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Haven-Not: Silver-Bullet Health "Solution" Misfires

Can you have a better A-Team than this?   Amazon, Chase & Berkshire Hathaway joint venturing  via a new nonprofit, Haven, to finally solve our health care problems!   While I was hopeful when this joint venture was announced several years ago, I was also deeply skeptical.  Rather than addressing the root causes of health costs, such as inactivity and unhealthy nutrition, Haven tried  to "develop new ways to improve access to primary care, simplify insurance coverage and make prescription drugs more affordable"--including by throwing a lot of "big data" tech innovations at these issues. While this approach was pitched as a breakthrough, it was more of a Disease Management 2.0--focusing on more cost-efficient "care," rather than less chronic conditions to begin with.  The latter is the ultimate solution, but requires far more than blue-chip brands plus high-tech to resolve--and a lot more time.   2-3 years of effort just scratches the surface.  Dramatic
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Rather Pay $2T per Year or $500B One-Time?

The answer to this question should be a no-brainer: Is it better to pay trillions of dollars annually in preventable chronic health costs, or pay a cumulative $500-600 billion or so one-time in  student college loan defaults or Great Recession mortgage losses ? Hmmm.  We got the massive Dodd-Frank Reform in 2010 to prevent future financial catastrophes, and hopefully Great Recession 2.0--which cost private lenders $535B, plus much collateral damage to families & the economy.  We then got  Obama-era regulations, subsequently reversed under Trump ,  to reduce student loan defaults.  Now Biden has proposed eliminating all  public college/university, historically black college and undergraduate student debt .   This would make a big dent in about $585B in expected student loan defaults.  So where are the massive federal proposals to head off chronic diseases before they start?   With total US health spending at about $4T/year, that implies about $2T/year in preventable annual chronic c

Dueling Delusions in Health Advocacy: “Affordability” vs. “Personal Responsibility”

One side insists that we must have affordable health care for all.   The other side insists that individuals must take personal responsibility for their own health. For the “affordability” advocates, they mean that individuals should all be able to pay an affordable amount for health care, even if that requires government-funded free or highly subsidized health care for many, such as Medicaid & the Affordable Care Act. For the “personal responsibility” advocates,  they mean that many people choose to do unhealthy things, so they become unhealthy.  Why should “responsible” healthy people with healthy habits pay for the "irresponsible" ones?  In fact, doesn't free and subsidized health care encourage unhealthy behavior, since unhealthy people pay little for the consequences of their choices? What the affordability proponents don’t discuss, is whether the country can afford to pay for widespread free or highly subsidized health care--especially when 60% of adults hav

Is K-12 Education Patriotic Enough?

Questions have been raised about whether education in America is patriotic enough.  There are even proposals from the Oval Office to invest $5B in making US education more patriotic.  But what is "patriotic education" and how can we make K-12 ed more patriotic? These questions get very deep very fast.  If we want to educate people to become more pro-American, what is it that we want them to say is great about America?  And in cases where our country falls short of our ideals, how is our patriotism supposed to react to that?   Some people would say that it is unpatriotic to complain about America.  Yet probably the most broadly revered part of the Bill of Rights, which in turn is probably the most revered part of our Constitution, is the 1st Amendment--guaranteeing freedom of speech and religion, the right "peaceably to assemble"--and the right to "petition the Government for a redress of grievances."  So if everything is already perfect, why would we need

Medical Advice as Theater of the Absurd

By now, it should be clear that doctors' admonitions to lose weight and exercise more have little impact on our long-term, day-to-day behavior.  We all know this already from sad personal experience.  But we also know it from many studies, and from the multi-decade worsening in Americans' obesity and other chronic conditions.  The medical profession has been begging us for countless years to improve our health behavior--to almost no avail. Yet the fantastical headlines persist, even in publications like the Washington Post :  "Losing 13 percent of your weight could lead to big improvements in your health"    It is hard enough for adults to lose even 5 pounds and to keep it off--much less the 15-30+ pounds implied by "13%".  It is very rare to pull off sustained weight loss of this magnitude.   In fact, the only proven way currently to achieve this much permanent weight loss, on a whole-population scale, is the last resort, when all else has failed--bariatric

Our W.E. Op-ed with Heritage: A COVID-19 vaccine won't save us, but improving our health can

My op-ed with Lt. Gen. Tom Spoehr (Ret.) at The Heritage Foundation was just published! There is clear potential for nonpartisan approaches to child health & wellness. We can do a much better job of developing healthy habits K-12, so that Americans have a much greater chance of a healthy life!:   https://www.washingtonexaminer.com/opinion/a-covid-19-vaccine-wont-save-us-but-improving-our-health-can    

Covid Karma, Chronic Hope, K-12

 94% of US Covid-19 fatalities have been among Americans with chronic disease, according to recent CDC analysis.  Another way to look at this:  if we had pre-pandemic halved the current rate of 60% of Americans with 1 chronic condition and 40% with multiple conditions, we could have had roughly speaking less than 100,000 Covid-19 fatalities to-date.   Reducing chronic disease this much is not just hypothetical (though it is not easy either):  around ½ or more of chronic conditions are preventable.   The biggest catch?  They are only preventable at such a high rate, if we develop healthier habits in childhood.  If we enter adulthood with unhealthy habits, it is very difficult for people to change course.   Any strategy to dramatically improve overall health for most of the population rings hollow, if it does not start in childhood.   And any strategy to develop healthy habits in childhood rings hollow, if it is not centered in schools.  It is simply too expensive and logistically imprac