lingering doubts that America’s cavalier attitude toward lousy food and
obesity is draining the nation’s health and economic vitality should
have been laid to rest a couple weeks ago. Two important studies were released
that quantified just how much our inability to resist fast food is
In Health Affairs, the premier journal of
health care market dynamics, economics and policy, Professor Ken Thorpe
and colleagues from Emory reported on a study comparing incidences of chronic disease in the US and in 10 European countries.
They found strong evidence that Americans have much higher levels of
lifestyle-related chronic disease than do Europeans – in other words,
we’re sicker – that American medicine tends to identify and treat
disease more aggressively than does European medicine, and that our
more excessive lifestyles and aggressive treatment patterns undoubtedly
contribute significantly to our much higher per capita health care
spending, which can be twice what Europeans pay.
The second study, from the Milken Institute, is called An UnHealthy America: The Economic Burden of Chronic Disease,
and it provides a calculation of the direct and indirect costs of seven
of the most common and costly chronic diseases. The findings are
staggering. America currently spends more than a trillion dollars –
more than $200 billion for direct care and more than $900 million in
lost productivity – on avoidable conditions. Unless we do something
differently, that number is expected to rise to $6 trillion by the
middle of the century, crippling the nation’s health status and
Dr. Thorpe and his colleagues present compelling evidence that, at
least in part, Americans pay so much more for our health care than
Europeans because we take such poor care of ourselves. And once we get
disease, we may not manage the care processes as well as Europeans do.
those points aside, in a sense there is little new in these studies.
Instead, they confirm what we already all know, and in a damning way.
As a people, we appear to be nearly unconscious of the impacts of our
habits on our health or prosperity.
America’s addiction to
fast, prepared and junk foods is, of course, continually stoked by the
propaganda machines of the processed food industry, which spend huge
sums on both marketing and lobbying.
America’s health care
crisis has two enormous wings. On one side, a fee-for-service
reimbursement system and a lack of transparency cultivate an
opportunistic culture that generates excessive care and cost throughout
the health care supply chain, the care delivery system and the
financing sector. On the other, a food industry preys on our children
without regard for the consequences to them or the welfare of the
Neither of these problems can be resolved until the
nation’s most powerful individuals – the business leaders who run firms
outside of health care and the food industries – unite to demand
greater adherence to behaviors that work for, rather than against