Roosevelt Institute | Cornell University

Perceptions of Healthcare in the United States

By Philip SusserPublished April 6, 2014

By Philip Susser, 04/06/2014 The aging American population is putting significant pressure on the effectiveness and affordability of healthcare in the United States. Confronting these problems requires a change in the perception of what healthcare really means.

By Philip Susser, 04/06/2014

            The United States faces both an aging population and increased longevity. By the year 2030, it is expected that 20% of the population will be over the age of 65. Undoubtedly, this demographic shift will put a great financial burden on our health care delivery system. How we confront this challenge in the upcoming years will be instrumental in determining the financial soundness of public programs such as Medicare and Medicaid as well as the pressure we put on health care systems in treating — what are currently — preventable conditions.

The principal cause of the increased cost associated with an elderly population will certainly be a rise in the number of chronic conditions in the United States.  Chronic conditions, such as diabetes, osteoporosis, and arthritis bring with them regular hospital trips, testing, medication, and overall decreased quality of life for affected individuals. More than two thirds of the current health care costs arise from chronic conditions. A crucial question then, one must ask, is how this proportion can be reduced in future years — so taxpayer dollars aren't drained by the treatment of these conditions but rather put towards education, fighting climate change, and other more productive avenues.

            Since unhealthy lifestyle choices predispose individuals toward development of chronic conditions later in life, promoting healthy choices early on in life will surely result in health benefits as one ages. Most elderly individuals with chronic conditions have more than one condition — over half of all Medicare beneficiaries with heart failure experienced greater than 5 other chronic conditions. Therefore, the costs in treating these conditions are coming from a concentrated slice of the population who experience a variety of conditions - often as a result of earlier health choices. Increased focus should be put on prevention and population health as a method of intervening in poor lifestyle choices before they adversely affect individuals and put strain on health care delivery systems. Promotion of education can be a start.

            Studies have shown that education is clearly linked to health and chronic conditions, even when controlling for demographics. More education reduces the risk of heart disease by 2.2% and the risk of diabetes by 1.3%. These numbers are quite significant when applied to the scale of the United States population. Individuals with more education are less likely to use illicit drugs, smoke, and drink heavily. Some hypotheses have suggested that education leads to greater income which influences ability to seek treatment. Others say that those who seek education are individuals with the ability to delay gratification and that this trait leads to better health outcomes. Since no one link between education and health can explain the relationship, it must be a variety of factors. I hypothesize, though, that the values associated with school and the act of learning, lead to more informed health decisions and a greater stake in society. Those with more education have a greater understanding of the context of their health decisions and their subsequent impact on their futures. With these findings in mind, increased quality of education, greater access to college education through the improvement of community colleges, and greater emphasis on healthy values within the classroom environment should be sought after in order to put students on the track to becoming healthy adults.

The United States needs to change their perception of healthcare and what it means to be healthy. Being healthy does not mean attainment of insurance or access to hospitals. Rather, health comes from individual decisions — to not smoke, to exercise regularly, and to eat healthy.  Until Americans come to grips with these terms, they will likely find that improving health through access to hospitals and health care will leave them with budget deficits, a shortage of doctors, and little improved health.