D. Dowd Muska


The High Cost of Hard Livin’

January 10, 2013

From Beaumont to Boston to Bellevue, Americans are desperate for relief from an uncommon problem: an illness that isn’t their own damn fault.

The 2013 flu season is pummeling the populace with Kimbo Slice-like ferocity. Those who were struck will soon be followed by millions of new sufferers -- the Centers for Disease Control and Prevention says that the bug has arrived five weeks ahead of schedule, and this strain is a nasty one.

Influenza victims bear little blame for their condition. Unlike their friends and relatives in the Sun Belt, residents of cold-weather regions must hunker down, dry and stuffy, for the bulk of the winter. Unless you’re a trustafarian, work is unavoidable, too, and germs abound in even well-cleaned offices, factories, and stores. It’s wise to get the flu vaccine, but when pressed, public-health officials admit that the needle’s effectiveness is just 60 percent. Hand-washing has its limits.

In addition to ubiquitous, ever-mutating viruses, bad genes and out-of-the-blue calamities contribute to healthcare costs. Children with leukemia don’t make themselves sick. Neither do law-abiding motorists t-boned by drunk drivers.

But in most cases, ailing Americans have only themselves to blame.

Mean-spirited? Insensitive? Kooky? The data make it clear that treatment for lifestyle-induced afflictions dominate medical expenditures. A 2009 analysis in Health Affairs reached the jaw-dropping conclusion that “three-quarters of the $2 trillion-plus that we spend on U.S. health care each year goes to paying the bills for chronic illness: cardiovascular and pulmonary disease, cancers, diabetes, arthritis, high blood pressure, depression.”

Let’s start with tobacco. Cigarette-puffing causes heart disease, stoke, cancer, bronchitis, emphysema, and birth defects. Yet despite relentless PSAs and confiscatory taxes, 20 percent of Americans won’t give up their coffin nails.

At least smokers, kicked out of many public spaces, need to move around to enjoy their vice. A survey taken in the late 1990s -- years before Call of Duty -- found that 40 percent of adults are completely sedentary, i.e., they never “engage in any exercises, sports, or physically active hobbies in their leisure time.” Average TV-watching is up to five hours a day, according to the Harvard School of Public Health.

Cheap food + couch potatoism = obesity. The level of fattitude in the U.S. is revolting. Last year the Journal of the American Medical Association reported that a third of adults are obese (not overweight, obese), a share that has undergone “little change over the past 12 years.” We’re twice as plump as the Czech Republic, and ten times portlier than South Korea. No one is ignorant of the facts. Packing on the pounds increases the likelihood of diabetes, heart disease, cancer, hypertension, and stoke. No matter. There’s always gastric-bypass surgery, right?

A just-published, 405-page tome from the National Research Council and Institute of Medicine cobbled together the scary stats. “U.S. Health in International Perspective: Shorter Lives, Poorer Health” found that while “life expectancy and survival rates” have “improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries.” When judged against the average of 16 peers, a list that included Germany, Australia, Japan, Norway, and Canada, the U.S. fared worse in “nine health domains,” including heart disease, HIV/AIDS, substance abuse, and “adverse birth outcomes.”

Americans’ refusal to clean up their acts imposes a horrendous financial burden. If you are unaware of the historical numbers, it’s best to sit down. Here is the last half-century of national healthcare spending, per capita, adjusted to 2010 dollars:

1960           $1,124

1970           $2,059

1980           $2,989

1990           $4,861

2000           $6,198

2010           $8,401

Expenditures exploded by a factor of 7.5 -- during an era when reliable research about nutrition proliferated, as did widespread recognition of the value of exercise. Amazingly, as society learned more about how to be healthy, its habits grew increasingly injurious.

The future promises more of the same. The citizenry has grown accustomed to forcing others -- either employer-paid insurance companies or taxpayers -- to subsidize its hard-livin’ ways. By further isolating its “beneficiaries” from the hidden costs of their poor choices, Obamacare is an immense step backward. (Republicans, honoring convention, are too gutless to tackle the true causes of the healthcare crisis. Might offend voters.)

Over the last five decades, America, once the most grown-up nation on the planet, has regressed into an embarrassing infantilism. It wants endless government goodies without high taxes and debt, happy children without two-parent households, and health without nutrition and exercise. It’s time for a massive booster shot of maturity.

D. Dowd Muska (www.dowdmuska.com) writes about government, economics, and technology. Follow him on Twitter @dowdmuska.

# # # # #