Health Matters

There’s this debate about whether or not health care is a fundamental right for Americans. The divide, like with most issues, seems to come down to ideology.

I was reminded again this weekend that this issue has been debated for the entirety of my lifetime, and another 30 years prior to my birth. It’s affected me personally and our family, especially relative to the birth of our son and now, seeing him transition into adulthood.

Mark came home for a quick visit to surprise his Mom on her birthday. These visits are always special because while Mark is no longer living on the left coast, a plane ride away, Providence is still not so close that we see him regularly, or as often as parents like to see their grown children.

As health goes, all three of us are fortunate. Short of some aches and pains, a few minor structural issues, and a few more assorted problems affecting Mary and I that are not life-threatening or debilitating, we’re all healthy as horses. That’s not to say that we’re not consumers of health care, either.

When Mark first graduated from college in 2006 and was living in Boston, I was adamant that he sign up for and maintain health insurance. Having sold the product and being aware of problems obtaining coverage later, as well as the risks of having no coverage, I felt that as a young man, this was an important investment.

In countries other than America, all well-known and some would argue, more economically viable, the availability of healthcare coverage for all citizens was decided long ago. I’m talking Germany, France, Great Britain, Canada–these aren’t third world nations. Even tiny Luxembourg has universal health care. Norway thought it important enough that they enshrined this right for their people all the way back in 1912.

The arguments against health and health care for Americans astound me. I’m not unaware of the challenges with our health care system, and there are certainly other factors that make Americans some of the unhealthiest people in what used to be called the industrialized world. Perhaps developed world might be a better term these days, since technology has long ago usurped industry as an economic factor.

It was gratifying to us as parents to hear Mark talk about having a doctor and having his eyes examined. We harangued him and pestered him for years after he left Wheaton to get his teeth cleaned at a low-cost clinic provided by Tufts in Boston when he lived there.

Right out of college, Mark struggled at times with employment. Several of his jobs didn’t provide health insurance. Because of our urging, he maintained a policy on his own. A couple of times, we helped him with the premiums, but he realized that having health insurance mattered. Even so, he went without insurance for a period of time after graduating with his MFA degree in 2011. He was fortunate not to have had any accidents or injuries during this period.

Now, his current employer, Brown, provides health insurance. Mark even has a vision plan, something Mary and I have been fortunate to have for a number of years. When you require glasses, having a plan that helps you get a yearly eye exam and update your prescription helps you not to bump into things.

I can’t imagine being 51 and not having health insurance. I’ve never known what it was like, save for a short period in my early 20s, of being without access to health care, or having some form of health insurance. I know millions of Americans aren’t as fortunate.

My current economic situation has dramatically changed. Being a free agent, I don’t have an employer-backed plan for myself. I now rely on my wife’s coverage, as a spouse. I’m happy to have that option. I have an appointment this week with a specialist for an ongoing issue affecting my left hand. It’s been painful, has altered my ability to lift weights, push myself up out of the pool while swimming, and even has been noticeable while cycling.

This isn’t a life-altering injury or malady. However, I notice it whenever I use my left hand. I can see a doctor for it and figure out what’s wrong because I have health insurance. If I didn’t, then I’d be forced to grit it out and potentially even cause permanent damage to the area, or to another part of my anatomy by altering my technique.

Health care in America should be a fundamental right. The fact that we’re still debating it after nearly 80 years is another indication that our national priorities aren’t where they ought to be.

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In order to balance the equation, let me talk briefly about the human element relative to health care, and yes, personal responsibility.

Almost four years ago, I realized that I had an issue with my weight. Like many formerly athletic men approaching middle age, I had been packing on the pounds. Too much bad food and not enough exercise had me tipping the scales at 259. I decided to do something about it.

I made a decision to begin tracking what I was eating, while also limiting processed food and eating more fresh fruits and vegetables. I also cut out excessive dairy products like cheese and ice cream. Instead of ice cream every night, I might have a cone after a weekend bike ride of 25-30 miles.

Mary and Mark running along Route 9.

Mary and Mark running along Route 9.

By the end of 2009, I had dropped 55 pounds. I was going to the gym three times each week and I was much healthier.

Over the past three years, I’ve maintained my weight, by-and-large, although both Mary and I had gained some weight back over the fall and holiday season. We decided at the start of 2013 to get serious about our weight again.

Over the past 16 weeks, both of us have dropped 22 pounds each. Having the support of one another has helped. Awareness and action are both components to being healthier.

Still, merely eating right and exercising won’t guarantee not having health issues requiring medical intervention. Both Mary and I have had to see doctors over the past year, even though we’re both in good physical health. As we both slide past 50, there are medical procedures that are necessary elements of aging and maintaining health over the second half of life.

If we lacked health insurance, we wouldn’t be able to afford to get the kind of preventive care that helps contain health care spending.

In theory, prevention as a medical strategy was one of the drivers of the growth of HMOs in America in the 1970s. That and the passage of the HMO Act of 1973.

While this isn’t a policy brief on health care costs, I did want to touch briefly on HMOs and their success, especially initially in helping to contain costs. In fact cost containment was a key factor in the growth of HMOs nationally.

The balance of evidence indicates that HMOs have reduced overall health care costs through several mechanisms and substantially contributed to a period of cost de-escalation during the 1990s. As costs receded during this time, it helped raise awareness of the importance of cost-containment, at least in the consciousness of the public, the press, and elected officials.

Unfortunately, costs are now increasing at a rapid rate and the issue again was front and center throughout the past decade, which is what drove the Obama administration to tackle health care once again, especially access to affordable care.

There are no easy solutions to this issue. Eating right, exercising regularly, and addressing some of the unhealthy dietary patterns of consumption are areas that might help bring down rates of obesity. However, providing access to health care for all Americans must continue to be on the national agenda. It also needs to be considered as an important priority as politicians begin to make tough choices on what to fund and what not to.

Physical activity is part of a healthy lifestyle.

Physical activity is part of a healthy lifestyle.