With health choices, we all share blame for debt woes


So who is to blame for our country's economic mess?

Is it the president, or the Republicans and/or the Democrats, or the fat cats on Wall Street or some of the corporate executives with what some folks feel is outrageous pay, or too many Americans who overextended themselves buying homes they really could not afford?

I must confess to not being smart enough to be able to tell. However there are two things I do know. One is that the American people as a whole are part of the problem. Bear with me as I explain my reasons for saying this.

In 2005, Tommy Thompson, a former Wisconsin governor and Health and Human Services secretary during George H W. Bush's first term, gave a speech in which he stated that the U.S health system was going broke and could self-destruct by 2013.

He said "seven out of 10 deaths in the past year were caused by lifestyle decisions."

In 2008, our total health-care spending was $2.3 trillion, which was more than 3 times the $714 billion in 1990. The costs for 2010 were not available online.

If seven out of 10 deaths are due to lifestyle decisions that means a lot of people made wrong choices and those choices cost billions of dollars. It appears to me that life is largely about choices.

Let's consider some of the bad choices people make.

No. 1. Start using tobacco. According to the Centers for Disease Control and Prevention, 443,000 people die prematurely each year due to the use of tobacco. And about 50,000 each year die from secondhand smoke -- someone else's poor choice.

No. 2. Wear the wrong shoes. Somewhere in the midteens, young ladies follow the dictates of fashion and start wearing high heels and pointy toed shoes. Eighty to 90 percent of all foot surgeries are done on women (American Family Physician, 1998). One lady told me, after learning what wearing bad shoes does to women, that she wished she had known that 30 years ago.

No. 3. Eat the wrong foods. About a third of all cancers are due to eating foods such as red meats, processed meats and barbecued meat.

No. 4. Eat too much fat and sugar. Americans have almost 17 times as much fatal coronary artery disease as rural Chinese. High saturated fat and high sugar diet are largely the cause for this marked difference in deaths (The China Study).

No. 5. Drink a lot of pop. In a study in Circulation 2007 it was reported that adults who had one drink of soda per day -- diet or regular -- had a 50 percent higher risk of developing the metabolic syndrome, which doubles the risk of strokes and heart attacks. Pop can also badly damage teeth.

No. 6. Overeat and grow obese. This is a complex problem and is not always due to overeating. In some cases it is genetic.

In my family there were six children. I am the most skinny and can't gain weight even if I try. At this stage of the game I am glad I have the skinny gene.

In my many years in medical practice I took care of many obese individuals. In part, because I never had to deal with that problem myself, I tried to deal with them very gently. Some people can lose weight. One of my daughters-in-law, before she ever met or knew my son, weighed 215 pounds, but cut down to 135 pounds and has been very successful at keeping it off.

The International Congress on Obesity met in Australia in September 2006. The chairman of the meeting, Paul Zimmet, had these worrisome comments to make, "This insidious, creeping pandemic of obesity is now engulfing the entire world ... It's as big a threat as global warming and bird flu."

Dr. Philip James, the British chairman of the International Obesity Task force warned, "We are not dealing with a scientific or medical problem. We're dealing with an enormous economic problem that , it is already accepted, is going to overwhelm every medical system in the world."

No. 7. Drink alcohol. Moderate drinking too often leads to alcoholism.

Moderate drinkers can run into someone else while driving and cause their deaths, too.

According to a Forbes article from 2006 one half of injured patients who end up in emergency rooms are there due to injuring themselves after drinking. In the report it mentioned that alcohol abuse costs the U.S. an estimated $185 billion per year.

The article also quoted Dr. Harris Stratyner, a renowned addiction specialist and was at the Mount Sinai Medical Center in New York, as saying, "Alcohol is a worthless drug that affects every cell in the body." He added that even hair transplants can fail because of the damage.

No. 8. Get involved in drugs. We have a huge drug problem in this country. According to the Office of National Drug Control Policy the use of illegal drugs cost the U.S more than $193 billion in 2007.

If seven out of 10 deaths are due to lifestyle decisions and if everyone would start making the right choices and living healthfully we could save a bundle of money. Since the $2.3 trillion was estimated for 2008 it could be up to $2.6 billion by now.

Suppose we could cut the spending for health care by a third.

In 10 years, we would have saved $8.6 trillion, which is far better than some of the projections that are being made for debt reduction.

But someone is going to say, "Wait a minute. All of those healthy people are going to get sick and die sometime. So your estimate doesn't make sense."

In part this is true, but it has been observed that a lot of those people who live heathfully don't end up with those chronic diseases that cost bundles of money to take care of.

If we all started living healthfully we might be able to put half of the doctors, dentists, and podiatrists out of business!

I mentioned that there were two things that I knew.

The second is that no business can survive very long on deficit financing, nor can any country. If we are going to pull out of the mess we are in some tough choices will need to be made.

It may be that beyond a certain age some types of surgeries or treatments may need to be denied. Or maybe there should be much higher taxes on tobacco and alcohol and sugary things.

Dr. Don Casebolt of College Place is a retired physician who is passionate about preventive medicine. He spent four years as a medical officer in the U.S. Navy, the last 2 1/2 years as a flight surgeon. He also worked on the Navajo Reservation for 22 years.


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