January is the month for resolutions.
For many Americans, this means renewing gym memberships, ordering a new pair of sneakers, and dusting off the basement treadmill. In my effort, I turn to the Nike running app on my phone, which has been dormant during the first half of winter, in hopes of getting in shape for the Ann Arbor Half Marathon in March.
Weight loss is perhaps the primary motivating factor for individuals getting back into running, but running also promotes strong bones, muscles and cardiovascular health.
Those who have made the commitment to bettering themselves in this new year are working against a wave of growing health concerns in our country.
Currently, more than one-third of U.S. adults and one-fifth of U.S. youths are considered clinically obese. Half do not meet the professional recommendations for aerobic exercise or physical activity. About one-in-five smokes cigarettes. And the Centers for Disease Control reports that over 9 percent of the U.S. population suffers from diabetes.
All told, about 117 million Americans have a chronic health condition, according to the CDC.
With such staggering health concerns, it’s hard to understand why the majority of well-intentioned New Year’s resolutions seem to fail so tragically by the third week of January. As in many aspects of American life, our priorities tend not to align with our best interests.
But let me put it into another perspective.
Every time an American is diagnosed with diabetes, or cardiovascular disease, or asthma, or cancer, it costs money. If those individuals happen to be covered via government programs such as Medicare or Medicaid, then the taxpayer is fronting at least part of the bill.
Recently, reforms have kicked in to try and combat the rising costs. Some physicians and health care companies can now receive reimbursements from health insurers if they are able to maintain a registry of healthy patients.
This prospect should make fundamental sense to physicians and health providers. Instead of being paid to fix the problem, they receive payment for preventing the problem from occurring in the first place.
But that couldn’t be further from the case.
The average clinic visit for a healthy patient — a 20-minute affair — nets the hospital a couple hundred dollars. However, cardiac surgeries can easily fetch $200,000.
This disparity is reflected in medical training. While a family practice physician might expect to earn about $180,000 by mid-career, a general surgeon can earn $350,000.
So when federal reforms seek to provide incentives for reducing costs, it seems they neglect some of the blatant financial disparities present in the current system — doctors get paid to treat sick patients, not healthy ones.
And many, such as Public Health Prof. Richard Hirth, have noted that these reforms leave out one critical element: the patient. In fact, our current system provides a notable lack of incentives for patients to stay healthy.
As we approach the last week of January, many Americans will have already fallen away from their New Year’s Resolutions and reentered the socio-economic quagmire of junk food and idle lifestyle promoted in our country.
But for those that remain motivated and committed to daily exercise and good nutrition, they are doing the country a financial service by staying at arms length from our health care system — free of charge.
Let’s all make a resolution to be supportive.