“The Health Care System Is Flawed. Let’s Fix It”; Can something good come from Brian Thompson’s murder?; What you can do to improve your health; Do you care about the 26 million?

Welcome to the December edition and Happy Holidays to all.

In SAVVY, Brian Thompson, CEO of UnitedHealthcare, was fatally shot on December 4, 2024. His boss, Andrew Witty wrote an essay, “The Health Care System Is Flawed. Let’s Fix It” that starts with looking at some cold hard facts about our US healthcare system.

In SKILLS, I don’t pretend to have solutions for improving the American healthcare system. But I refer you to a mix of research findings that recommend actions you can take as an individual to improve your physical, addiction and mental health.

In SOUL, why can’t the richest and most powerful country in the world care for the health of their citizens as a right and priority? It’s not about money, because we spend more than other developed countries but get far worse health outcomes.

Andrew Witty is the chief executive officer (CEO) of UnitedHealth Group, the parent company of the UnitedHealthcare insurance business whose CEO, Brian Thompson, was fatally shot on December 4 this month.

Mr. Witty wrote a guest essay opinion piece “The Health Care System Is Flawed. Let’s Fix It” in which he said: “We know the health system does not work as well as it should, and we understand people’s frustrations with it. No one would design a system like the one we have. And no one did. It’s a patchwork built over decades.”

Of Brian Thompson, he wrote “the ideas he advocated were aimed at making health care more affordable, more transparent, more intuitive, more compassionate — and more human.”

Those are worthy goals. So in this Tips & Topics, if we are to reach those goals, it starts with looking at some cold hard facts about our US healthcare system.

Tip 1

Poll finds more than half of people in the U.S. have negative views of health care cost, equity.

• The Hill (10/6, Shapero) reports that more than half of people in the U.S. “said they have negative views of the cost and equity of health care in the” country, according to a West Health-Gallup poll.

• Three-quarters of respondents “gave the U.S. health care system failing grades for affordability” regardless of income, and

• 56% “rated the U.S. health care system negatively in terms of its provision of equitable care.”

• The results found “the percentage was higher among women, and Black and Asian American respondents, who were more likely to give the system a failing grade for equity.”

Tip 2

Amid Health Sector Inflation, Millions of US Adults Feel Unprepared for Healthcare Costs.

• “More than 70 million adults feel unprepared to pay for healthcare costs, while health systems are facing a tight labor market and ongoing supply chain issues, highlighting the financial repercussions of inflation in the healthcare industry,” according to findings from a Deloitte report.

• Deloitte surveys found “nearly a third of respondents said inflation was the top reason they are concerned about covering unexpected healthcare needs.

• Meanwhile, 28 percent, or 72 million adults, reported feeling less prepared to pay for routine and unexpected healthcare than last year.”

Tip 3

Americans falling farther behind rest of developed world when it comes to health, life expectancy.

• HealthDay (12/6, Thompson) reported, “Americans are falling farther behind the rest of the developed world when it comes to health and life expectancy, a new study shows.” Researchers found that “life expectancy in the United States is expected to increase to 79.9 years in 2035 and 80.4 years by 2050, up from 78.3 years in 2022.”

• Although “that sounds good,” it is “actually a modest increase that will lower the nation’s global ranking from 49th in 2022 to 66th in 2050 among 204 countries around the world, they found.” The findings were published in The Lancet.

Tip 4

Despite higher healthcare spending, America’s health outcomes are not any better than those in other developed countries.

Does Higher Healthcare Spending Lead to Better Outcomes?

• Higher healthcare spending can be beneficial if it results in better health outcomes. However, despite higher healthcare spending, America’s health outcomes are not any better than those in other developed countries. The United States actually performs worse in some common health metrics like life expectancy, infant mortality, unmanaged diabetes and safety during childbirth.

• A healthcare system with high costs and poor outcomes undermines our economy and threatens our long-term fiscal and economic well-being.

Tip 5

An estimated 26 million Americans, or 8 percent of the U.S. population, lacked health insurance in 2023.

• While the United States still lags countries that have universal coverage, today’s uninsured rate represents a sea change from the years prior to the Affordable Care Act (ACA), when twice as many people — 49 million, or 16 percent of the population — lacked health coverage.

• Gallup poll released earlier this month found that 28% of Americans “say health care coverage in the U.S. is excellent or good,”

• 65% of Americans “say their personal health care coverage is good or excellent.”

• Americans who rated their health as “fair” or “poor” were “more likely to rate their health insurance negatively, as were those who were insured under the open marketplace through the Affordable Care Act.”

SKILLS

For over 30 years of my career, I worked to transform addiction treatment from a program-driven, fixed length of stay, one-size-fits-all system of care to a person-centered, outcomes-driven, individualized continuum of care.

I don’t pretend to have solutions for the even more complex challenge of improving the American healthcare system. But in SKILLS, I refer you to a mix of research findings that recommend actions you can take as an individual to improve your physical, addiction and mental health (no drugs or pharmaceuticals required).

Tip 1

Playing Music, Singing in Group May Improve Brain Health Later in Life.

Psychiatric News (2/2) reported, “Playing a musical instrument and/or singing in a group may improve brain health later in life,” research shows. Published in the International Journal of Geriatric Psychiatry, the study “found that playing a musical instrument, singing, and overall musical ability was associated with significantly better performance in working memory and executive function.”

Tip 2

Physical activity and fitness have many benefits for mental and physical health.

• HCP Live (1/12, Derman) reported, “Physical activity could help prevent depression in older adults, according to new research.”

• Research Identifies Most Effective Exercises For Easing Depression HealthDay (2/15, Miller) reports that research indicates “walking, jogging, yoga,” and “strength training... are the most effective exercises for easing depression.”

• Physical fitness tied to better mental health among children, teens. The New York Times (4/29, Richtel) reports, “Physical fitness among children and adolescents may protect against developing depressive symptoms, anxiety and attention deficit hyperactivity disorder, according to a study published... in JAMA Pediatrics.”

• NBC News (8/8, Bendix) reports, “Walking just 4,000 steps per day is associated with a lower risk of death, according to” an analysis.

• HealthDay (7/10, Mozes) reports, “Even slow walking can help improve... mental and physical health, say the British researchers who tracked more than 1,400 adults age 60 and up.”

Tip 3
Tai chi more effective than aerobic exercise for blood pressure reduction for prehypertension.

Healio (2/9, Schaffer) reported, “Among adults with prehypertension, 12 months of tai chi significantly decreased office systolic BP by a mean of 2.4 mm Hg more than aerobic exercise, along with greater reductions in 24-hour and nighttime ambulatory systolic BP, data show.”

Tip 4
Large Majority of Adults Who Have Pets Feel That Their Pets Have a Positive Impact on Their Mental Health.

Psychiatric News (3/1) reported in a news release, APA President Petros Levounis, M.D., M.A., said, “It’s easy to overlook the role of pets when we’re talking about mental health.” Dr. Levounis added, “But for people who do enjoy the company of animals, they can be a source of companionship, comfort, love, and friendship.”

Tip 5
The Less Screen Time the Better. Watching TV and Other Screens Have Significant Health Effects.

• Youth Who Spend Less Time On Screen Media Exhibit Improved Behaviors, Study Finds. Psychiatric News (7/12) reported study results show that youth who took part “in a two-week family intervention to reduce time spent on smartphones and other screen media showed improved behaviors relative to youth that did not participate.”

• Women who spend time on TikTok have greater risk of decline in body image satisfaction. NBC News (8/7, Rosenblatt) reports, “Women who spend time on TikTok are at a greater risk of disliking their own bodies and feeling worse about their appearance.”

• Research Finds Link Between Time Spent Watching Screens with Higher Odds for ADHD, Depression in Children. HealthDay (10/9, Mundell) reports, “A study tracking almost 10,000 9- and 10-year olds for two years finds a link between time spent watching TV and other screens with... higher odds for ADHD and
  depression.”

• Toddlers who are exposed to more screen time have fewer conversations with their parents or caregivers by an array of measures. They say less, hear less and have fewer back-and-forth exchanges with adults compared with children who spend less time in front of screens.

• Screens are not just linked to higher rates of obesity, depression and hyperactivity among children; they also curb face-to-face interactions at home — with long-term implications that could be worrisome.

SOUL

I am in Hawaii with my oldest daughter, Miya, and her family for Christmas. It is hard to believe that it is now 12 years since my older granddaughter was born in Australia less than 50 miles and 50 minutes away from where I was born and raised.

Australia is about the same size as the continental USA with a population of 27 million (8% of the US population) and about the same number of people who don’t have healthcare insurance in the USA.

When Miya was pregnant with my older grandgirl, she experienced how the universal healthcare system of Australia worked compared with her pregnancy with my younger grandgirl born in the USA:

• She got good care in both Australia and the USA.

• Both labor and deliveries were smooth and uneventful.

But here were some of the differences:

• In Australia, she was encouraged and facilitated to use midwives and natural birth methods and birthing centers.

• In the USA, she had to research and search for options to use midwives and natural birth methods. The emphasis was on more expensive and medical obstetricians and hospitals.

• In Australia, she had several follow-up home visits postpartum to assist in lactation care and adjustment to parenting.

• In the USA, no such service was offered.

• In Australia, she received $5,000 from the government to assist in the care of their baby.

• In the USA, no such support.

This is not about Aussie boosting and American bashing. This is about the baffling and saddening question as to why can’t the richest and most powerful country in the world care for the health of their citizens as a right and priority? It’s not about money, because we spend more than other developed countries but get far worse health outcomes.

I know that as a parent, I am vigilant about making sure all my children have adequate health insurance. I bet you do for your family as well.

How is it then that as a country and collective conscience, we are comfortable with 26 million Americans not having what we want for our families? It’s good that we have halved the uninsured numbers from 49 million or 16% of the population to 26 million.

But how can we use the huge amount of healthcare dollars we already spend in the USA more efficiently than other developed countries who spend less, but get better health outcomes than we do?

As an older adult the USA takes care of me and my generation with healthcare for all. So I am blessed. But what about that 26 million of us?

UNTIL NEXT TIME

Thank you for joining us this month. See you next year in late January.

David