Health Catastrophe

Posted by: eric on October 7, 2009 at 6:48 pm

In the developed world, the twentieth century was a time of steady advancements in human health. Food became cheap and plentiful, improved sanitary conditions slowed and stopped the spread of many infectious diseases, and antibiotics dramatically reduced infections, once the leading cause of death. As a result, life expectancies greatly increased, mortality rates declined, and millions of additional people got the chance to live long, productive lives.

Today, unfortunately, much of that progress is threatened.  The Millennials’ world is threatened by epidemics of chronic disease and infectious diseases. These problems are made worse by an increasingly overburdened, ineffective, and unequal health system, as well as by environmental, nutritional, agricultural, and industrial practices that serve financial and political power interests rather than human needs.

It now appears that the emergence and rapid global spread of AIDS in the 1970s, abetted by the failure of authorities in the United States and around the world to take the threat seriously and invest in the systems needed to uncover, analyze, track, and treat the disease, may be merely a harbinger of even more deadly health threats to come.

Diseases of which most Americans are only vaguely aware, such as bovine spongiform encephalopathy (“mad cow disease”), SARS (which infected 8,400 people in 2003 and produced estimated losses of 60 billion dollars to the world economy), Nipah virus, and potentially pandemic avian influenza (“bird flu”), have the potential to spread worldwide and cause thousands or even millions of deaths. So do other diseases that are better-known but equally dangerous, including new drug-resistant strains of tuberculosis and the resurgent polio virus.  Does this sound overstated? Listen to how Margaret Chan, M.D.,the highly-respected director-general of the UN’s World Health Organization, summarizes the current situation in WHO’s 2007 World Health Report (for emphasis, I’ve highlighted selected sentences that might otherwise be overlooked in the flow of Dr. Chan’s sober prose):

The disease situation is anything but stable. Population growth, incursion into previously uninhabited areas, rapid urbanization, intensive farming practices, environmental degradation, and the misuse of antimicrobials have disrupted the equilibrium of the microbial world. New diseases are emerging at the historically unprecedented rate of one per year. Airlines now carry more than 2 billion passengers annually, vastly increasing opportunities for the rapid international spread of infectious agents and their vectors.  Dependence on chemicals has increased, as has awareness of the potential hazards for health and the environment.  Industrialization of food production and processing, and globalization of marketing and distribution mean that a single tainted ingredient can lead to the recall of tons of food items from scores of countries. In a particularly ominous trend, mainstay antimicrobials are failing at a rate that outpaces the development of replacement drugs.  These threats have become a much larger menace in a world characterized by high mobility, economic interdependence and electronic interconnectedness. Traditional defenses at national borders cannot protect against the invasion of a disease or vector. Real time news allows panic o spread with equal ease. Shocks to health reverberate as shocks to economies and business continuity in areas well beyond the affected site. Vulnerability is universal.

Life-threatening infectious diseases aren’t the only health problem we face, of course. We are already living through an epidemic of preventable chronic disease. An estimated 133 million Americans—45 percent of the population—suffer from a chronic illness such as asthma, diabetes, or heart disease. These illnesses kill millions of Americans every year and absorb an estimated 75 percent of total healthcare costs. If current trends continue, fully one-third of all the children born in 2000 will develop diabetes during their lifetimes.

The sad fact is that this epidemic could be largely prevented through proper nutrition, a cleaner environment, and preventive medicine. We are sickening ourselves while insurers and pharmaceutical companies rake in record profits treating symptoms rather than curing people.

Even more insidious is the practice by hospitals of setting up diabetes treatment centers as loss leaders to attract patients for amputations and treatment of congestive heart failure, two common results of diabetes that also happen to be highly profitable. It’s a perverse form of customer acquisition that serves the hospitals, not their patients.

Flawed incentives create destructive practices by insurance companies as well. High rates of patient churn make it natural for insurance companies to be basically unconcerned with the long-term health of their clients and to focus instead on immediate financial gain. Driven by short-term considerations—annual profits, quarterly results, share prices—they have no reason to reimburse customers for the cost of preventive care. Instead, they focus on denying care and treat only acute cases they cannot avoid.  The inevitable long-term result is a population that is steadily getting sicker.

2 Responses to “Health Catastrophe”

  1. Wilbur Parker Says:

    Very nice, I sure will be coming back more often. I bookmarked your site also, thank you.

  2. Domain Guidebook Says:

    Fairly interesting post. Couldn’t be written much better. Browsing this post reminds me of my old friend. He constantly kept babbling about this. I will forward this post and I’m pretty sure it will be a good read for ‘em. Thanks for sharing!