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On Aging: The coming crisis in health care
Branch WEB
Dr. Roger Branch Sr.

The health care system in the United States is broken. Regardless of the merits or lack thereof of the Affordable Care Act, core issues have not been solved. Some have not been addressed. Further, that system is about to be hit by an epidemic, which might well overwhelm it.

The obesity epidemic is already here. It is an international pandemic, but this country is hit hard. Two-thirds of the population are overweight, and 35 percent of them are obese, according to a study done in 2012. Now, in 2016, that percentage is probably higher. Approximately 75 percent of American youth ages 17-24 are ineligible for the draft. (What would happen if the equivalent of World War II engulfed the country?) It is estimated that obesity causes 300,000 deaths in the U.S. each year and 28,000,000 - yes, 28 million - worldwide.

The cause is simple: People are consuming more calories than the body burns. This comes from too much food and drink, the wrong kind of food and drink, and a sedentary lifestyle. Addiction to food, drink and electronics can be as enslaving and destructive as the more familiar addictions to drugs, alcohol and nicotine.

Obesity kills. It causes all sorts of illnesses. Cardiovascular diseases lead the list. These include heart attacks, strokes, coronary arteries and hypertension (high blood pressure). A report by the Centers for Disease Control and Prevention states that heart disease was the leading cause of death in the U.S. and the world in 2015, killing 17.3 million people.

Diabetes, particularly type 2, often results from obesity and the associated lifestyle patterns. Constant monitoring and treatment become costly and uncomfortable facts of life. It can cause vision loss, wounds that do not heal, amputations and stresses on many bodily functions.

Excess weight is crippling. Everyday wear and tear on crucial joints like the hips, knees and ankles accelerates. The added stress may contribute to arthritis. These problems are painful and basically incurable. Hips and knees can be replaced with artificial joints, but they do not work as well as the original healthy joints. They might be preferable to pain and disability, but they are not perfect replacements. And they cost.

Obesity is expensive. According to a 2008 report by the CDC, the cost of obesity in this country was $14.7 billion.

Many people live with the diseases mentioned previously, not daily on the edge of death but under medical care and using a wide range of treatments to survive. If over-the-counter medicines, vitamins and supplements of questionable value were added to the prescription drugs being taken, it would be impossible to estimate that part of treatment costs.

These costs may continue for years, although obese sufferers do not live as long as other people who have similar diseases but who are not obese. Costs add up as years go by, and as the number of obese people grows, the number of health problems and associated costs also grows. Early retirement due to disability will further burden Medicare, Medicaid and insurance companies that cover health care.

The obesity epidemic is in its earliest stages. It will get much worse. It is prevalent at all ages, even among children. They do not enter the health care system with simple cases of sniffles that last a week but with problems that persist.

What has this to do with senior citizens? First, the aging population has its share of obese people. They suffer as the others do and might have poorer access to treatment. More important is the fact that all seniors increasingly will have to compete for financial and other resources with younger people who require health care because of obesity. Medicare, designed to provide health care for the elderly, also supports those who have become disabled. As obesity leads to disability, the already-stretched funds of Medicare will be flooded by additional needs and demands. When that money is exhausted, where will seniors go for the help that they paid for through Social Security?

Insurance companies will offer plans but perhaps at costs beyond the reach of many seniors. What about federal and state governments? Their recent track records provide little reason for optimism.

Beyond the matter of paying for health care, there are other questions about resources. Where will physicians and related professionals be found? Small towns and rural areas are already underserved. Certain specialists will be in great demand: cardiologists, endocrinologists, neurologists. What about family practitioners who are the frontline helpers for most seniors? With all of the restrictions, paper work and delayed reimbursement typical of third-party payment, medicine is beginning to look less attractive to young people who are making career choices. Will seniors struggle to find healers as well as money to pay them?

Roger G. Branch Sr. is professor emeritus of sociology at Georgia Southern University and a retired pastor.



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