Rising Healthcare Costs Will Be the New Norm

The biggest U.S. industry is treating sick people, and it’s growing. Dr. Sears shares how to keep your share of expense to a minimum.

Today, healthcare in the United States consumes nearly 18% of the gross domestic product or about $3.2 trillion dollars per year.1 The amount spent on healthcare is more than three times the amount spent on education (supposedly good for the future of the country), and nearly five times more than spent on the military (supposedly to protect us from rest of the world). The biggest industry we have in the United States is treating sick people, and it’s growing. That’s not how you make America great.

Evidence-Based Medicine, and What We Have to Show For It

Evidence-based medicine is the guiding principle to our healthcare system. The premise is to use validated scientific research to make decisions about the care of individual patients. However, I believe the focus has truly been geared towards using drugs to treat illness as opposed to helping individuals improve their overall wellness.

In the last 15 years, the cost of U.S. healthcare has doubled, and in 2015 it rose by another 6%. That spells trouble for a country with an aging population. To add insult to injury, we also pay twice as much per capita on healthcare than other developed countries, yet the U.S. ranks like a developing country.2

Does a country have an obligation to provide some basic health services to its citizens? Of course it does, just like they have the obligation to provide police services to protect their citizens from internal violence. But these are two-way obligations. We also have an obligation to obey the laws as well as take care of themselves the best we can.

In the good old days, healthcare services were minimal at best. For the poor and the elderly, they were almost non-existent. If they paid for them, they quickly became destitute. Their only recourse was showing up at hospital emergency rooms. The hospitals that run those emergency rooms were becoming bankrupt by providing such basic care knowing that they would never be reimbursed. That’s why hospitals were such a strong lobby for the passage of Medicare and Medicaid. Now 50 years later, we are seeing fiscal consequences of this hospital bailout, which is making the bailout of Wall Street in 2008 look financially insignificant.

Much of our current healthcare expenses come from the treatment of chronic diseases. Most of these have a metabolic origin. That means they are primarily diet-induced. It is diet-induced inflammation that causes chronic diseases.3 In my opinion, the only “drug” there is to reverse such inflammation is an anti-inflammatory diet. Thinking that new technology will save us from ourselves is living in a fool’s paradise. New technology means more expensive healthcare, but not necessarily better health outcomes.

The Shift from Evidence-Based Medicine to Evidence-Based Wellness

We need is a new paradigm of healthcare based on what I call “Evidence-Based Wellness.” There are thousands of markers of chronic disease, but very few for determining wellness. If you can’t measure something, then it is difficult to monitor it, let alone optimize it.

Our current thinking is that if you don’t have a chronic disease, then you are probably well. Most chronic diseases only occur after years, if not decades of inflammatory assaults by low-level chronic cellular inflammation.4 Chronic diseases don’t happen overnight until there is enough accumulated damage that organ function is eventually compromised.

The usual treatment after that point is taking drugs for a lifetime to treat the symptoms, but not the underlying cause (cellular inflammation) that caused the loss of function in the first place.

Much of what is made of our increasing longevity is indicative of benefits of modern medicine. But once you factor in the decreased mortality of early childhood and mortality during childbirth, the increase longevity, especially in those who reach the age 50, has not increased that much.

Frankly, the greatest impact in health in the 20th century was not drugs, but improved sanitation (to reduce infectious diseases) and getting physicians to wash their hands (to reduce mortality during childbirth).

It is not longevity that is most important in life, but a longer health span. Health span is defined as years of longevity minus years of disability. In Western Europe (whose per capita healthcare costs are about half of those in the United States), the life span after age 50 has been increasing nearly three times faster than the health span.5 What a great trade-off, getting more years of compromised health. This is great news for drug companies, but not such great news for the taxpayers and their government who pay the increasing healthcare costs.

In my opinion, the real thrust of medicine should be understanding how to maintain wellness for as long as possible as opposed to simply extending lifespan. That can be achieved by committing to an anti-inflammatory diet for a lifetime. That’s my story and I am sticking to it.

References:

  1. Martin AB et al. “National health care spending: Faster growth in 2015 as coverage expands and utilization increases.” Health Affairs 36:1-11 (2017).
  2. Murray C and Frank J. “Ranking 37th — Measuring the Performance of the U.S. Health Care System.” New Engl J Med 362:98-99 (2010).
  3. Franceschi C and Campisi J. “Chronic inflammation and its potential contribution to age-associated diseases.” J Gerontol A Biol Sci Med 69:54-59 (2014).
  4. Sears B. The Mediterranean Zone. Ballantine Books. New York, NY (2014).
  5. Fouweather T et al. “Comparison of socio-economic indicators explaining inequalities in healthy life years at 50 in Europe. Eur J Pub Heal 10:1093-1099 (2015).

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About Dr. Barry Sears

Dr. Barry Sears is a leading authority on the impact of the diet on hormonal response, genetic expression, and inflammation. A former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology, Dr. Sears has dedicated his research efforts over the past 45 years to the study of lipids. He has published 40 scientific articles and holds 14 U.S. patents in the areas of intravenous drug delivery systems and hormonal regulation for the treatment of cardiovascular disease. He has also written 14 books, including the New York Times #1 best-seller, The Zone, which have sold more than 6 million copies in the U.S. and have been translated into 22 different languages.

Comments

  1. George

    There have been articles in the news saying that statins reduce inflammation and suggesting that more
    people will benefit from taking them. Can you explain why there is such a difference of opinion on the
    benefits of taking statins?

    Reply
    • Barry Sears

      Statins are very poor drugs for primary prevention of a heart attack. More than 100 people who have never had a heart attack would have to take statins for more than 5 years to prevent new heart attack. That means the other 99 individuals will see no benefits, but will have a significantly increased likelihood of developing diabetes.

      It is true that people with a familial hypercholesterolemia (LDL cholesterol levels greater than 200-400 mg/dl) do have an increased risk of heart attack, but this condition is caused by a genetic defect and is only found in 1 out 250 individuals. It has blindly assumed at all elevated LDL cholesterol levels (greater than 130 mg/dl) would also lead to increased risk of heart attack. This is assumption has not held up.

      Statins do have a slight anti-inflammatory effect like an aspirin, but an anti-inflammatory diet will have a far greater effect on reducing elevated LDL levels as well as reducing inflammation which is the underlying cause of an atherosclerotic plaque rupture.

      When it comes to highly promoted drugs, always follow the money trail.

      Reply
  2. Lynn Ripak

    Dr. Sears,
    To a certain degree yes; but, we cannot afford to pay for what we are paying for at the current time. It is sad to see people who pay nothing for healthcare abuse the system by running to the Hospital Emergency Room for everything. The Emergency Room is just that an emergency. There are many clinics which are more cost effective to use. Chronic conditions are followed up by physicians but what if you have changed your diet and exercise but still present with a thyroid condition. What can a person do to assist this condition without traditional medication – this is very common especially in women.

    Thank you.

    Reply
    • Barry Sears

      Thyroid conditions (especially hypothyroid) will need hormonal supplementation. However, this tricky since the T4 form that usually given must be transformed into the T3 form to be active. Furthermore, one may have to alter cortisol levels that are often low in cases of hypothyroidism. Fortunately, both drugs are very inexpensive, but require a skilled physician to administer them correctly.

      Reply
  3. JPIsbell

    Agree with your overall assessment. Prevention is so much better, cheaper, wiser than treatment. What is improbable involves enough people making the changes necessary in their lifestyle to markedly decrease the cost of medical care despite the encouragement and rationale to do so.

    Reply
  4. Don Perman

    What is one to think about the holistic doctors being what appears to be murdered over the development of curing medical conditions with out the use of drugs. What to do ?

    Reply
    • Barry Sears

      You never “cure” a chronic disease, you only manage it. For holistic physicians, they have to band together to undertake well designed clinical trials to support their observations. This was done for chelation therapy in which it was found to be effective in the treatment of diabetic cardiovascular patients, but no significant value in other cardiovascular patients without diabetes.

      Reply
  5. Mark McGinn

    great perspective, Barry, can you review the best measures of Evidence Based Wellness ?

    Reply
    • Barry Sears

      There are three test with the following ranges:

      AA/EPA ratio: 1.5 to 3

      TG/HDL ratio: less than 1

      Glycosylated hemoglobin (HbA1c): 4.9-5.1%

      Reply
  6. Marlane

    That’s right Dr Sears we shouldn’t always be thinking what can my Healthcare always do for me? But how can I work at being and maintaining the best version of Me. It takes the right tools,technique and patience to fix many things. Quick fixes a lot of times are only temporary. Proper nutrition education starting ASAP with the adult population and educating the young in our schools can change the path of health care destruction.

    Reply

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