Part 3 (1/2)

While prevention is always the goal, better management of chronic conditions is also essential. Right now we have a system that happily pays for a diabetic to have his foot amputated for about thirty thousand dollars but won't pay for visits to a nutritionist or podiatrist to keep that foot healthy. That's insane.

Tipping the Scale One-third of American adults are now obese-almost three times as many as in 1960. If we don't drop the Twinkies and pick up the carrot sticks, that number is expected to rise to almost one-half by 2020. Obesity rates are 50 percent higher for African Americans than for whites, and 20 percent higher for Hispanics, which explains why these groups suffer from an epidemic of diabetes.

Obesity-related health-care costs in 1998 were $74 billion. They are now $147 billion.

A Duke University study found that medical costs claimed from on-the-job injuries were seven times higher for obese workers.

In addition to diabetes, obesity has been linked to other chronic and degenerative diseases, like Alzheimer's. A 2010 study from Boston University School of Medicine found a link between stomach fat and a higher risk of Alzheimer's disease. Dr. Susanne Sorensen, who is in charge of research for the Alzheimer's Society, responded, ”This is not really surprising as a large stomach is a.s.sociated with high blood pressure, cholesterol and diabetes-all major risk factors for dementia.” Is it so much of a sacrifice to go for a jog or eat a salad if it means being able to stay lucid and vital in your old age?

An Inherited Problem Obesity is especially dangerous for pregnant women. About one in five women is obese (which means she has a body ma.s.s index, or BMI, of at least 30) when she becomes pregnant.

These mothers have much higher rates of Cesarean births, with all the risks of surgery. As BMI rises, women become two (BMI of 30-35), three (BMI of 35-40), and even four (BMI over 40) times more likely to have a Cesarean than a woman of normal weight, for whom the Cesarean rate is 11 percent.

The babies of obese mothers have double the risk of being stillborn and three times the risk of dying in their first month. They are 11 percent more likely to be born with a defective heart, and that gap jumps to 33 percent when the mother is one hundred pounds or more over a healthy weight.

These babies are less likely to be carried to term and thus more likely to need intensive (and expensive) neonatal care. A New York Times New York Times story about an obese woman who had a stroke and gave birth to her baby prematurely found that while a normal delivery would have cost about thirteen thousand dollars, the costs for this woman and her child were over two hundred thousand dollars! story about an obese woman who had a stroke and gave birth to her baby prematurely found that while a normal delivery would have cost about thirteen thousand dollars, the costs for this woman and her child were over two hundred thousand dollars!

And this problem doesn't stop with mothers. One of the most publicized interviews I've conducted for my Fox News weekend show was with First Lady Mich.e.l.le Obama. Shortly after a.s.suming the role of First Lady, she announced that she would make childhood obesity one of her major areas of focus. I was thrilled to hear it. I have taken a lot of heat from fellow conservatives who would demonize the Obamas for anything and everything, but that's absurd and as appalling as it was for yahoos like Keith Olbermann to do the same thing to President George W. Bush. We do have a serious crisis with childhood obesity in this country, and if you doubt it, here's an experiment for you. Go through your personal belongings and dig out your cla.s.s photo from the third grade. The following day, pay a visit to a third-grade cla.s.s somewhere in America-doesn't matter what part of the country, doesn't matter if it's a private or a public school. Walk into that cla.s.s and take a look at the kids and compare them to the look of your your third-grade cla.s.s. I promise if you do this, you will never again doubt that there have been dramatic changes in the health of children in this country. third-grade cla.s.s. I promise if you do this, you will never again doubt that there have been dramatic changes in the health of children in this country.

Since 1980, the number of obese children in the United States has tripled, to about 17 percent. We are seeing children as young as seven with type 2 diabetes (which used to be called adult-onset diabetes) and preteens taking medication for high blood pressure along with their grandparents. It is very sad and very scary to think that our children may have a shorter life expectancy than we do and that they will age with much illness and suffering.

A survey by C.S. Mott Children's Hospital in Ann Arbor, Michigan, found that over 40 percent of parents with obese children thought that their children were a healthy weight! We can't solve the problem if we don't recognize it.

There are more obese children in the southeastern part of the country, the so-called stroke belt. In 2010 the Archives of Pediatrics and Adolescent Medicine Archives of Pediatrics and Adolescent Medicine reported that Oregon has the lowest percentage of obese children and Mississippi has the highest. States where children watch more TV and are less physically active have higher obesity rates, just as you would expect. reported that Oregon has the lowest percentage of obese children and Mississippi has the highest. States where children watch more TV and are less physically active have higher obesity rates, just as you would expect.

A 2010 study from the University of Michigan found that obese children are 63 percent more likely to be bullied than thin children. Their obesity wasn't just a threat to their physical health-they also had higher rates of depression and loneliness. Even though childhood obesity has become all too common, it is still not accepted.

A study from Ohio State University in 2010 had three recommendations for reducing childhood obesity: eating dinner as a family, cutting back on TV to no more than two hours a day, and making sure that children get enough sleep.

We also need more playgrounds and walking trails, more unstructured outdoor play, more recess and physical education at school (which many schools have cut back or eliminated since No Child Left Behind), and healthier school meals, with a special emphasis on eliminating high-calorie beverages. Children should exercise for at least an hour a day, at least five days a week.

This is an issue that I've personally invested in. To be clear, I don't want the government to become ”sugar sheriffs” and tell us what to eat or tax us for eating what they don't think we should eat. I do believe individuals should arm themselves with the facts and then make rational, adult decisions about their health and future. But the cost of ignoring the epidemic of childhood obesity is a staggering financial burden to taxpayers in the form of increased health-care costs for those on taxpayer-funded programs like Medicaid, as well as a body blow to the human capital that will be lost by a generation whose lives will be cut short by chronic diseases that will plague them until they die a premature death.

It's even having an impact on the military: Revelations made public in April 2010 by a panel of retired military officers showed that three out of four youths between the ages of seventeen and twenty-four were unfit for military service, primarily because of obesity!

It is crucial that we keep our children at a healthy weight, because those who are overweight or obese when they're young tend to remain so. We are setting our children up for a lifelong battle. And it's a battle that we're losing.

Take Care of Yourself Our society suffers from a double whammy when it comes to our health. We have become more sedentary by watching TV and sitting at our computers, activities that have a symbiotic relations.h.i.+p with sugary and salty snacks. It's very difficult to eat a bag of chips when you're swimming or playing basketball.

An old Chinese proverb certainly applies to becoming physically fit: A journey of a thousand miles really does begin-literally and figuratively-with a single step. People say they hate exercise. But think back to when you were a child-what did you enjoy? Bike riding? Skating? Just as people who say they hate vegetables can come up with at least one they like if they think hard enough, everyone can find a physical activity that is not a ch.o.r.e. Start small in both time and energy expended. Take the stairs instead of the elevator; park at the opposite end of the mall from the store you're going to. Ideally, you should exercise for at least thirty minutes a day, at least five days a week.

As for losing weight, don't say, ”I have to lose fifty pounds”; say, ”I am going to gain my health,” and when you do, take the steps to get healthy-good nutrition and realistic exercise. We all know the drill: eat smaller portions; limit high-calorie foods (those that are high in fat and refined sugar); eat more fruits, vegetables, and whole grains. But as I pointed out in my book about my own health journey, most of us need to spend a couple of weeks in ”detox” from the fatty and sugary foods that we are literally addicted to.

I think it's a big mistake to set a weight-loss goal. First, to be healthy, we need to change our lifestyles, not just our waistlines. Second, Americans by nature don't want to lose lose but to but to win win. If the goal is to lose lose weight, it goes against our instincts. Set a goal to weight, it goes against our instincts. Set a goal to win win health, and when you take the steps to do it, weight will take care of itself. health, and when you take the steps to do it, weight will take care of itself.

Any amount of weight you get rid of in the process of getting healthy and keep off does you good. Your goal is to be healthier, not to be America's next top model.

A Sensible Approach to Health Care Of course, no matter how well you take care of your body, things happen and you need to go to the doctor. And in order to stay truly healthy, you need to engage in preventive medicine as well. It is essential that we go for regular health screenings, such as mammograms and Pap tests for women, PSA tests for men, and colonoscopies and cholesterol tests for everyone. When detected early, breast, prostate, and colon cancer have survival rates of more than 90 percent. But a test can't save your life if you don't take it. Less than 40 percent of colorectal cancers are caught early, simply because people don't get tested. Aside from saving your life, early detection often leads to treatments that are much less grueling, debilitating, and expensive.

To do all this, we need doctors, and we need hospitals, but we need a sensible approach, and nationalized medicine is not the answer. In devising ObamaCare, the president got his priorities reversed. Rather than emphasize gaining control of spiraling health-care costs, he concentrated on getting more people into the already flawed system. It might have had a chance to work, if he had taken the other way around. Here's how: If costs are brought under control first, then more people would be able to afford health care in the private system. Also, this approach would slow the unsustainable rise we've seen in Medicare and Medicaid. Now, of the thirty million people slated to enter ObamaCare, about twenty million are coming in through an expansion of Medicaid.

Let's look at it another way. What you and I will be paying to subsidize other people's health care under ObamaCare could have instead been covered by cost reductions brought about by a truly free market. Instead, we get higher spending. The country is already well on the road to economic ruin (if you've been paying attention), and Medicare is on the way to rationing. ObamaCare, a huge mistake moving in the wrong direction, is foisted upon us at a critical time when eighty million baby boomers are about to enter Medicare and, in most cases, subsequently face most of their lifetime medical costs.

We should be doing several different things. We must allow health insurance to be sold across state lines-now prohibited-in order for the insured to shop around for the most reasonable policies. We need to implement legal liability reform so that personal injury lawyers can't treat the health-care system as a grab bag. But most of all, we need health insurance that is consumer based, not employer based. It's simple: You can't have a functioning free market when the person paying for the service and the person using the service are not the same. Up to now, when it comes to costs, no one has been minding the store. Because the increased costs are just taken out of wages, employers don't care. Because the employer is handling the payments, workers don't care. In fact, they may think that health care is free, but it's actually about as free as the proverbial free lunch. No such thing under the sun. Instead, it's to health care that their wage increases have gone for the last decade. Wages have not stagnated because employers aren't spending more on health care per employee; they've stagnated because those increases are going directly to the insurers, not into workers' pockets.

Right now, the working consumer-whether under a private or a government plan-pays only twelve cents on the dollar for health care. The other eighty-eight cents come from the employer. If you had to pay only twelve dollars for every $120 in groceries you bought because your boss would pay the difference, you wouldn't be reaching for the Hamburger Helper; you'd be stocking up on lobster and prime rib. Because of the present system, in other words, workers don't really have incentives to compare the relative cost and quality of physicians and hospitals or to refrain from overuse. Not every situation is an emergency. When people don't question whether or not they really need a test or procedure, it's probably because they have too little skin in the game.

Not only is ObamaCare cost prohibitive, it's already been shown to not work! In chapter 2, I mentioned how the federal government ignored the negative results of the health-care ”experiment” known as RomneyCare. It could be argued that if RomneyCare were a patient, the prognosis would be dismal. ”No one but Mr. Romney disagrees,” quipped Joseph Rago, senior editorial writer for the Wall Street Journal Wall Street Journal, in a piece ent.i.tled ”The Ma.s.sachusetts Health-Care Train Wreck.”

Governor Romney himself wrote a piece in the Wall Street Journal Wall Street Journal shortly after signing the bill, promising that everyone in Ma.s.sachusetts ”will soon have affordable health insurance and the cost of health care will be reduced.” A n.o.ble goal, indeed, but when the Ma.s.sachusetts Taxpayers Foundation stepped into the lab to examine this experiment-in-progress, they found that health care, which was 16 percent of the state budget in 1990, had jumped to 35 percent in 2010. (That's not a typo; health care is consuming over a third of the entire state budget!) Ma.s.sachusetts spends about twenty thousand dollars to insure a family of four, while an employer-based policy costs about thirteen thousand. shortly after signing the bill, promising that everyone in Ma.s.sachusetts ”will soon have affordable health insurance and the cost of health care will be reduced.” A n.o.ble goal, indeed, but when the Ma.s.sachusetts Taxpayers Foundation stepped into the lab to examine this experiment-in-progress, they found that health care, which was 16 percent of the state budget in 1990, had jumped to 35 percent in 2010. (That's not a typo; health care is consuming over a third of the entire state budget!) Ma.s.sachusetts spends about twenty thousand dollars to insure a family of four, while an employer-based policy costs about thirteen thousand.

You get one guess as to who now has the highest average health-insurance premiums in the country. Yep, it's Ma.s.sachusetts! We hear so much flak from the administration about ”unsustainable” increases nationwide in health-care costs, but according to the Boston Globe Boston Globe, premiums in Ma.s.sachusetts under RomneyCare are rising 21 percent to 46 percent faster than the national average. Rather than costs being reduced, as Romney promised, everyone-government, businesses, and consumers-is paying more.

If everyone in Ma.s.sachusetts is paying more, it must mean patients are receiving better care, right? In fact, just the opposite is happening. By almost three to one, Ma.s.sachusetts's residents believe that the quality of their care has been reduced. The people of Ma.s.sachusetts partic.i.p.ated in an experiment that blew up in their faces, and now they have to stand in line at the burn clinic.

If our goal in health-care reform is better care at lower cost, then we should take a lesson from RomneyCare, which shows that socialized medicine does not work does not work. Period. It astounds me that those on the left, claiming to advocate for those less fortunate, would push for a program that will, no doubt, put everyone in danger.

I recognize it's a tough world out there. It's scary to hear that people have lost their houses because they lacked health insurance or got dropped when they became seriously ill. I don't deny that these can be problems. But it has been less well publicized that some people lose homes indirectly indirectly as a result of rising health-care costs, even when they aren't dealing with a catastrophic illness. These tend to be folks who tried to make up for the stagnation in their wages by refinancing their homes on what they thought was their equity-equity that proved to be illusory and vanished in the downturn. Because what would have been their wage increases got diverted into ”employer-paid” health insurance, they relied on the borrowed money to buy cars and take vacations and pay college tuition. If they had stuck with their original mortgages, which had lower balances and payments, they wouldn't have lost their homes. I think we can understand why these choices were made, even if we can agree that they did not turn out to be sensible. as a result of rising health-care costs, even when they aren't dealing with a catastrophic illness. These tend to be folks who tried to make up for the stagnation in their wages by refinancing their homes on what they thought was their equity-equity that proved to be illusory and vanished in the downturn. Because what would have been their wage increases got diverted into ”employer-paid” health insurance, they relied on the borrowed money to buy cars and take vacations and pay college tuition. If they had stuck with their original mortgages, which had lower balances and payments, they wouldn't have lost their homes. I think we can understand why these choices were made, even if we can agree that they did not turn out to be sensible.

When Government Plays G.o.d When we conservatives warned that ObamaCare did not bode well for Grandma's life expectancy, we were accused of fearmongering. But nothing is more frightening than the words of President Obama's choice to head Medicare, Donald Berwick: ”The decision is not whether or not we will ration care-the decision is whether we will ration with our eyes open.” Funny, I never heard this among the administration's talking points when they were rounding up health-care votes in Congress. Dr. Berwick looks to Britain's socialized medicine for his inspiration: ”I am romantic about the National Health Service. I love it.” Uh-oh.

But we were in trouble even before ObamaCare pa.s.sed. Tucked away in the $787 billion stimulus was the establishment of the Federal Coordinating Council for Comparative Effectiveness, which will become our version of Britain's National Inst.i.tute for Health and Clinical Excellence, the ironically and Orwellian-named NICE. NICE decides who lives and who dies based on age and the cost of treatment. So the stimulus didn't just waste your money; it planted the seeds from which the poisonous tree of death panels will grow.

Dr. Berwick warns: ”Limited resources require decisions about who will have access to care and the extent of their coverage.” Yet if we were healthier, our resources would be sufficient to care for everyone.

Who will get rationed? Well, the very old and the very young, obviously, the most helpless and vulnerable among us. But it will also be those who don't live politically correct lives-those who have too many cigarettes or c.o.c.ktails or cans of soda. ”Death by Chocolate” won't just be a cute name on the dessert menu.

I fully realize that all health care is somewhat rationed, from the triage of the paramedics at the accident scene to the emergency room, where the most critical patients are given priority. But it's one thing for your own doctor to tell you you shouldn't have a procedure and quite another for it to be a government worker. I think I need a trip to the doctor just from thinking about giving the government that much power!

Dr. Berwick's belief system is fundamentally un-American: ”The complexity and cost of healthcare delivery systems may set up a tension between what is good for the society as a whole and what is best for an individual patient.” That's what happens under socialism. Individuals-your child, your parent, you-don't matter and may have to be sacrificed. By contrast, we have always believed that every life is precious; we have built the freest and most prosperous society in human history precisely by championing the individual. Americans believe that society exists to serve the individual, not the other way around.

CHAPTER SIX.

If You Don't Hear the School Bell Ring, Cla.s.s Never Starts We Need an Education System That Values All Students

I love rock'n' roll just as much as, if not more, than the next guy. One of my favorite tunes is the Pink Floyd megahit ”Another Brick in the Wall”: ”We don't need no ed-u-cay-shun . . . Hey! Teacher! Leave those kids alone!” But as catchy as that song is, I don't think it should serve as a motto for our education system. Unfortunately, if you look around, that seems to be the case. love rock'n' roll just as much as, if not more, than the next guy. One of my favorite tunes is the Pink Floyd megahit ”Another Brick in the Wall”: ”We don't need no ed-u-cay-shun . . . Hey! Teacher! Leave those kids alone!” But as catchy as that song is, I don't think it should serve as a motto for our education system. Unfortunately, if you look around, that seems to be the case.

Case in point: A friend of mine owns a printing business, and as part of the job-application process he gives a prospective employee a ruler and a piece of paper. He tells the wannabe employee to mark one-eighth of an inch, one-sixteenth of an inch, and a few other simple measurements. He tells me that only about one in ten actually know what he's talking about!

If we are going to regain and retain our prosperity and keep America compet.i.tive in the twenty-first century, our children must get properly educated. Not only does a lack of education make children less compet.i.tive among their peers-often confining them to a life of low-paying, dead-end jobs (not to mention government handouts), but, as Americans grow up to be less educated than their counterparts in other countries-like China and India-our nation becomes less compet.i.tive as whole.

Already we see this trend taking a toll on American jobs as large companies seek talent from abroad to fill the s.p.a.ces Americans aren't skilled enough to fill. High-tech companies such as Microsoft, Google, Apple, and Cisco have had to recruit top talent from other countries such as India, Taiwan, Israel, and j.a.pan, which have held students to higher standards in math and science while our students continue to fall behind in these areas. Our children are growing up without the basic skills they need to stay compet.i.tive in the job market. We're pus.h.i.+ng them through a broken system and setting them up for failure on the other end.

Our children are our most valuable natural resource. The children we're educating (or not educating) today will grow up to be the presidents, business leaders, doctors, and scientists, not to mention teachers, of tomorrow. But you'd never know we were grooming such important people by the haphazard way in which we structure their education. ”Book learning” needs to go a long way toward a focus on the student and not just the school. We need to ignite the innate curiosity in the minds of young people and inspire them to be lifelong learners with an insatiable appet.i.te for knowledge and wisdom.