at which point pharmaceutical agents are introduced to “manage” the illness. I heard a story recently of a person starting to exhibit early signs of multiple sclerosis, a disease that is characterized by modern medicine as incurable and irreversible. His doctor, in a callous manner, told the patient that he wasn’t “symptomatic enough” to start medication and that he should come back to the office when the disease progressed to a level deemed acceptable to start pharmaceutical intervention.

 

Though this is an extreme example of modern healthcare at its worst, it exemplifies the fundamental flaw in the way the system works. We wait until the patient develops high blood pressure, then we put them on a pill that doesn’t cure him of the underlying cause, but instead, “manages” their blood pressure as long as he is taking the medication. 

“The spotlight shines on new drugs and medical technologies. Hospital ads boast about the newest robotic surgery and high-tech imaging procedures. It all seems wonderful- until you stop to realize that these are the technologies created to deal with the results of neglected health, the alchemy of converting neglect into revenue.”
-Dr. William Davis, Undoctored

What if health care actually focused on promoting and optimizing health instead of just managing disease? I once heard a story of the traditional model of healthcare in ancient Chinese medicine. In this model, patients would pay a monthly fee to their local doctor if they were healthy. If a patient developed an illness, then he would withhold payment to his doctor that month because his doctor failed to do his job of maintaining and promoting health.


Adapting this medical mindset in today’s society would certainly require a paradigm shift of tectonic proportions. In a modern context, what would that paradigm shift even look like? I will answer that question in next week’s newsletter.  


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