We may be required to buy medical insurance, but what we really need is health insurance

The Affordable Care Act was intended to make insurance coverage more secure and affordable, and insure millions of uninsured Americans. The Supreme Court has now deemed the individual mandate portion – the requirement that everyone purchase health insurance – to be constitutional.

Certainly, some aspects of medical insurance coverage are in need of reform.  But a much greater need exists – the need for Americans to reform their health by reforming their diets.

Of course there will be continued debate on this subject, but when we look at the big picture (the overall health of the American people), the Supreme Court’s decision and even government involvement is irrelevant. Regardless of the government’s involvement, the health of Americans will not improve unless the eating habits of Americans improve.

The U.S. per capita health costs are the highest in the world. Health care made up more than 17% of the GDP in 2010. Health care costs rose 5.8% in the year ending February 2012, and costs are predicted to continue rising.  As health care costs rise, so will insurance costs. Overconsumption of medical care (for example, overuse of diagnostic tests) is a significant driver of health care costs.1 

These high costs do not bring about better outcomes than other developed countries. In the U.S. life expectancy is lower than in similarly developed nations whose per capita costs are lower.1  The U.S. is ranked 38th in life expectancy, 37th in infant mortality, and 37th in overall health outcomes, according to the World Health Organization. We cannot expect the Affordable Care Act to significantly improve the health of Americans – its aim is only to increase access to care, which also mean more needless drugs, radiation exposure and surgeries. More medical care does not translate into better health, as much of what doctors do is harmful, such as prescribe antibiotics for viral infections, perform angioplasties and bypass surgeries on stable CAD, or perform CT scans, prostatectomies and other worthless, expensive invasive interventions that serve to protect the doctor, not the patient. Actually interventions that do not extend life are worse than worthless because they create harm. People should not be denied access to care in emergencies, but overall our population (including lower income people) need less medical care, not more.

It is normal in our society to follow a disease-causing diet and sedentary lifestyle. A huge proportion of the health care dollars spent in the U.S. are spent on largely preventable diseases, whose rates are rising.   More medical care supports dependency on medications and the emotional expectation that drugs buy us health, rather than healthy habits and proper dietary choices.  Modern medicine actually weakens personal responsibility. Healthy lifestyle promotion and implementation protect people from medical tragedies, reduces the need for and the side effects and damage from excessive medical care and prescription drugs.

  • Heart disease, cancer, arthritis, hypertension, diabetes, and high cholesterol are all included in the top ten causes of direct health expenditures.2
  • Almost 70% of Americans are overweight or obese, and recent data estimates that obesity adds $2741 to an individual’s annual medical costs – equating to $190 billion/year or 21% of national health expenditures.3,4
  • Cardiovascular disease was estimated to cost over $297 billion in 2008.2
  • The most commonly prescribed drugs are cholesterol-lowering drugs – 20% of middle-aged Americans and about 40% of older Americans take them.

It is the number of Americans sick with preventable diseases, not the number of uninsured Americans, or the cost of prescription drugs that is of most concern. More affordable prescription drugs are not what we need – reduced need for prescription drugs is what we need.. More than increasing access to care, we need less requirement for care.  To truly improve the health of the American people and reduce health care spending, Americans must take control of their own health.

We know now that genes are mostly irrelevant – what really counts is gene expression in response to the body’s environment, primarily diet and lifestyle. For example, in people with a certain genetic alteration known to increase heart attack risk, still eliminate risk with  high vegetable and fruit consumption.5

Type 2 diabetes is a lifestyle disease, and it can be reversed, often quite quickly with the appropriate diet. Excess weight is the primary risk factor for developing type 2 diabetes, and conversely weight loss with a low glycemic, nutrient-dense, nutritarian eating style and exercise is effective at reversing the condition. For example, in a recent study, my colleagues and I found that 62% of participants in the study reached normal (non-diabetic) HbA1C levels within seven months on a high-nutrient diet, and the average number of medications dropped from four to one.6 Plus, a recent study confirmed that lifestyle interventions are more cost-effective than metformin for diabetes prevention in high-risk individuals.7

Cardiovascular disease is preventable and reversible with the proper diet and lifestyle modifications, as documented by much medical research.8,9  Medical interventions – cholesterol-lowering drugs, stents and bypass surgery – do not cure heart disease. A large meta-analysis of the data on surgical cardiac interventions demonstrated conclusively that heard disease patients who undergo these interventions do not have fewer heart attacks or longer survival.10,11  Now millions more will have access to be harmed by interventional cardiologists and cardiac surgeons. 

Cancer risk is also largely tied to lifestyle. The American Institute for Cancer Research estimates that about one-third of common cancers could be prevented by following a healthy diet, exercising, and maintaining a healthy weight. I believe that figure could be more than double that protection if Americans were to truly take charge of their health; eat a health-promoting diet based on immune-boosting and cancer-fighting foods, exercise daily and maintain a healthy weight.  Green and cruciferous vegetables, mushrooms, beans, and onions are associated with significantly large risk reductions for common cancers.  After all, look at the cancer rates in other countries in South Asia before the explosion of the fast food revolution; a small fraction of today’s rates of cancer deaths was the norm.12-15

Here is my point:  Regardless of whether we are required to purchase medical insurance, know that we can only buy real health insurance in the produce section of the local supermarket.

 

References:

1. Brawley OW. The American Cancer Society and the American Health Care System. Oncologist 2011;16:920-925.
2. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart Disease and Stroke Statistics--2012 Update: A Report From the American Heart Association. Circulation 2012;125:e2-e220.
3. Cawley J, Meyerhoefer C. The medical care costs of obesity: An instrumental variables approach. J Health Econ 2012;31:219-230.
4. Obesity Accounts for 21 Percent of U.S. Health Care Costs, Study Finds. 2012. ScienceDaily. http://www.sciencedaily.com/releases/2012/04/120409103247.htm. Accessed April 20, 2012.
5. Do R, Xie C, Zhang X, et al. The effect of chromosome 9p21 variants on cardiovascular disease may be modified by dietary intake: evidence from a case/control and a prospective study. PLoS Med 2011;8:e1001106.
6. Dunaief D, Gui-shuang Y, Fuhrman J, et al. Glycemic and cardiovascular parameters improved in type 2 diabetes with the high nutrient density diet. Presented at the 5th IANA (International Academy on Nutrition and Aging) meeting July 26 & 27, 2010 Hyatt Regency Tamaya Resort & Spa 1300 Tuyuna Trail Santa Ana Pueblo, NM, USA J Nutr Health Aging 2010;14:500.
7. The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention: an intent-to-treat analysis of the DPP/DPPOS. Diabetes Care 2012;35:723-730.
8. Ornish D, Brown SE, Scherwitz LW, et al. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990;336:129-133.
9. Esselstyn CB, Jr., Ellis SG, Medendorp SV, et al. A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician's practice. J Fam Pract 1995;41:560-568.
10. Trikalinos TA, Alsheikh-Ali AA, Tatsioni A, et al. Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis. Lancet 2009;373:911-918.
11. Coylewright M, Blumenthal RS, Post W. Placing COURAGE in context: review of the recent literature on managing stable coronary artery disease. Mayo Clin Proc 2008;83:799-805.
12. Ahn YO, Park BJ, Yoo KY, et al. Incidence estimation of female breast cancer among Koreans. J Korean Med Sci 1994;9:328-334.
13. Jung KW, Park S, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2009. Cancer Res Treat 2012;44:11-24.
14. Zhang J, Dhakal IB, Zhao Z, et al. Trends in mortality from cancers of the breast, colon, prostate, esophagus, and stomach in East Asia: role of nutrition transition. Eur J Cancer Prev 2012.
15. World Health Organization Mortality Tables. [http://apps.who.int/whosis/database/mort/table1.cfm]


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Comments (27) Read through and enter the discussion with the form at the end
Skaag Argonius - June 29, 2012 12:35 PM

Fortunately, many Americans are now starting to understand just this. I was very excited to see your book (Eat to Live) on the number 1 spot of NYT's Best Sellers list (In the Advice Section).

If the majority of Americans implemented your dietary philosophy, the entire health care industry would be completely revolutionized. It would change so much we wouldn't be able to recognize it anymore. Ironically, this would free up resources for even more useful research into extending life expectancy, producing cures for rare diseases, rare cancers, etc.

Dustin Rudolph - June 29, 2012 12:47 PM

Very well said Dr. Fuhrman. I've always told others that we cannot legislate our way out of this healthcare crisis by tweaking access to care. Sure this may help some get medical care after they are sick, but it does little to nothing in preventing and reversing the chronic diseases they suffer from in the first place. We are all individually responsible for our own health. Emergencies and rare diseases will always happen even to healthy people, but we can make a tremendous difference in our own lives and the lives of others by taking control of our own diet and lifestyle. Thanks for posting this article!

Marianne - June 29, 2012 1:34 PM

There are two separate issues here, living a healthy lifestyle and having adequate health insurance for the uninsured. I totally agree that a healthy lifestyle can prevent a lot of disease and make for a better quality of life. However, even people who eat well and exercise get cancer, have accidents, have congenital health problems, and contract communicable diseases. Medical insurance is necessary for all. And i really think politics shouldn't enter into Dr. Fuhrman's main message about creating the best possible lifestyle for yourself.

mike rubino - June 29, 2012 6:42 PM

Well written doctor. This whole sick care insurance thing to me is a scam to have more people get tested, take pills, get needless procedures and risky but worthless operations while ignoring the responsibity to manage their affairs and the affairs of those trusted to them. The medical pharma complex has sold a bill of goods to the country that the answers to sickness lies with them , yet as you say, most of these diseases would go away if people ate responsibly. If so,health insurance would then truly be affordable.

Carrie (Carrie on Vegan) - June 29, 2012 7:00 PM

It's scary that so many people are sick, but hopeful at the same time that diet has the power to change this situation. Thank you, Dr. Fuhrman, for getting the word out there that what we eat affects our health and that we have the power to change!

Kate - June 29, 2012 7:34 PM

Hmmmm....I think since Dr. F is a physician, his opinion on this issue is politically correct and appropriate for this forum. What? Everyone can have a political opinion about something except Dr. F? Anyway, I agree. I really don't want to be forced to pay for the care of people who refuse to care for themselves. Anytime you take money from my pocket by force, it is theft. This is law enforced theft.

NOLA - June 29, 2012 8:21 PM

your comments are correct, but health insurance is needed in this country. it is too bad that is the only answer right now. i am 79 and in the health care field. i, too, believe that preventive medicine and a healthy lifestyle is the answer.

Michael Freifeld - June 29, 2012 9:23 PM

While access to medical care is important for our citizens it is not sufficient nor is it the primary issue. There is no doubt that the best way to get a handle on our runaway medical care costs is to fundamentally improve the health of our people. That is the real work to be done and it can only be accomplished by improving our nutritional practices. Our citizens need better access to real, whole foods not McDonald's or Burger King. Our students need to be taught what we scientifically know about human nutrition, not what agribusiness wants to impress upon them. Our politicians need to favor the health of the people of our nation, not their own political self-interests. To do less will continue to weaken the strength of our nation. Ultimately this is not just a matter of public well being, it is a matter of national security.

Thank you Dr. Fuhrman for weighing in on The Affordable Care Act and health care in general. Here's my vote for you as leader of Health Care Reform for our nation.

Dee - June 29, 2012 9:48 PM

We all must take ownership for the problems in the US Healthcare System and below are a few of the many issues we are facing.
Patients demanding unnecessary treatments or medical "fixes" while refusing to change eating habits and lifestyle.
Doctors overprotecting their licenses with excess tests and procedures as a consequence of patient/lawyer relationships - no Tort Reform.
Lawyers with power to create laws with little understanding of healthcare dynamics e.g. EMTALA
Pharmaceutical and insurance companies treating human life as a business and profit gain.

The good news is that the patient has tremendous power to control a significant portion of the Healthcare System cost. Let us do it- Eat To Live!

Penelope - June 29, 2012 11:39 PM

Dr. Fuhrman, can you not communicate your information
to President Obama? I can never understand why there
is so much information out there on alternative health,
and cures, and reversing disease, but it seems to fall on
deaf ears.......or never reaches them. Isn't there another
soul in Congress who also believes in what you believe in
and can get this across to the rest. Just boggles my mind.
Thanks for all your information.

Victoria - June 30, 2012 2:29 AM

Marianne, I agree with you to a degree, but can see Dr Fuhrman's point. And after all, everyone is talking about the Supreme Court's decision, and assuming it will mean either worse or better healthcare for every American. But Dr Fuhrman's point has not been made elsewhere, and is an essential one: we cannot rely on medical professionals to manage our health, as so many tend to do. There are even a lot of men who "leave the medical stuff up to their wives"! But it is up to each one of us to be responsible for our health, not our doctors or spouses. Highly relevant.

KEN EATON - June 30, 2012 6:32 AM

If Congress would vote on a bill which would include ALL Americans under this "sickcare" bill, or it would be disposed of for all, we wouldn't need to worry about this "stupidity". A bill that would include everyone under all legislation, such as telling Congress fibs as E. H. has done and as many ibn Congress have done, would further solve the problems.

Billy - June 30, 2012 7:21 AM

I think Dr. Fuhrman is entitled to his informed oinion and I think he makes very good sense. I think we can make a lot of decisions to control our own health without needing the medical field. Politics effect us one way or another in everyday life whether you want it to or not.

Lisa McCann - June 30, 2012 9:40 AM

I agree with Marianne (June 29) that affordable care (often meaning insurance) is as important as a healthful way of living. There is no guarantee of good health and long life, although proper diet, exercise and mental attitude are essential to physical well-being. I do support, to a reasonable extent, cutting back on routine medical testing, scans, and so forth.

However, I find myself in an odd situation. I am almost 70 and started Medicare coverage two years ago. I have had a non-specific automimmune illness, Graves' disease and high blood pressure, which thanks to Dr. Fuhrman and Dr. Benson, are no longer in the picture. Because of their anti-autoimmune diet I don't take any medication and feel fine. I'm confident that my vital organs and systems are cruising along well.

Yet, I am at an age when serious disorders can show up rather rapidly. Medicare does not cover "wellness" visits (meaning no prescription medications being taken), so seeing my regular doctor to check for any changes isn't covered. And most Medicare supplements won't pay for visits Medicare doesn't cover. So I have cut out my "wellness" visits.

I'm delighted to be disease-free. But I'd like to know what to look for as I age (more rapidly now than before). Medicare won't help me with that. I would very much like to see some useful information about this subject, which will also be of interest to other people over 65.

Marianne - June 30, 2012 10:50 AM

As you can already see, injecting politics into your message changes the focus of the discussion. And whatever opinion you rightfully have, bringing it into your discussion on your website immediately turns off half your readers.

Catherine - June 30, 2012 12:36 PM

As an elementary educator I am apalled to see pizza served 3 x in one week. The last day of school they were given a boxed lunch with smoked "slim jim" style sausage, processed cheese and crackers and juice. There was no other option available. Try giving that to kindergarteners. The public then criticizes teachers stating that they ahave not been trained properly. Has anyone ever questioned how these types of foods affect the learning process in young children? In addition, several of the students threw away their boxed lunches or only drank the juice and ate the crackers. From lunch they returned to their classes to "learn." On what fuel, I ask you? I hear all about training teachers, but what of training school district nutritionists about how to feed our young minds.

JenLamSis - June 30, 2012 3:05 PM

Excellent article. Love the last line! Glad of the Supreme Courts decision.

Laura - June 30, 2012 9:25 PM

I think it's imperative for all Americans to have access to preventative services, recommended screening & testing, and of course treatment where necessary. But, Dr. Fuhrman is right - Americans in general will not improve their health until they start taking responsibility for managing it and make smarter lifestyle choices. Case in point - a friend of mine who is overweight developed sleep apnea that was so bad, it affected his breathing. So what did his doctor recommend? That he have his tonsils and uvula removed, which he did. But what was the root cause of the sleep apnea? It was his weight problem, which by the way also puts him at risk of diabetes, heart disease, stroke and cancer. If he had followed Dr. Fuhrman's nutritional advice and started an exercise program, he would have started sleeping better and he would truly be a much healthier person today. My friend IS sleeping better, but he's still overweight, still at risk for those diseases plus he lost his tonsils which are part of his throat's immune system. Unfortunately, with our current health care system, most doctors don't address the root cause of conditions because those issues generally take longer to fix and require lifestyle changes. What I learned from my friend (and from Dr. Fuhrman) is improve your health literacy and take charge of your health now! "He who is not his own doctor is a fool." - Hippocrates

Theresa Anderson - July 1, 2012 2:00 AM

Not just Health Insurance but what I often say is Health Assurance by eating GOMBBS!
This nation would be literally set free from the tyranny of disease by adopting a Nutritarian Lifestyle. Thank You Dr. Fuhrman..you always say it so well.

Robert - July 1, 2012 9:00 AM

Let's not whine about having to pay for insurance benefitting others. They may need it for any number of reasons, not least because they don't know any better.
Let's focus on, as Dr Fuhrman puts it, "healthy lifestyle promotion". First and foremost, let's lead by example. The fact that I'm in better shape than colleagues 10 years younger doesn't go unnoticed. Second, we can support Dr Fuhrman's research and publications. Lastly we can address coercive measures.

Insurance companies aren't stupid, they'll reduce rates for those they consider lower risk, they'll pay for measures they consider will reduce costs,

If the act in its current form does not allow an insurance company to reduce rates on the basis of a person's commitment to a healthy lifestyle, we can lobby to have it changed. We can encourage insurance companies to pay for an annual wellness visit and have the physician collect simple measures of health factors under the individual's control (such as BMI, lipid factors, aerobic and muscular fitness) and have him grade, taking into account personal circumstances, the person's commitment to health.

Search results for "I hate broccoli", now vastly outnumber "I love broccoli".
I see a challenge: "What specifically can we tell our congressmen to work on, in terms of public policy, to turn this around?"

Patty - July 1, 2012 1:25 PM

Amen, Dr. Fuhrman.

The winners in this debate: Big pharma.

Phil Weinstein - July 1, 2012 4:52 PM


(Lisa, Medicare does have wellness checkup benefits, e.g. Google, "medicare wellness visit").

I hope no one is seriously suggesting that public health policy shouldn't be informed by the opinions of professionals, such as Dr Fuhrman, whose life work is all about positive health outcomes.

Democracy is inseparable from political process. Neither "politics" nor "science" should be regarded as special interests. Indeed, we all benefit from public policy being informed by fact-based opinions. I very much welcome Dr. Furhman's comments on these "political" (public policy) issues.

Diane Lassen - July 1, 2012 6:15 PM

So well stated. It is a sad state for the American people where we would rather take a pill that could harm us, rather than change our diets and move our bodies! As a health coach, I feel like a salmon (wild-caught, of course) swimming upstream against the tide of chicken Mcnuggets and french fries. People refuse to believe that their health is something that they are in control of. The wave of health coaches and progressive-minded doctors like Dr. Fuhrman and Dr. MArk Hyman are putting the real information out there: we DO have control over our health, for better or worse. We can override out genetic tendencies by adopting a lifestyle that keeps our "bad" genes turned off and our protective genes turned on. We can eat a heart-healthy and anti-cancer and anti-diabetes diet and spare the planet all at the same time. Kudos to you, Dr. Fuhrman. Think I'll go out to the garden and pick me some fresh greens....

Zorafra - July 2, 2012 12:43 AM

I agree with Dr.Fuhrman 100%, thank you for your information. If I had the power and authority I would make "nutrition and healthy eating" or "healthy cooking" a mandatory class to teach kids at school. Also would banned many food products which is FDA approved with unhealthy ingredients which causes many disease. Many of us gets fooled by food products not only are not healthy for us, as is claimed in front of the food packages, but they are causing more health problems. Many parents are so proud of themselves that feeding their kids with like "nonfat dairy " or snacks with "artificial sweetnert” thinking they are helping them. Not reading or even know how to read the nutritional facts or ingredients to see how bad are those to consume by anybody.
when people learn how to eat healthy & having a healthy life styles not only health care cost would be much less also so many other acts, behavior, & productivity get better too.

David Brewer - July 3, 2012 8:35 AM

Hippocrates settled the universal access debate centuries ago. Other industrialized nations “got it” put in place universal healthcare at less cost in many instances, with significantly better life outcomes. For those who want a balanced comparison of our healthcare system with some of the best in world, CNN’s Fareed Zakaria’s March 2012 special, Saving Health Care, is germane. According to the CIA World Factbook, we rank 50th (78.49 years) in terms of life expectancy. Canada, whose universal access healthcare system was widely criticized during the healthcare debates, ranks 12th (81.48 years). But Dr. Fuhrman is correct. We must ultimately focus on being healthier versus just structurally better medical care. We've lost 36 friends in the last four years, all but four died before the age of 70. All were middle to upper middle class with access to the best medical care. We're African Americans and this disturbing trend is reflective of our historically high fat diets. African-American women would rank 63rd (77.4 years) in life expectancy, with African-American men ranked 143rd (70.9 years). Since a disproportionate number of African Americans are at or below the poverty line, lack of access to affordable healthcare is also a critical component of these low life expectancy numbers. So, universal access to affordable healthcare remains a critical and important goal. However, once the healthcare system is structurally reset to a more affordable universal access system, our medical costs will continue to increase exponentially, unless we launch a national crusade to change the diets and lifestyles of all Americans. As a former superintendent of a major school district, I can attest that there is a tsunami of health problems awaiting us in the next 50 years in the next generation of Americans. Our competitiveness as a nation is directly proportional to the productivity of our citizens. Just as sick children cannot learn, sick and debilitated adults cannot produce. Bottom Line – Politicians will not and cannot solve our problems. We must snatch the reins from them. Let’s launch a national “Nutritarian” crusade so that America will remain the best and most productive nation in the world well into the 22nd century.

zorafra - July 4, 2012 1:42 AM

To David Brewer: I agree with your idea of : "Let’s launch a national “Nutritarian” crusade so that America will remain the best and most productive nation in the world well into the 22nd century. “ and that has to start as mandatory study of healthy eating & cooking at school as I mentioned on my comment of July 02nd above. A good percentage of american don’t know much about what they eat and how to cure a lot of health problem with right eating.
I had acid reflux years ago and got rid of it completely with learning what to eat to cure it and it’s gone 100%.. But that doesn’t make pharmaceutical companies so happy!! too bad

mike rubino - July 4, 2012 6:50 PM

David very well said.

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