By the time you read this, the Iowa caucuses will be over and all attention will be redirected towards the state of New Hampshire. While our messy political process might not let us sleep any easier, we will at least have confidence that there is no topic off limits in this presidential campaign. Or is there? As it turns out, there is a six-letter word no one dares to utter…health.
Health. Not to be confused with health care, the system we pay for, or healthcare, an adjective referencing the professionals who treat us. In 2014, The Commonwealth Fund issued a report, often referenced on the campaign trail, noting that the U.S. spends substantially more on health care among eleven industrialized countries, but ranks last overall when it comes to outcomes. We are dead last on efficiency and equity. We are last on infant mortality. We are last on deaths that are preventable if access to care is provided in a timely manner. We are second to last on healthy life expectancy at age 60. However, not one candidate appears willing to discuss the possibility that the $8,508 we spend per person each year for disease care is completely unrelated to improving the health of Americans. If any of these candidates were willing to have a conversation about health, I can’t help but wonder what that conversation would be like.
Unfortunately, the conversation can’t focus on prevention. While the Affordable Care Act did much to improve access, the prevailing definition of prevention fails to address the root cause of illness, because the Congressional Budget Office (CBO) defines prevention as a process that involves screening, testing, and vaccination. Prevention, says CBO, increases utilization and “leads to higher, not lower, medical spending overall.” Prevention is not about identifying and addressing the underlying causes of disease.
The conversation could focus on environmental toxins or air pollution. Let’s take a look at what’s happening in Flint, Michigan and how water and air quality affects our health directly, and the consequences of an aging infrastructure. All these are causing a devastating impact on the future health of an entire generation of children. Also, a new study determined that 27 percent of all global cancer deaths occur in China, with the most common being lung cancer. Air pollution is taking a heavy toll on the health of the Chinese with an average of 7500 deaths per day due to cancer.
I would also like the conversation to address our food supply. The impact of regenerative farming practices on the health of the soil, the importance of relying on organic, and the essential need to pasture animals, all of which serve to reduce the carbon footprint with the added bonus of ensuring a healthy food supply for the duration.
The conversation could also be about natural ways to be healthy. We could place nutrition as the core of health care instead of using food as a weapon on Capitol Hill in the debates on price supports. We could reimburse people for taking dietary supplements since our current farming practices and food consumption paradigms create nutrient deficiencies that lead to disease. We could also reward the merits of alternative practices such as yoga, meditation, acupuncture and chiropractic. We could talk about all of this. Instead, our candidates are as quiet as the plains of Iowa post-caucus on the topic.
And yet, this pathological optimist is reminded this process has just begun, leaving ample opportunity for the choir to whom I preach to reach out and touch those candidates. Check the upcoming primary schedule and seek out the opinions of the men and women who seek to shepherd this country for the next four years. Ask what they think is the difference between disease care and health care, and be prepared to enlighten.
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Biography: Karen Howard, CEO and Executive Director of Organic & Natural Health Association, is a visionary and results-focused leader who has spent more than 30 years working with Congress, state legislatures and healthcare organizations to develop innovative healthcare policy and programs. She has held a variety of executive positions, including serving as professional staff for a Congressional committee, and has policy expertise in the diverse areas of integrative and complementary medicine, managed care, healthcare technology and mental health. An advocate at heart, she has worked to strategically advance the mission and vision of organizations through effective advocacy and strong collaboration.