Health care needs personal responsibility

The Virginia Gazette

Many say that the American Healthcare System doesn't provide the same quality care as the other Industrialized nations of the world. We were told when Barack Obama became president we were on our way to bringing the Healthcare in this country up the world standard. When we are compared to other nations such measures as infant mortality rate and life span are the measures cited. We have been told for years that the infant mortality rates in the U.S. are significantly worse than in other countries. We have been told that the life span of Americans is shorter than others.

Let's look at Infant Mortality rates. What is being measured is the number of deaths up to the age of one after a "live birth." The problem is there is no universal standard as to what constitutes a live birth. For example, if a baby is born at 26 weeks gestation in France, that does not constitute a 'live birth' while it does in the U.S. There are many babies born at 26 weeks that survive due to outstanding neonatal ICU's in our country. However, those babies have a lower survival rate than babies born after 26 weeks.

Just as important, in the U.S. we have the highest rate of drug addicted mothers and babies in the world. We have more babies who die in their first year of life than others in the industrialized world because of that. If we had the same rate of drug addiction and the same definition of live birth as the rest of the world, our infant mortality rate would be equal to or better than the rest of the world.

Next let's look at longevity. Asian Americans have the longest expected life span followed by Hispanic Americans, Caucasians and African-Americans. Our expected life span is shorter in this country than some others, but why? It turns out we have the highest homicide rate, the highest number of deaths from drug overdoses and the highest death rate from automobile accidents in the world. If we had the same rates as the rest of the world the life span in the U.S. would be equal or better than the rest of the world.

Do we focus on those two issues because we have a bad health-care system, or an incredibly dysfunctional social system?

In the U.S., we have the highest rate of obesity and the most morbidly obese people in the world. Virtually every obese person knows they are overweight, knows that it is unhealthy, yet they continue to eat. If they know this, how is this the health care system's fault?

In a similar vein, more than 20% of our population smokes tobacco with virtually everyone knowing they shouldn't because it is unhealthy. More importantly the federal government knows that tobacco is the most addicting substance and lowers smokers' life spans by eight years compared to non-smokers. Yet, the government refuses to ban tobacco. Our government allows more than 20 percent of its citizens to obtain an addictive substance and then ask the other roughly 80% who don't smoke to supplement their health insurance costs. There is simply no justification for allowing tobacco to be legal. Since all smokers know they shouldn't smoke how is that the health-care system's fault?

I have been practicing medicine for 40 years and admit our system has many, many problems that need fixing. One of our most serious problems is the overprescribing of medications to people who don't need them. Americans consume almost 70% of all the prescribed medicines in the world. Thus when our government passed the Affordable Care Act it was a political stunt, not anything about the real improvements we need.

The arguments above have been used over and over again to demonstrate why our health-care system is inferior. However, they are just not valid. The numbers discussed above are due to a lack of personal responsibility, not a lack of care or education. In 40 years of practicing medicine, I have not had one patient say to me, " I didn't know smoking was bad" or one obese person say, " Really? I didn't know being overweight was bad for me." Virtually everyone who is abusing narcotics knows they shouldn't be.

C'mon people lets take the politics and political correctness out and start doing what we need to do to fix ourselves.

Rein, of Williamsburg, is an Anesthesiologist who has practiced locally for 30 years and an Adjunct Professor at the College of William and Mary.

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