Few issues have become so intensely debated and politically charged as the need to reform the health care system. This debate has resulted in the ObamaCare program (The Affordable Care Act), which aims to expand and improve health care, thereby reducing health care costs.
Presently, US health care costs constitute 18% of GDP, up from about 5% around 1970 (1). These costs are burdensome and many sectors of our society are paying the price. School programs are being scaled back because of the escalating costs of retiree health care benefit programs, as illustrated in Michigan where they are “laying off teachers, scrapping programs and mothballing extracurricular activities…[because of]…health care bills of retirees.“(2). About 60% of personal bankruptcies are now attributed to medical care costs (3) and these rising costs are eroding family incomes (4), among many other devastating outcomes.
It is also far from evident that the almost four-fold increase in the costs of healthcare (as a percent of our dollars) since the 1970s is leading to better health outcomes.
A solution is urgently needed but, in my opinion, this will not happen if we depend on the health care reform proposals offered in recent years, either from the political right or the political left. These proposals mostly concern who will pay a bill that is dependent on the use of expensive pills and procedures. This is not the needed solution because it ignores a strategy that decreases demand for services by improving health.
Current prevention programs are inadequate
Present day wellness programs are mostly cosmetic. Advisories to quit smoking, wear seat belts, use stairs not elevators, monitor blood pressure, use alcohol in moderation, and exercise regularly, make medical sense but, except possibly for smoking cessation, I don’t see how they can have much effect on improving health and reducing health care costs. Similarly, the United States Department of Agriculture makes dietary recommendations (think Food Pyramid) but these also are modest, at best, and highly questionable at worst (5).
As a consequence, by relying on modest or ineffective dietary and lifestyle recommendations (6,7) the health care system as a whole allows, even encourages, the use of very expensive pills and procedures. Consider, for example, the preventive component of the new ObamaCare program (3). This program wants to offer “free preventive women’s services, including mammograms,” to ensure “that there are no out-of-pocket costs on patients receiving … colonoscopies and provide lower prescription drug costs for people on Medicare.” These will cost money but there is little evidence they will significantly improve overall outcomes (8-10).
Much the same criticism can be made of personalized medicine and other projects of corporations (11) and governments (12) to target medical interventions to specific organs, ailments and individuals (14). I can find little or no evidence that these measures will improve health and decrease demand for health care services. In fact, I suggest (and the pharmaceutical industry hopes) that the thrust of personalized medicine will increase the use of pharmaceuticals as doctors will target illnesses detected earlier.
Add to this the alarming statistic that the third leading cause of death in the U.S. is the use and misuse of pills and procedures (15). Is it any wonder we have an ineffective, costly health care system? Our health care system is travelling a path to self-destruction, regardless of who pays the bill.
When I examine the various proposals made in recent years to reform this system, I see all as having one remarkably consistent omission. It is our neglect of the remarkable ability of nutrition to promote health and decrease illness. I particularly refer to the emerging evidence on the exceptional health benefits provided by a whole food plant-based (WFPB) diet—or should I say, re-emerging evidence. Re-emergence because the idea of the healing power of food has been around at least since the time of ancient Greece. Hippocrates said it best when he exclaimed, “Let food be thy medicine.”
I am referring here not only to the well-known ability of nutrition to prevent diseases like heart disease, cancer and diabetes but to the ability of the WFPB diet to actually treat and thus reverse diseases that are already diagnosed or forecast by out-of-range risk factors.
A WFPB diet (5) is defined as one rich in antioxidants and complex carbohydrates. It also avoids animal-based foods, refined carbohydrates, and added fat typically used to make processed, convenience foods. The remarkable health benefits of the WFPB diet is attributed to its being naturally low in fat (10-12% of diet calories), low in protein (10-12% of calories), high in complex carbohydrates (75-80% of calories) and abundant in natural vitamins and minerals.
The science behind a WFPB diet is compelling. A WFPB lifestyle is effective in the short and long terms against a broad spectrum of diseases and ailments (16,17). Population-level studies show lower chronic disease rates the closer diets approximate the nutritional composition of a WFPB dietary lifestyle (7,18). That is, these population studies show the effects on a long term basis and that this dietary lifestyle serves the body’s innate biological tendency to repair itself and so constantly create health. But a WFPB diet can also act to reverse disease progression in a manner that is surprisingly fast (a few days to a few weeks). Such a diet can therefore function as a medical treatment.
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