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As the Republican and Democratic national conventions are approaching, the debate on how to address soaring Medicare costs is heating up. But there is much more heat than light, and our country seems more polarized than ever.
Health care costs (really, sick care costs) are now reaching a tipping point. Many Republicans are recommending that Medicare be privatized or even abolished since Medicare, Medicaid, and the Children's Health Insurance Program accounted for 21 percent of the Federal budget in 2011, or $769 billion. Many Democrats are advocating raising taxes and letting the deficit increase. Not much common ground when the issues are framed in this way.
Here's a third alternative: address the underlying causes of illness. These causes are primarily the lifestyle choices we make each day: what we eat, how we respond to stress, whether or not we smoke, how much we exercise, and how much love, intimacy and social support we have in our lives.
This is a radical approach -- "radical" comes from the Latin word meaning "root." When we address these root causes of our health and well-being, we find that our bodies often have a remarkable capacity to begin healing themselves and much more quickly than had once been thought possible. We can make much better health care available for many more people at far lower costs when we treat the causes rather than the symptoms.
More than 75 percent of the $2.8 trillion in health care costs are due to chronic diseases such as coronary heart disease and Type 2 diabetes that can be largely prevented by making comprehensive lifestyle changes. We don't need to wait for a new drug or laser or high-tech breakthrough; we simply need to put into practice what we already know.
For example, in the EPIC study of 23,000 people, walking for just 30 minutes/day, not smoking, eating a reasonably healthy diet, and keeping a healthy weight prevented 93 percent of diabetes, 81 percent of heart attacks, 50 percent of strokes and 36 percent of all cancers. Bigger changes in diet and lifestyle can do even more.
In the INTERHEART study of 30,000 men and women in 52 countries in all seven continents, lifestyle factors accounted for almost all of the risk of heart attacks in both sexes and in all ages.
Think about it: Heart disease and diabetes, which account for more deaths in the U.S. and worldwide than everything else combined, are completely preventable by making comprehensive lifestyle changes. Without drugs or surgery. Today.
In addition to preventing chronic diseases, these comprehensive lifestyle changes can often reverse the progression of these illnesses. My colleagues and I at the non-profit Preventive Medicine Research Institute proved, for the first time, that lifestyle changes alone can reverse even severe heart disease. At any age.
We also found that this same program of comprehensive lifestyle changes can reverse Type 2 diabetes and may slow, stop, or even reverse the progression of early-stage prostate cancer.
Our research has shown that when comprehensive lifestyle changes are offered as treatment (not just as prevention), significant cost savings occur in the first year because the biological mechanisms that control our health and well-being are so dynamic.
For example, Highmark Blue Cross Blue Shield found that overall health care costs were reduced by 50 percent in the first year when people with heart disease or risk factors went through our lifestyle program in 24 hospitals and clinics in West Virginia, Pennsylvania, and Nebraska.
In another study, Mutual of Omaha found that they saved $30,000 per patient in the first year in those who went through our lifestyle program. Steve Burd, the visionary CEO of Safeway, put many of these principles into practice at the work site and found that overall health care costs decreased by 12 percent in the first year and have remained essentially flat since then.
At a time when the power of comprehensive lifestyle changes to prevent and reverse chronic diseases is becoming more well-documented, the limitations and costs of high-tech medicine are becoming increasingly clear:
- Recent studies have shown that angioplasties and stents do not prolong life or prevent heart attacks in stable patients, costing $60 billion per year.
- Type 2 diabetes and pre-diabetes will affect half of Americans in the next eight years at a projected cost of $3.3 trillion. Lowering blood sugar with drugs does not fully prevent the economic and human costs of diabetes (including heart attacks, strokes, amputations, impotence, kidney failure, and blindness), but lowering blood sugar with diet and lifestyle prevents all of these human and economic costs.
- Only 1 out of 49 men treated for prostate cancer lives longer because of the surgery or radiation treatments; the other 48 often become impotent, incontinent, or both. Because of this, the U.S. Preventive Services Task Force recently recommended that men not even be screened for prostate cancer, since there is such pressure to undergo treatments that, for most men, do not benefit them but may cause them harm in the most personal ways. Intensive lifestyle changes can be a third alternative.
Changing lifestyle actually changes your genes -- turning on genes that keep you healthy and turning off genes that promote heart disease, prostate cancer, breast cancer, and diabetes -- hundreds of genes in just three months. People often tell me, "Oh, it's all in my genes, there's not much I can do about it." Knowing that changing lifestyle changes our genes is often very motivating -- not to blame, but to empower.
Medicare is now covering "Dr. Ornish's Program for Reversing Heart Disease" after 16 years of review. This had bipartisan support -- from Bill Clinton and George W. Bush when they were president, from Nancy Pelosi and Newt Gingrich when they were Speaker of the House, from Congressmen Dan Burton (conservative Republican from Indiana) and Charles Rangel (liberal Democrat from New York), and many others from both parties as well as from independents.
Why? Because these are human issues that affect all of us and transcend our polarized political process, enabling us to find common ground. For Republicans, this appeals to their core values of empowering the individual, personal responsibility, and freedom of choice. For Democrats, this appeals to their core values of making better health care available to more people at lower costs.
Dean Ornish, M.D.
Medical Editor, The Huffington Post
Founder & President, Preventive Medicine Research Institute
Clinical Professor of Medicine, University of California, San Francisco
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