Stop Excessive Medical Spending with Inexpensive Wellness Strategies

The debate on how to revamp the health care system in this country has been missing a — make that the — key point. We’re spending about $500 billion a year treating Americans for just 10 conditions, many of which are, in fact, preventable through lifestyle. What are these illnesses that are costing so much yet are so easy to avoid? Here’s the list published by the Agency for Healthcare Research and Quality (AHRQ) of the top 10 categories of health care expenditures here in the US…

  • Heart conditions — $76 billion
  • Trauma — $72 billion
  • Cancer — $70 billion
  • Mental disorders, including depression — $56 billion
  • Asthma and chronic obstructive pulmonary disease — $54 billion
  • High blood pressure — $42 billion
  • Type 2 diabetes — $34 billion
  • Osteoarthritis and other joint diseases — $34 billion
  • Back problems — $32 billion
  • Normal childbirth — $32 billion

IT’S HARD TO BELIEVE BUT…

These out-of-control health care costs are largely driven not by a commitment to promoting what’s healthiest for consumers, but — outrageously — by what is most profitable for the health care industry. Daily Health News contributing editor Andrew L. Rubman, ND, points out that while we spend the most of all industrialized nations on health care, our resources are allocated so inefficiently that we also have some of the worst outcome figures.

For example, there is a near myopic focus on prevention of heart disease by lowering cholesterol with pharmaceutical drugs. Despite lingering questions about their effectiveness and potential serious side effects such as liver damage and muscle problems, cholesterol-lowering statins remain among the best-selling drugs in this country. Through incentives and aggressive
so-called educational efforts, drug companies influence physicians to buy into the “statins for health” medical model. However, there are serious concerns regarding the interpretation of clinical research designed to support a causal relationship between LDL or “bad” cholesterol levels and cardiovascular disease, says Dr. Rubman. And, despite all this, there is now a push underway to give statins to our increasingly overweight children.

Another example: Windfall profits are racked up not by preventing diseases such as type 2 diabetes, but by treating their complications. For instance, Dr. Rubman points out that as matters currently stand, patients may find it easier to get insurance reimbursement for a $40,000 amputation than for simple, inexpensive preventive measures. Visits to a nutritionist for advice on how to keep diabetes in check and avoid such dire complications are required to be covered by insurance in only 11 states. (For more on this topic, see Daily Health News, July 24, 2006.)

A BETTER WAY

Far better would be to provide support for, and boost awareness of, the many other simple, low-cost and low-tech strategies to prevent disease and enhance wellness. For example, says Dr. Rubman, the following measures cost very little and can help combat heart disease (number one on the top expenditure list) quite effectively…

Supplements. In European hospitals, many physicians administer the antioxidant supplement L-carnitine to patients with symptoms of heart attack or stroke. Multiple studies support the use of L-carnitine in the management of acute and chronic cardiovascular disease. This inexpensive amino acid derivative is tolerated well and can be used to improve oxygen utilization and reduce heart muscle damage.

Dr. Rubman notes that we need to shift our focus from cholesterol to inflammation as the key culprit in cardiovascular problems. For this, he prescribes naturally anti-inflammatory omega-3 fatty acids to reduce blood clotting and heart rhythm problems, and lower harmful triglyceride levels and blood pressure. In your diet, good sources of omega-3s are fish such as herring, salmon and tuna (eat twice a week), and seed oils such as canola and flaxseed.

Chromium, a trace nutrient, has been shown to improve cardiovascular risk factors such as blood lipid levels, as well as to moderate insulin receptor sensitivity and manage blood sugar levels in patients with diabetes — which, as we know all too well, frequently goes hand in hand with heart disease. Chromium deficiency can lead to insulin resistance and increased blood glucose levels. Studies show that daily chromium supplementation reduces fasting blood glucose levels in people with type 2 diabetes who are chromium-deficient. Chromium has a very good safety profile.

Lifestyle modification. It sounds so boring and simplistic, but more and more research shows that a proper diet and regular exercise are essential to prevent or manage many of the ailments on the top 10 list above. We all know the rules — more fresh fruits, vegetables… lean protein… healthful carbohydrates… and far, far less of the refined carbs that send blood sugar levels alternately spiking and crashing. Blah, blah, blah, right? The problem is, this method isn’t as easy, as convenient or as fast-acting as taking a pill. Our desire for indulgence and immediate gratification is killing us and costing billions of dollars along the way.

AN OUNCE OF PREVENTION

Along these lines, I was heartened to see a report issued this summer from the Washington, DC-based Trust for America’s Health, estimating that implementing community-based health programs aimed at diet, exercise, smoking prevention and other known factors that influence chronic disease would save about $16 billion a year in health care costs. Their analysis showed that investing in effective prevention programs costing less than $10 a person could reduce the rates of type 2 diabetes and high blood pressure by 5% within just two years… cut heart disease, kidney disease and stroke by 5% within five years… and lower rates of some forms of cancer, arthritis and COPD by 2.5% in 10 to 20 years.

As our grandmothers said, an ounce of prevention is worth a pound of cure. In Dr. Rubman’s view, it’s time to shift the medical paradigm from controlling symptoms to addressing their underlying cause — enhancing wellness to prevent disease. Only then can we more effectively and more economically manage common, chronic health challenges. Who can argue with changes that cut health care costs while improving our health?

Source: Andrew L. Rubman, ND, director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut.

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