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US Healthcare Crisis

By Dr. Thomas Hardy

WillworkforHelathcare            The high and continually rising cost of health care in the US and other industrialized nations is well known. United States government (CMS-Centers for Medicare and Medicaid Services) data show that in 2007 the cost per person was close to $7500, and is projected to be about $13,000 per person in 2018. In 2009 the National Health Expenditure (NHE) had grown to over 17% ($2.5 trillion) of the Gross Domestic Product of the United States and its share is projected to increase to 19.3% by 2019.

          Personal health care spending for the 65 and older population is much higher ($14,797 in 2004) compared to spending per child (5.6 times) and 3.3 times the working age population. In 2004 the elderly comprised the smallest population group in the nation, however, as the baby boomer population ages, a large number of Americans will qualify for Medicare, an entitlement which is already facing severe challenges in funding.

          Coinciding with the rise in health care expenditure there has been a rise in health insurance premiums for all Americans. According to a survey of employer – sponsored health benefits conducted by Kaiser/HRET, the average cost of a policy for a family of four was $7,000 in 2001, and in 2009 the cost had almost doubled.

          The majority, up to 75%, of treated medical problems are for lifestyle-associated diseases and their associated attendant side problems. Fortunately, all of the diseases associated with lifestyle can be prevented or reversed by simple but effective behavior modifications.
Lifestyle associated diseases include those that are caused by what we eat, habits we develop, and lack of physical activity.

What and How Much We Eat

           In terms of our diets and over eating, the Centers for Disease Control National Health and Nutrition Survey III shows that obesity most commonly leads to Type 2 diabetes, high blood pressure, and heart disease. Unfortunately, over one-third of Americans are now obese and over 2-thirds are overweight with Body Mass Indices of greater than 30 and 25 respectively.

Obesity and Type 2 Diabetes

           Diabetes is a condition characterized by too much sugar in the blood. Too much sugar in the blood acts as a corrosive and harms the blood vessels. Small blood vessels like those found in the eyes, kidneys, and toes are particularly affected by this disease.

          Type 2 diabetes develops when either the body does not produce enough insulin , or the body ignores the insulin that is produced. Insulin is the hormone required to remove sugar (glucose) from the blood stream and put it into our cells so the body can use it. Obesity diminishes insulin’s ability to control blood sugar, and therefore leads to an increased risk of developing diabetes. Over time, the body is no longer able to keep blood sugar levels in the normal range.

Obesity and Heart Disease

            Overweight and obese people have an increased incidence of heart disease, and thus fall victim to heart attack, congestive heart failure, sudden cardiac death, angina, and abnormal heart rhythm more often than those who maintain a healthy body mass index. Moreover, obesity often increases the risk of heart disease because of its negative effect on blood lipid levels, which increase in obese patients. People who are obese tend to have higher levels of LDL, (bad Cholesterol), and lower levers of HDL, (good Cholesterol) resulting in an optimal setup for a bad outcome.

Obesity and Hypertension

            Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Hypertension, or high blood pressure, greatly raises your risk of heart attack, stroke or kidney failure. Being overweight or obese increases the risk of developing high blood pressure. In fact, blood pressure rises as body weight increases. Losing even 10 pounds can lower blood pressure—and losing weight has the biggest effect on those who are overweight and already have hypertension.

Obesity and Cancer

            Our food choices not only have a direct effect on the above-mentioned metabolic problems, but can also expose a person to higher risk of certain types of cancers.  The American Cancer Society in its recommendations for preventing cancer advises maintaining a healthy weight throughout life. It advises eating a healthy diet with an emphasis on plant sources by consuming five or more [DWS1] servings of vegetables and fruits daily, choosing whole grains over processed foods, and limiting intake of processed and red meats. The ACS also advises limiting the use of alcoholic drinks.

Plant Based Diet: Likely a Panacea

              There is now very good evidence that a plant- based diet is perhaps the one thing that prevents diseases such as stroke, hypertension, and many types of cancers, according to Dr. Caldwell B Esselstyn, of the Cleveland Clinic Foundation. In fact, such diets have been documented as being able to reverse coronary artery disease and type 2 diabetes.


             It is well known that tobacco smoke is the cause of many health problems. It is a chief contributor to cancers, heart disease, lung disease like emphysema and asthma, and vascular disease. It is simply an activity that must be avoided in order to maintain a healthy lifestyle.


            There are many benefits to being physically active. It has been shown to help prevent cancers, obesity with its associated problems, Type 2 diabetes, heart disease, and depression. It is recommended to engage in at least 30 minutes of vigorous physical activity 5 or more days per week. Many sources suggest starting a simple walking program to reap the benefits of exercise.

Effects on Health Care

            These simple and inexpensive lifestyle modifications – plant-based diet, moderate exercise and avoidance of harmful substances - are proven methods used to treat or prevent many diseases that affect Americans today. There may come a time in the future when it is deemed cost prohibitive to provide the type of high tech care (designer medications, interventions, operations) to many patients.   Simple changes in diet, habits and activity, in large part are the answer to reducing the escalating level of health care expenditures, and are ultimately the key to driving down the cost of health insurance to more affordable levels.

Thomas Hardy, MD
International Council for Corporate Health