Our Health Care Crisis - A Perfect Storm of Politics, Economics, And Disease

Dana S Kellis MD PhD MBA FACP

“He who has health has hope, and he who has hope, has everything.”  Own Arthur

fixingushealthcare.com

Saturday, December 14, 2024

Dear Mr. President, Honorable Members of Congress and Distinguished Staff and Fine Citizens

The deteriorating health of Americans helps to drive the Health Care crisis in our country. Although distracted by other events, we must turn our attention to fixing the US health care system. Demand for health services will dramatically increase in the coming few years.  Why is this?  Briefly, major determinants of our health continue to worsen. 

The obesity epidemic already strains our nation’s health care resources.  The incidence of obesity amongst Americans more than tripled since 1960, from 14% then to 43% currently.  The incidence of morbid obesity increased 10-fold, from 1% to 10% currently.  Childhood obesity rates tripled from 5% in the early 1970’s to 16% in 2020.  The financial and physical impact of obesity rivals that of the Covid epidemic, and these costs continue to increase.  By 2035 up to 80% of Americans will be overweight or obese.  Not only does obesity markedly increase a person’s risk for heart disease, cancer, diabetes and infections, individuals most likely to be affected by obesity are also most likely to have limited access to health care.  Obesity rates are far higher among the poor, those with lower levels of education, and those living in states with lower access to health care. 

According to the American Diabetes Association, nearly 12% of Americans suffered from diabetes in 2021, and nearly a third of Americans over the age of 65 had diabetes. Perhaps of even greater concern, nearly 100 million Americans had pre-diabetes in 2021.  These rates will increase by 165% by 2050.  Associated with obesity, lack of exercise, and genetic predisposition, patients with diabetes have a markedly increased incidence of heart disease, vascular disease, kidney insufficiency, neurologic disorders including dementia and neuropathy, diminished vision and other conditions. 

Many other conditions affecting Americans’ health show marked increases in prevalence.  In the last quarter century, gun deaths nearly doubled from just over 28,000 in 1999 to 48,200 in 2022.  On average, 132 people die every day in America from gun violence .  In the last five years, alcohol-related deaths increased 29%, from 138,000 to 178,000, and these numbers don’t include the increased incidence of cancer, heart disease, neurologic illness, fatal automobile accidents and injuries and many other effects of alcohol on the health and well-being of Americans. 

With the markedly decreased incidence of smoking, and the development of effective screening tools for some of the most common types of cancer, cancer mortality rates have fallen precipitously over the past several decades.  Nevertheless, the incidence of 6 of the 10 most common types of cancer - breast, prostate, endometrial, melanoma, pancreatic and kidney – is increasing, with projections that cancer mortality rates will begin increasing again in the near future. 

The importance of these trends cannot be overstated.  As the number of Americans who can’t afford the costs of their care continues to increase, so too the numbers of Americans with life-threatening illnesses, injuries, and conditions show significant increases, thus creating a tidal wave of unfunded, highly resource-intensive care that could potentially undermine the foundations of our American health care (non) system.  We experienced our nation’s health care resources being overwhelmed by the Covid epidemic that fortunately was mostly resolved with the development of an effective vaccine along with attenuation of the virus’ lethality.  Imagine, though, if we suddenly found ourselves in a similar degree of overload of demand for services, and there was no end in sight? 

With the Covid epidemic in our ‘rearview mirror’, it seems little has changed in our approach to dealing with population-level urgencies and emergencies.  What can be done?

• Many of the conditions I mentioned are ultimately preventable.  Most are associated with lack of access to adequate health care resources and poverty.  Restructuring our health care (non) system to provide access to care and treatment for all Americans needs to be a top-level priority.

• The lessons of Covid apply to our current situation.  We need focused leadership to lead the response to our health care crisis.  Hoping a “laissez faire” approach will get us where we need to be is delusional at best.

• This is an American challenge not isolated to either political party.  Subjecting the victims of this crisis to political maneuvering is the height of hypocrisy.  We need a dedicated bipartisan effort to bring our resources together and find the best ways to apply them to our current situation.

With American ingenuity and will, we can get our country to a better place, but now is the time to act!

Respectfully submitted,

Dana S Kellis MD PhD MBA FACP

fixingushealthcare.com

Copy to: We The People at fixingushealthcare.com