I was walking home from work recently and I overheard two men “discussing” “healthcare”.
“We can’t have a system led by the big insurance companies,” one man said. “No way,” the other man replied. “It’s just not working. My premiums keep going up every year; like 25 percent a year. It’s crazy. Plus, I’ve got a huge deductible and co-pays for everything to boot.” “Something has to be done about this,” the first man chimed in, getting angrier. “Obamacare is a mess,” he said. “They can’t get anything right in Washington.”
Can you see why I put “discussing” and “healthcare” in quotes? First, this is a complaint jam session; nothing is being discussed. Second, neither man said anything about health or about caring for one’s health; they complained about insurance and government.
Let’s be really clear. When most people are talking “healthcare”, they’re talking about medical care and medical insurance. Medical care is the treatment of the symptoms of sickness by physicians and other medical professionals. Medical insurance is insurance to pay for the treatment of the symptoms of sickness. “Healthcare” is sick care. It has little to do with fostering health. Or wellness.
I prefer the word wellness over the word health. Wellness has positive implications and is all-encompassing. To be well means to thrive as a person. What would it mean to truly care for our wellness? I mean both what would it mean to care for our wellness as individuals and what would it mean for us to care for one another’s wellness?
Let’s hold those questions in our minds for a moment and talk about one of the greatest examples of collaboration ever accomplished by humans*: car insurance. Car insurance is a phenomenal collaboration*. Car insurance works. Car insurance works really well. Have you noticed the sheer absence of people holding signs and chanting about car insurance? That’s because there’s nothing to complain about. Car-insurance companies also consistently have really funny ads. There’s a lot to like about car insurance.
In 2015, I paid $624 for a year of “good” (modest deductible, good coverage) car insurance. In 2016, I paid $641 for the same insurance. In 2017, I paid $660 for the same insurance. If I was in a small car accident that was my fault, say one that would cost $2,000 to repair, I’d pay $500 and my insurance company would pay the rest. If my car were totaled in an accident that was my fault, I’d pay $500 and my insurance company would give me enough money to buy a brand-new replacement car (an approximately $20,000 value). I pay a relatively modest amount of money into the system, and I have the assurance that if something goes wrong with my car, I can get it repaired or replaced. My annual premium increase have been modest, sustainable increases in line with the inflationary increases in the costs of most goods and services. This whole situation is working really well for me. I think most people would say car insurance works really well for them too. No one has e-mailed me asking me to go march in Washington to fix car insurance anyway.
What makes car insurance such an effective system? Is it the lack of big insurance companies and meddling from the government? That’s not even close to the answer, much to the dismay of the fellowship of the complaining miserable. State Farm, Allstate, Progressive: these are mega companies moving billions of dollars. And the government has it’s hands all over our cars. We’re required by law to have insurance in order to register our cars, which is also required by law. To maintain our insurance and keep our cars registered, we must have our cars inspected regularly to ensure they’re in good working order and safe to operate. In addition, we must each also have a driver’s license ensuring we know the rules of the road, have good driving skills, and can see well enough to drive safely. The fees (taxes) we pay to register our cars and have them inspected are relatively modest. So are the fees for driver’s licenses. The government also imposes speed limits on most roads, requires us to wear seat belts, and doesn’t allow us to drive under the influence of alcohol or while using our phones. The government regulates car companies as well and sets standards for the safety of the cars they make. This government intervention helps keep most of the cars on the road running well and most drivers driving safely. Together, insurance companies, the government, and all of us run a very effective car-insurance system. We pay very modestly into the system, annual expenses rise in a sustainable manner, and when big things go wrong with our cars, it’s easy breezy to get us back on the road. No massive deductibles. No co-pays. No waiting months for an appointment. No real hassles at all.
This system works so well because most of us take great care of our cars and drive safely. Other than Tyler Durden, when he decided to have a “near-life experience”, I’ve never seen a person get in a car accident on purpose. People generally obey at least the spirit of most traffic laws. Nearly everyone’s car is inspected ensuring that their windshield wipers are in good working order, their lights work, and their tires have enough tread to get great traction. Most people also have regular maintenance performed on their cars by mechanics. This system works so well because the overwhelming majority of the cars on the road are in excellent working order.
The people in the medical-insurance system, not so much:
- According to the John Hopkins University Medical School, 84 million people in the United States (27 percent) live with cardiovascular disease.
- According to the American Diabetes Association, 39 million people in the United States (13 percent) live with type-2 diabetes and the number of people living with type-2 diabetes is growing at a rapid rate. The total cost of treating type-2 diabetes in the United States increased 45 percent (from $174 billion to $245 billion) in just the five years between 2007 and 2012.
- According to the Centers for Disease Control and Prevention, 40 percent of people in the United States will develop type-2 diabetes in their lifetime.
- According to the Alzheimer’s Society, the global cost of dementia is over $600 billion annually, about the same as the Gross Domestic Product of Switzerland.
- The World Health Organization has declared depression a worldwide epidemic, with five percent of the population living with the disease. In the United States, nearly 15 percent of the population takes an antidepressant medication, with this rate steadily growing in recent decades.
- According to the Centers for Disease Control and Prevention, more than two-thirds (69 percent) of adults in the United States are overweight/obese. Nearly three-quarters (74 percent) of men are overweight/obese. Almost two-thirds (64 percent) of women are overweight/obese. More than one-third (35 percent) of children are overweight/obese.
- According to the World Health Organization, about 60 percent of all deaths around the world are the result of these non-communicable diseases (a.k.a. lifestyle diseases).
- According to the Centers for Disease Control and Prevention, about 70 percent of all deaths among United States citizens are the result of these non-communicable disease (a.k.a. lifestyle diseases).
- According to the Centers for Disease Control and Prevention, these non-communicable diseases (a.k.a. lifestyle diseases) account for 86% of medical costs in the United States.
Our “healthcare” problem isn’t a problem of insurance, it isn’t a problem of government, it’s a problem of health. Of wellness.
As such, no amount of think tanks focused on the medical-care system and/or medical-insurance system is going to be able to solve this problem. The numbers will never add up. Not with free-market medical insurance. Not with single-payer medical insurance. The dollars and cents will never add up. In 2015, I paid $252 per month ($3,024 per year) for a year of “blah” medical insurance (very high deductible, fair coverage). In 2016, I paid $301 per month ($3,612 per year) for the same insurance. In 2017, I paid $359 per month ($4,308 per year) for the same insurance. I’ve already been informed of my projected premium for 2018 for the same insurance and these near-25-percent annual increases are projected to continue. Is it because “Obama had has head up his ass” or because “The Republicans just want to screw us all”? I wouldn’t give any of them that much credit. The reason for increasing deductibles, rising premiums, and rising co-pays is, in insurance speak, more and bigger claims. I know it’s easier to be mad at a politician or Blue Cross Blue Shield, none of who I claim to be angels, but they’re not the problem. The problem is the number and size of claims. The number and size of claims, if you’re willing to accept the truth, is directly proportional to the sinking wellness of citizens of the United States. You don’t have to be Will Hunting rogue studying at the Massachusetts Institute of Technology to understand this is a math problem, not a malice problem.
The amazing car-insurance system would fall apart too if we all stopped taking care of our cars and started driving recklessly. Premiums and deductibles would skyrocket. There’d be a long wait to get in to see a mechanic. They’d add co-pays to the system. People would be chanting in public spaces: “Fix car care. Fix car care. Fix car care.” It’d be a mess. But that’s what the overwhelming majority of people are doing with themselves: They’ve stopped taking care of themselves and they’re living recklessly. As such, there’s no realistic way to insure us and our wellness.
We don’t need an insurance solution for our wellness problem. We need a wellness solution for our wellness problem.
We need to align a highly functioning medical-care system, with a highly functioning medical-insurance system, with a highly functioning self-care system. No one seems to want to talk about that. And don’t tell me that you agree and that “preventative medicine” should be “covered”. “Preventative medicine” is really early detection of disease. Sure, that’s helpful because it’s easier and less expensive to treat the symptoms of sickness when you find them earlier rather than later. But true disease prevention is self-care. Self-care prevents disease altogether.
According to the World Health Organization, about 80 percent of non-communicable diseases (a.k.a. lifestyle diseases) are preventable by exercising well, eating well, and related self-care.
What if we took 80 percent, even 40 percent, even 20 percent of the claims out of the medical-insurance system? Blue Cross who? Medical insurance would quickly become a non-issue. And, as a side effect (pun intended), millions of us would be feeling better. That’s priceless.
I’m not calling for anything regarding medical insurance. Insurance is terribly boring to me. Insurance is also fear-based which isn’t how I operate. I stand for life. For wellness. For thriving. Wellness doesn’t happen in hospitals or in Hartford (“The Insurance Capital of the World”) or at “healthcare” rallies. Wellness happens in communities, on hiking trails, among friends, in dance halls, at dinner tables, in vibrant workplaces, at farmers’ markets, etc. Wellness happens when, like Andy Dufresne when he decides he’s not going to spend the rest of his life in Shawshank State Penitentiary, we realize: “It’s either time to get busy living or it’s time to get busy dying.” I mean really living. Thriving. Who’s with me?
*Car insurance is a great example of collaboration only by very recent standards. Pre-agricultural people collaborated in ways that blow most people’s minds. Prior to the advent of agriculture a mere 10,000 years ago, all humans lived as hunter-gatherers (a.k.a. foragers). Hunter-gatherers were fiercely egalitarian masters of collaboration. I speak of hunter-gatherers in the past tense because most humans become farmers about 10,000 years ago and factory workers about 300 years ago. However, some humans remain hunter-gatherers today and continue to live in very egalitarian, collaborative societies.
Remember your mantra for today: NOURISHING MOVEMENT, NOURISHING FOOD, NOURISHING LIFE.
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