Only You Can Lower Healthcare Costs

If you don’t know my story, I went part time at my job in October 2017 after exceeding my target financial independence net worth.  One of the reasons I stay part time instead of fully retiring is to keep my healthcare benefits. 

To be honest, healthcare costs scare me.  My Dad died 30 years ago and I remember seeing the bills for those chemo treatments.  I can only imagine what they’d be now. 

The healthcare problem is complex.  It’s easy (and lazy) to simply point the finger at the insurance companies, drug companies, or the practitioners and say “they’re robbing us” or “they charge too much”. 

What about us?  What’s our responsibility to take care of ourselves?  

 

Reality Check

Here’s the deal – America’s obesity rate is now a whopping 42.4%.  That’s a milestone not worth celebrating.  And about 72% of Americans are overweight. 

So if you pick 10 random Americans more than 7 on average will be overweight and 4 will be obese. 

So what? 

Well, being overweight and obese leads to chronic diseases such as type II diabetes, hypertension, and cardiovascular disease to name just a few of many. 

And here’s a short list of the effects of the obesity epidemic…

• The lack of able-bodied recruits for America’s military is our “next existential threat” –  Just watch this TED talk from 3-star General Mark Hertling about this issue. It’s from 2012 but the problem has only gotten way worse in the past 7 years.
• Obese employees incur more than double the amount in health care, workers compensation, and short-term disability costs than normal weight employees.
• Americans are retiring later, dying sooner, and sicker in between, and obesity is the leading culprit.
• Healthcare costs for a person with diabetes are over $13,000 per year.  For a person without diabetes they’re about $2,500 per year.  This New York Times piece details the massive toll this disease is taking on our country.
• Chronic conditions now affect 15 percent to 18 percent of children and teens, and even those estimates may not fully account for obesity and mental health woes.

 

Stop Complaining, Look In The Mirror

So we complain about the high cost of treatment and insurance, while conveniently ignoring the fact that as a country we need so much more treatment for things we shouldn’t.  

From the NACDD:

According to the Centers for Disease Control and Prevention (CDC), chronic disease accounts for approximately 75 percent of the nation’s aggregate health care spending – or an estimated $5,300 per person in the U.S. each year. In terms of public insurance, treatment of chronic disease constitutes an even larger proportion of spending – 96 cents per dollar for Medicare and 83 cents per dollar for Medicaid.

You read that correcty, 75%.

When faced with these numbers I hear many say today “these conditions are mostly genetic”.

Bullshit.

From the Cleveland Clinic:

“Poor lifestyle choices, such as smoking, overuse of alcohol, poor diet, lack of physical activity and inadequate relief of chronic stress are key contributors in the development and progression of preventable chronic diseases, including obesity, type 2 diabetes mellitus, hypertension, cardiovascular disease and several types of cancer.” 

If you want more studies just use your google machine and read, America’s chronic diseases are mostly a result of lifestyle decisions and mostly our own fault.

So we’ve established now that chronic diseases are mostly our own fault and they account for 75% of America’s aggregate healthcare spending. Or to flip that around, almost three quarters of America’s aggregate healthcare spending could be significantly reduced if we simply changed our behaviors.

Okay, we have the power. Why don’t we do it?

Again, from the Cleveland Clinic:

Despite an understanding of what constitutes a healthy lifestyle, many patients lack the behavioral skills they need to apply everyday to sustain these good habits.

I think it’s time we stop bitching about our healthcare costs and fix them – by changing our behaviors and taking care of ourselves. 

The solution is US.  We can’t just keep getting fatter and hope it will solve itself, or that a magic pill will be invented.

As this article simply states, “The fastest way to lower costs, or at least to slow the upward spiral, is to reduce the number of Americans who carry excess weight, smoke, or drink too much alcohol.” 

 

Now You’re Mad, Don’t Send That Hate Mail

Before you finish that angry email or tweet you’re typing up, here’s the deal.  If you’re overweight or obese, I don’t dislike you – I commiserate with you because I was once too. 

I GET IT. 

I was a fat kid growing up and reached borderline obese in my mid-20’s, topping out at 230 pounds.  Now I weigh 162 pounds and feel amazing.  Let me tell you, it’s really friggin’ hard to maintain a healthy weight in our modern culture, I know that. 

And I know most of you are struggling with it, I sincerely feel for you.  The bad news is that the deck is stacked against us. 

There are simply more hurdles than ever to prevent us from staying at a normal weight.  As recently as the 1940’s and 50’s most Americans were a normal weight and exercise was not common.  Now we exercise more than ever and are fatter than ever. 

How can this be?  We haven’t changed genetically in that short of a time frame, we’re the same species. 

Here are some reasons why:

• We’ve injected conveniences into virtually every aspect of life to avoid physical effort of any kind.  We move way way less than we used to.  That’s not just exercise, which fewer than 25% of people get enough of.  That includes chores and things we used to do to simply live.  Now it’s all automated or outsourced.  Why lift a finger?
• We increasingly have sedentary jobs.  Computers are great and have done wonders for society.  Except for the fact that they’ve helped make us fat.  Oh, and we watch over 5 hours of TV/video a day.
• The ubiquity of toxic and shitty foods.  Our modern food environment is full of processed and sugar-laden franken-foods, and we’re addicted to them.  Hell, they’ve been engineered to be addictive. 
• The inaccuracy and bumbling of the science on food.  We’re the victims of changing opinions, and no one seems to have the answers.  Advice from the so-called experts changes all the time, they might as well just throw up their hands and be honest about it and say “ugh, I dunno”.  Hell, I can do that.
• We’ve increasingly fled to the suburbs and exburbs which require long car commutes and complete car dependency.  This goes back to the lack of moving, but it deserves it’s own mention because it’s the sedentary hell that most people live every day. 
• We’re eating out more than ever.  Yes, this is 100% our own fault.  Not only is this financially a horrible move, it’s a horrible move for your health too.  Portion sizes are mostly ridiculous and the food is mostly bad for you. And don’t get me started on fast food.  You can join in on all the “taco hell” jokes and laugh at that stuff, but here’s the deal – ya’ll are still eating that garbage in droves, and it’s keeping you fat and making you sick.
• If you want a more detailed discussion of the societal factors affecting obesity, dive in.

At the end of the day we have a huge amount of control over these things, except some aspects of the medical science part.  These are winnable battles.  But it takes a ton of discipline and self control, and it’s fucking hard.  

According to this article self-control is overrated.  I’m here to tell you it’s not – it worked for me and it can work for you. 

I’m no better than you, trust me.  I just cultivated the discipline and self control to take control of my weight.  It took me about twenty years to get to where I am, and I’m still working on it.  I’ll always be working on it because society is always dreaming up ways to make me fail.

And be aware that I fail often.  I’m human, I get it.

This is a real societal issue, and the forces behind it are too strong for just good intentions and advice to solve it.

 

I Have Faith In Americans

It’s not like Americans haven’t shown they can change behaviors before.  Smoking in America has decreased from 42.4% in 1965 to 13.9% in 2017.   We did that.

But solving the obesity epidemic will be way, way harder.  Obesity, unlike smoking, is caused by a multitude of diverse behavioral factors that are built into our modern lifestyles.  You can’t change one habit and fix it.  And ironically, the decrease in smoking may have worsened the obesity epidemic since smoking curbs your appetite. 

A common refrain in the FI community is that if you have debt you should treat it like your hair is on fire.  I say if you’re overweight or obese you should do the same. 

Getting to a normal weight improves virtually every aspect of your life, from sex drive to brain activity to energy levels.  But if we do it as a society we can drastically cut the costs of healthcare in America. 

And that’s something that everyone who strives for financial independence should get behind.

We have the power.