The Health Care Crisis and Wellness Coaching

Here is a short exerpt from the wellness coaching book that I am finishing up.  Hope you enjoy:

Just in case you haven’t noticed, there is a health care crisis in the United States; one that is different from the much touted health insurance crisis.  For example, according to researchers at Johns Hopkins Medical School the United States spends 44 percent more per capita on health care than Switzerland, which has the second most expensive health care system in the world.[i]  The same study reported that the per capita health care expenditure in the United States was 134 percent more than the average in developed countries.   One might expect that such a large expenditure would result in world-class health care.  It doesn’t.  The United States ranks 27^th in the world in life expectancy at birth and 39^th in infant mortality. 

   

America's health care system is in crisis precisely because we systematically neglect wellness and prevention. 

Tom Harkins – U.S. Senator

Here are a few more statistics on the state of health care in the United States:

• The latest Gallup-Healthways Well-Being Index, which shows that 63.1% of adults in the U.S. were either overweight or obese in 2009[ii].  By comparison, only 44.8 percent of the population was overweight or obese in the period from 1960-1962.
• While the United States has the most expensive health care system in the world, it isn’t the best.  The World Health Organization (WHO) recently rated America thirty-seventh in the world, in between Costa Rica (36^th) and Slovenia (38^th)[iii].  Most expensive doesn’t necessarily meant best.
• If you think that things have changed since the WHO rankings in 2000, think again.  In a 2007 ranking of eight developed countries, the United States came in last.[iv]
• About three-fourths of all Americans die from preventable degenerative diseases including heart disease, cancer and diabetes.[v]
• Obesity is growing faster than any other public health issue in the United States. About, 31 percent of Americans are considered obese and, if current trends continue, more than 100 million U.S. adults — or 43 percent of the population — will be considered obese by 2018. Over the same period, obesity could add $344 billion to the nation's annual healthcare costs and account for more than 21 percent of healthcare spending.[vi]
• Only 31 percent of adults over age 18 engage in regular physical activity (three or more sessions per week of at least 20 minutes each).

Diabetes, high blood pressure, heart disease and cancer are, for the most part, life-style diseases.  Ten years ago Jan Breslow, M.D., the then president of the American Heart Association wrote that, "Progress in reducing deaths from coronary heart disease is threatened by alarming increases in obesity, physical inactivity and cigarette smoking as well as the aging of the population.”   Over the past ten years obesity has increased, physical activity has decreased and the population has gotten older.  The only bright spot is smoking.  Smokers comprised 24.6 percent of the adult population in 1995 and only 20.8 percent in 2006.

If the above aren’t enough, statistics in a July, 2000 issue of the Journal of the American Medical Association indicated the risk of relying on traditional health care.  The article noted that medical errors are the third leading cause of death in the United States, following heart disease and cancer.  More than 250,000 people die each year in the United States due to medical error including:

• 106,000 from the adverse effects of medication,
• 80,000 from infections they get while in hospital,
• 20,000 from non-medication errors in hospital,
• 12,000 from unnecessary surgery, and
• 7,000 from medication errors in hospital.

While health care professionals had made wonderful advances in responding to acute trauma it hasn’t been effective in treating chronic diseases.  However, it may not be completely rational to expect health care professionals to cure life-style issues like heart-disease, cancer or diabetes when most Americans don’t eat right, exercise or manage stress.

According to the groundbreaking medical report Death by Medicine, published in 2003 by Drs. Gary Null, Carolyn Dean, Martin Feldman, Debora Rasio and Dorothy Smith, 783,936 people in the United States die every year from conventional medicine mistakes. That's the equivalent of six jumbo jet crashes a day for an entire year.  If that is what illness care does, then we need wellness care.

Traditional health care in the United States is really illness care.  No one goes to the doctor because they are well.  People go to their doctor because they are sick, or because they are afraid of getting sick.  Few, if any, go to the doctor and say, “I feel absolutely wonderful, and I want to feel even better.  What should I do?”  While we may need a better illness care system, what is really needed is wellness care.  That’s why wellness coaching is booming.  The role of the wellness coach is to work with individuals to help them improve their overall state of wellness.
 

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[i]            Anderson, G. F., U. E. Reinhardt,  P. S. Hussey, and V. Petrosyan.  (2003).  It’s the Prices, Stupid:  Why the United States is So Different from Other Countries.  Health Affairs, Vol. 22, No. 3, pp. 89-105.

[ii]           Hendrick, B.  (2010).  Percentage of Overweight, Obese Americans Swells:  Americans Are Eating Poorly, Exercising Less, and Getting Bigger, Survey Finds.  Accessed at http://www.webmd.com/diet/news/20100210/percentage-of-overweight-obese-americans-swells on 25 January 2010

[iii]           WHO. (2000).  The World Health Organization’s Ranking of the World’s Health Systems.  Accessed on line at http://www.photius.com/rankings/healthranks.html on 25 January 2010.

[iv]           New York Times Editorial.  (2007).  In an Eight Country Ranking the United States Came in Last.  New York Times, 12 August, 2007.

[v]           Weil, A.  (2009).  Why Our Health Matters.  New York:  Hudson Street Press, p. 14.

[vi]           United Health Foundation.  (2009).  America’s Health Ranking:  A Call to Action for Individuals and Their Communities.  retrieved from http://www.americashealthrankings.org/2009%5Creport%5CAHR2009%20Final%20Report.pdf on 25 January 2010.