How to save money while improving our health

With historic legislation that went into effect  March 2010, 32 million legal residents of the US should now have health insurance of some kind.

This is wonderful but it does nothing to address the question of what eats up to $ 2.3 trillion or 16% of our GDP. Here are some of my ideas about things that we can do to reduce cost without compromising quality.

1. Focus more lifestyle issues like nutrition and physical activity
In the United States we spend around 10% of our income on food. In the rest of the developed world it is closer to 20% (and in places like India, it might be as high as 50%).The ample availability of  inexpensive high-calorie food does not mean that it is nutritionally complete. Why is it that we spend more on medical care than we do on food ( and its the other way around in Europe and Japan)? Couple that with our sedentary lifestyle, and we have a lethal combination. We would do a lot better with a more plant based diet and 60 minutes of physical activity a day than by taking more pills to prevent health problems. Putting healthy people on Crestor ( at $3.50 a pill) is unlikely to be a wise move.

2. Tort reform
Defensive medicine results in testing worth millions of dollars simply because a doctor who has been through the harassment and humiliation of a lawsuit spares no expense not to go through the same experience again. And yet Obamacare does nothing more than lip service to address this issue.

3.Comparative effectiveness research
Figuring out which treatments actually work and sticking to those can save us millions. But there are numerous vested interests in promoting expensive interventions that add little or no value. Research may not be enough to change attitudes shaped by years of brainwashing by aggressive marketing.

4. Creating more accountability
By rewarding healthy behaviors and discouraging unhealthy behaviors, we need to foster more individual accountability for our own health. Insurance is good for catastrophic illness. Consumers need to have "more skin in the game" in decisions about fancy imaging tests and generic vs. brand name drugs so that we can all be more responsible stewards of shared resources.

5. Aligning consumers, providers and the money managers ( insurance companies)
There is often a disconnect between the patient-doctor partnership and the hospitals and insurance companies because of conflict of interest. For example, the patient and doctor might want a longer stay in the hospital but the hospital makes more money from a shorter length of stay.


6. Focus more on wellness
By encouraging people to take better care of themselves: be it by meditation, hypnosis, biofeedback, massage we can build more resilience and better health. We need to shift the focus to self-care: that is the essence of health.

7. Stop looking for nails just because you have a hammer
Over-treating either at the end of life is inhumane and expensive. Medicalizing normal conditions by changing the definition of normal is a deceptive way of selling more drugs or tests. Suggestive advertising has created new diseases and syndromes out of everyday experiences stemming for lack of self-care.