The Experts Agree On Healthcare

WE SPEND an enormous amount on health care in the United States. But what do we get in return? One of the most extensive studies of health care, the famous RAND study on health insurance conducted between 1974 and 1982, found that the availability of free health insurance didn’t seem to have a significant health outcome, except that people consumed about 30 percent more health care when it cost them less.

Robin Hanson attributes this anomalous result to the notion that the activity we call “medicine” covers two types of medicine. There is medicine that makes you better. Then there is medicine that makes you worse.

[H]ealth policy experts know that we see at best only weak aggregate relations between health and medicine, in contrast to apparently strong aggregate relations between health and many other factors, such as exercise, diet, sleep, smoking, pollution, climate, and social status.

Whatever “health policy experts” may know, politicians know that people want more affordable health care. That’s because we don’t spend money on health care because it works, according to Robin Hanson. We spend it because it “shows we care.”

In the Obama era, you might think there is no point in listening to a libertarian analyst like Hanson. But you never know. In the Wall Street Journal last week the goo-goo guys told us that the science on alternative medicine is decided. We are talking about “‘Alternative’ Medicine is Mainstream” by Deepak Chopra, Dean Ornish, Rustum Roy, and Andrew Weil. What do they assert?

Many people tend to think of breakthroughs in medicine as a new drug, laser or high-tech surgical procedure. They often have a hard time believing that the simple choices we make in our lifestyle — what we eat, how we respond to stress, whether or not we smoke cigarettes, how much exercise we get, and the quality of our relationships and social support — can be as powerful as drugs and surgery.

We spend $100 billion a year on two major procedures, angioplasties and stents, they write. Yet a recent study “found that angioplasties and stents do not prolong life or even prevent heart attacks in stable patients.” Another study “followed 30,000 men and women on six continents and found that changing lifestyle could prevent at least 90% of all heart disease.” The disease that accounts for the most premature deaths, they say, “is almost completely preventable by changing diet and lifestyle.”

And, they claim, Candidate Obama agreed with us. According to the Obama campaign literature:

An increasing number of Americans are suffering and dying needlessly from diseases such as obesity, diabetes, heart disease, asthma and HIV/AIDS, all of which can be delayed in onset if not prevented entirely.

Historians looking at life expectancy agree too. In Rising Life Expectancy: A Global History. James Riley identifies six areas that have reduced mortality: “public health, medicine, wealth and income, nutrition, behavior, and education.” Unfortunately it is difficult to determine how much each of these factors contribute to a longer life.

So liberals, conservatives, and historians are agreed. Medicine by itself is not the primary factor in life expectancy. Lifestyle choices are the real drivers of healthy living.

How does a new Democratic administration deal with the fact that lifestyle choices drive health, well-being, and life expectancy? The answer is simple. Consistent with its liberal culture of compulsion it cranks up ways to force Americans to eat right, exercise right, and live right. How will the Obamanoids do that? They will start by bashing the corporations.

Mayor Bloomberg of New York City has already shown how it works. People are getting fat! Evil fast-food corporations are manipulating them with deceptive advertising and super-size portions! We must force the fast-food corporations to serve healthy food to American consumers and end America’s obesity epidemic!

When the arm-twisting of the fast-food corporations fails then the food Nazis will resort to sterner measures. There are already hints of this in Britain, where the government is starting to mutter about denying expensive medical procedures to the morbidly obese.

What are they talking about? Nobody will actually be “denied” medical care. What do you think medical ethicists are for? If procedures to treat morbidly obese patients don’t produce positive outcomes, then it’s perfectly ethical to change the standard treatment protocols and cut out the wasteful and ineffective procedures.

After all, why not? A government that has gutted the value of a dollar by 96 percent in less than 100 years can surely find a way to erase a trivial problem like the $34 trillion Medicare unfunded liability. All you have to do is bash a corporation and then change the rules while nobody is looking.

Christopher Chantrill blogs at www.roadtothemiddleclass.com. His Road to the Middle Class is forthcoming.

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