America's super-expensive and poorly ranked health care system is under scrutiny. You may have noticed.
The Affordable Care Act is turning out to be a hard thing to kill. One reason may be its name and the idea behind it. When it comes to our personal well-being, who doesn't love affordability and care?
Congress will take the time it takes to work out their version of an agreement, but meanwhile, we can all agree that throughout the public debate, back and forth, right and left, all the talk and tension is about insurance markets, insurance premiums, entitlement subsidies and the millions of people who will lose their medical insurance.
Here's what's missing: prevention and education. Preventing illness and injury saves billions of dollars, but that's not how our for-profit system figures things. Of all the spending we do on medical care in this country, only 4 percent — four pennies of every dollar — goes toward prevention and health education.
The other 96 percent goes to support a system of doctors, hospitals, insurance, technology and testing that treats illnesses and injuries after they occur.
Keep in mind that medical errors and mistakes by doctors and hospitals is now the third-leading cause of death in the United States. When we are made great again, this will have to change. Believe me.
Prevention and education: It's so far back on the Congressional burner it's left the kitchen. I find it frustrating and cruel. But recently I read an interesting and encouraging new book by Dr. Larry Cohen, founder and executive director of the Prevention Institute, and I'm beginning to feel better.
Cohen — who looks like the kind of guy everyone calls Larry — is a world-class authority on developing practical prevention and education strategies for communities. He's been doing it for more than 30 years. He fought the tobacco lobby and helped win, and he is very up-to-date on what's working, what's not and who is standing in the way.
I underlined his book wildly; then we had a phone call; and now I have hope.
"It's been a struggle, but we're seeing gathering momentum," he told me. "It's like a snowball going down a hill. The ball is getting bigger and bigger."
And why is that? "People 'get' prevention," he explains in his book. '"It's a natural instinct to look out for the health and well-being of family and friends. On a personal level, we understand that by eating and sleeping well, staying active, reducing stress, and getting medical care, when necessary, we'll live longer, healthier lives.
"That's what makes it so stunning that, as a country and a society, we often encourage the opposite of what our own instincts tell us to do. Why is this? Do we all lack discipline and self-control?"
Nope. Behavior is a factor, Dr. Cohen says, but it goes way beyond that.
"Our best intentions and efforts often clash with the experiences we have in our communities, the products that are available, " Cohen writes.
"Are there safe parks with children playing and elders walking? When we walk out our doors, are we greeted by an abundance of healthy, affordable food or a proliferation of fast food chains?
"Do televisions and radios blare with pharmaceutical ads promising an instant cure (just beware of the side effects — nausea, impotence, and in serious cases may include death)?"
"The answers to these questions lie at the heart of our ability to actually lead healthy, safe lives."
Of course, the answers only lead to more questions, because the pace of progress is so painfully slow, but Cohen understands that change comes from the bottom up, and in "Prevention Diaries" he chronicles many wonderful success stories of people making a difference: communities coming together to get junk food out of schools; to make healthy food more affordable; to pass more taxes on sugary sodas; to build safer streets, more bike lanes and more play areas; and to lead a very significant shift toward community-centered health.
"The change is happening everywhere. Prevention is nonpartisan," Larry says, and of course, he's absolutely right. "No one likes being sick."
NEXT WEEK: More good news about what you can do to practice prevention, even if our health care system doesn't really want you to.
ENERGY EXPRESS-O! OH, DARN
"Prioritizing profit over health explains why lobbyists representing medical, insurance, and pharmaceutical interests shell out $1.4 million every day to maintain the status quo." — Larry Cohen
Marilynn Preston — healthy lifestyle expert, well being coach and Emmy-winning producer — is the creator of Energy Express, the longest-running syndicated fitness column in the country. She has a website, marilynnpreston.com, and welcomes reader questions, which can be sent to [email protected] She also produces EnExTV, a digital reincarnation of her award-winning TV series about sports, fitness and adventure, for kids of all ages, at youtube.com/EnExTV and facebook.com/EnExTV. To find out more about Preston and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.