What is becoming increasingly clear as the debate over Obamacare gets louder and more partisan is that the arguments have little to do with health care. Ostensibly, Obamacare is designed to create a more comprehensive system of care and coverage. Really, though, it’s just a law about dollars and cents. The slews of articles written about Obamacare do not belong in the health section of the paper. They should be filed under Finance. Or Politics.
This is no small thing. In draping this fiscal problem in a hospital gown, we can’t see what’s really at issue. And this confusion is especially dangerous because a national conversation that detracts from the real issue - an aging population that needs more, better and more effective health care - will have long-term devastating consequences. Pretending that we are doing something about health care is worse than doing nothing.
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So enough Obamacare, which is not about improving the health care we need to meet our growing – exploding - needs. To get the U.S.’s fiscal house in order, to improve our system of giving and receiving care, to promote a healthy population that can meaningfully contribute to economic growth, and to make the most of the 21st century’s aging population and the health needs that consequently arise – to do any of this, much less all of it, the charade must end.
We need to put the health back in health care.
Health care systems can only succeed in the 21st century if they get better at promoting health and wellness. Good health must be the baseline that deters behavioral, age-related diseases. Preventable diseases will bankrupt us if we don’t get better at stopping them.
This is no new insight. The old chestnut – that an ounce of prevention is better than a pound of cure – has only become more relevant today as the population ages. But somewhere in the cacophony of Obamacare laudations and calumniations, this has been lost. Instead of seriously debating how to generate better health and preventive practices we’re stuck talking about payment schemes, forced mandates, and broken websites that make MySpace look like the-next-big-thing.
Too bad.
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As the U.S.’s chattering classes chase their tails and take to their soapboxes, age-related, non-communicable diseases (NCDs) continue to rise to epidemic proportions.
Of the many NCDs – diabetes, cardiovascular disease, vision loss, skin deterioration and more – Alzheimer’s is the fiscal nightmare of the 21st century. It will ruin countless lives as the disease uniquely consumes lives of families and caregivers, not just those with the disease.
Treatments for the disease are, of course, notoriously lagging, and research and development for new therapies is extremely complex, costly, and time-consuming. The ways we care for those with Alzheimer’s, moreover, are expensive, impersonal, and grossly inefficient.
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There are calls from advocates, doctors, caregivers, politicians, and countless others for greater funding for both R&D and innovations in caregiving. But the truth is that while we need to invest in both, we can afford neither.
This is exactly the problem with the debates around Obamacare: Awful and costly diseases like Alzheimer’s continue to grow while attention is being paid to actuarial issues, not prevention. It may be no small coincidence that UK Prime Minister Cameron is dedicating more of his time to Alzheimer’s than trying to fix the unfixable National Health Service – their Obamacare, if you will.
A new report from Alzheimer’s Disease International, headquartered in London, provides a path to breakthroughs. The report pulls together and synthesizes a disparate set of research and shows the connection between cognitive impairment and poor diet and nutrition. Good nutrition, it points out, can “influence our risk” of developing Alzheimer’s. Poor nutrition – and its consequences, like obesity and heart disease – can “predict onset of dementia” in later life.
This is huge. It may be a key to unlocking the solution to an incurable, irreversible, degenerative disease that already affects 36 million people worldwide and is projected to skyrocket to 115 million by mid-century.
So what can the U.S. do to get on track?
First, it can start listening to what’s going on outside the Beltway. The World Health Organization has declared Alzheimer’s a “public health priority” and is beginning to dedicate far more attention to healthy aging under the leadership of its Head of Ageing and Life Course, Dr. John Beard. The G8, under British leadership, has made beating Alzheimer’s a top goal. The OECD has recognized the economic significance of Alzheimer’s, and China has pledged to move long-term care out of institutions and into the home, not least because of the unique nature of Alzheimer’s.
Second, the blahblahblah sermons on Obamacare – whether for or against – should come to a close. There is only so much space in the national discourse on health and it is a sham to consider we are debating health when we debate Obamacare.
Love it or hate it, Obamacare is a distraction. It’s an insurance play, with an actuarial basis, that has no potential to promote health and wellness. And in the early 21st century, in which 77 million baby boomers will “get old” and the 80+ segment is growing at unprecedented speed, health and wellness is, as they say, where it’s at.
Enough lipstick. This pig needs to get well.
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