What are we really entitled to?

For the past year the future of the American economy has centered on the word “entitlement,” especially in terms of health care. But no one is quite certain about what the word means. Social Security is not really an entitlement because it is a forced savings program that promises you the money you put into an old-age fund will be given back to you when you need it, some time in your 60s. The fact that the government has been using that account as a piggy bank to fund itself without raising taxes and leaving behind government I.O.U.s in place of the funds is another matter. But you are definitely entitled to at least get back the money you put into it.

Medicare is a completely different matter. In this case, you put very little money into a fund (which is also heavily borrowed from by the government), and you expect to get a lot more back. In my view, you are entitled to get back the money you paid into Medicare, and anything more should be considered a gift from a rich uncle (Sam), who is no longer very rich.

In an attempt to resolve this problem, Congressman Paul Ryan came up with a plan that went nowhere but had at least some intellectual merit: You pay into the medical fund for old age, and you get back what you paid in (and a little more) at age 67. The most notable feature of this plan was getting an annual voucher for about $6,000 based on 2012 dollars to be applied for private health insurance premiums after age 67.

At the current Medicare tax rate, the only way to pay in more than $6,000 into proposed trust fund on an annual basis is if you make more than $200,000 per year. Since there aren’t too many Americans making that type of salary, it’s your rich uncle who must make up the difference. Even if you were making $200,000 per year for 40 years and only planned to live another 15 years after retirement, it is still a pretty good deal, as it is forced savings for health-care insurance in the future. Any overpayment on your part will only help those who are not lucky enough to make $200,000 a year for 40 years. Unfortunately, this proposal was politically dead on arrival

The real problem with any health-care entitlement program was pointed out in a well-reasoned article in the May 19th issue of The New Republic — you can’t cure chronic disease, you can only manage it (1). In addition, new research analyses of the current state of Americans in old age indicates that we aren’t doing a very good job of managing chronic diseases (2). Although Americans are living longer, the length of life with chronic disease and loss of functional mobility (i.e. independent living) have rapidly increased since 1998. We are living longer because the elderly are essentially on life support generated by increasingly more expensive drugs that only marginally extend the lives of the very sick. We are not going to cure heart disease, cancer, stroke, and definitely not Alzheimer’s. The best we can do is to help manage their outcomes. Unfortunately, these are also diseases of the elderly, and the cost of increasing each year of life after 65 has risen from about $50,000 in the 1970s to nearly $150,000 in the 1990s. This could possibly be justified if the rich uncle were still rich.

The solution according to the authors of the New Republic article is redirecting the money that we can spend to maximize expenditures on public health care (prevention and elongation of independent living) as opposed to “curing” elderly with chronic disease that usually results in the decreased quality of life (1). The primary beneficiaries of this shift in medical thinking should be children followed by working adults, with the lowest health-care priority going to those over age 80. It sounds harsh, but that is exactly how socialized medicine works in Europe.

So what do you do to protect yourself in the future, especially if you are nearing 65? My suggestion is to start aggressively reducing cellular inflammation by following an anti-inflammatory diet and lifestyle. That’s the only thing you are really entitled to and that will also be the only thing your “rich” uncle can realistically pay for in the future.

References

  1. Callahan D and Nuland S. “The quagmire: how American medicine is destroying itself.” The New Republic. May 19, 2011
  2. Crimmins EM and Beltran-Sanchez H. “Mortality and morbidity trends: is there compression of morbidity?” J Gerontol B Physchol Soc Sci 66: 75-86 (2011)

Nothing contained in this blog is intended to be instructional for medial diagnosis or treatment. If you have a medical concern or issue, please consult your personal physician immediately.

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About Dr. Barry Sears

Dr. Barry Sears is a leading authority on the impact of the diet on hormonal response, genetic expression, and inflammation. A former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology, Dr. Sears has dedicated his research efforts over the past 30 years to the study of lipids. He has published more than 30 scientific articles and holds 13 U.S. patents in the areas of intravenous drug delivery systems and hormonal regulation for the treatment of cardiovascular disease. He has also written 13 books, including the New York Times #1 best-seller "The Zone". These books have sold more than 5 million copies in the U.S. and have been translated into 22 different languages.

40 thoughts on “What are we really entitled to?

  1. If the government gets its greasy hands on something it is inevitably destroyed and without any financial backing besides our tax dollar (i.e., Social Security, Post Office, Amtrack, etc). They consistently ruin everything in which they get involved. So, all these people get these wonderful “entitlements” that do not deserve them on the backs of those that work hard our entire life. It is infuriating!! And in conjunction with these damages to our republic people continue to vote cheats, bullies, liars, hypocrites, and swindlers into office. No wonder there is so much “inflammation” to go around.

    • I expect reasonable, plausible information on nutrition from ZoneLiving…NOT political expressions. This e-mail from ZoneLiving was NOT acceptable!!!

        • I appreciate Dr Sears giving his insight into a problem we are all facing – and empowering us to do what only we can do – stay healthy. Information should be viewed as a gift – not a stone to throw. You don’t have to accept it, you don’t have to use it, but maybe it will prove helpful. It is up to you.

      • While Dr. Sears has the freedom of speech let him speak. What he says is true and is very acceptable for those who love freedom….. Not to mention it is very plausible information regarding Nutrition and ZOne livings healthy lifestyle… God Speed.. try and keep an open mind.

      • Guy…I do not live in the U.S. but belly aching over lousy government is a universal past time. I immediately saw “the bottom line” that Barry intended: that more should be done by the government in relation to prevention and since that is just in embrionic stages, it is up to each and every one to start by looking in the mirror. It is pretty difficult to target children with nutrition info, so it is educating parents that something may happen.

  2. I would gladly opt out of both programs and promise never to take one thin dime….. but of course that will not happen. I pay more in Social Security/Medicare taxes than anything else. When you are self employed, 15% comes right out to go to the Government hog to be mismanaged and squandered. It is disgusting. So glad that my husband and I are healthy and
    know how to keep the odds in our favor (ZONE) to stay that way! Thanks, Dr Sears – you have made a huge difference in our lives.

  3. It’s not politics–it’s a fact! We have the worst outcomes, highest infant mortality of industrialized nations, lowest life expectancy of industrialized nations, highest rates of obesity, and now a generation that is expected to have shorter life than their parents! I used to work in the pharma industry, but couldn’t take enough showers to get the scum off at night–R&D budgets in pharma are a pitiful small expense–the majority of the expense? Direct to consumer advertising! Now, there isn’t enough profit margin for generic drugs for companies to make them–so they’re not! We’re talking ADHD drugs, effective chemo drugs . . . .you name it. Pharma wants you to buy the newest–i.e., the most expensive! So, I got out of pharma and went into the health insurance industry–and it was worse than pharma! One day we’ll wake up and decide we don’t want providing health care to bankrupt the country–probably on the same day we use that very last drop of oil. Healthcare doesn’t want to take care of people and give them choice. When I worked in it, I tried like hell not to be in it! All of us did! I’m the HR director for an international firm–yes that means employees who have health insurance that doesn’t pay their CEO’s $5,000,000 to stop people from getting the care they need! These employees pay far less for their coverage (with better outcomes and second opinions built in) than most employees pay for private insurance in this country. Despite what “Rush and the boys” will tell you, 99% of them love it! My mother had a breast cancer recurrence, after 5 years. She had the ‘best care money could buy’, including the ‘good’ radiation. She had localized radiation for one week, instead of whole breast radiation for 6 weeks. She was one of the ‘lucky’ ones because she had other insurance besides Medicare–to pay for this new treatment. We buried her on December 3rd of last year. I became sick to my stomach when I opened the December 2010 Journal of Oncology which basically said whole breast radiation is the standard of care, and that 100%!!!!!! of the women selected for targeted radiation had other insurance–and THAT was the ONLY criteria for the treatment!!!! WHAT!!!!!?????? It went on to say oncology radiologists spend a fortune for this piece of equipment and they have to get the money back somehow (at the time Medicare didn’t cover this treatment). If you read the article ‘between the lines’ they said they’re basically strapping themselves in the for onslaught of lawsuits. This is stuff that needs to be said! It’s not political! It’s quality of life and burying a mother, who if she had the proven treatment and not the most expensive, would probably still be alive today. I saw people denied treatment every single day just so the insurance company could show a favorable loss ratio to the shareholders, and subsequently, increased earnings per share. In this country, the objective is NOT get in the healthcare system . . . .take control . . . .follow a diet which controls insulin levels and reduces inflammation.

    • Truer words have not been spoken. The pharma and managed insurance have made a travesty of the medical industry. It’s no wonder that costs are so far out of control with the “push” these two industries have had on doctors (and consumers…notice I said consumers not patients). We are so focused on the next wonder drug we forget the basic mantra “Let food be thy medicine and medicine be thy food”. Kudos to you for having a soul and not only looking at the bonus you can make by pushing the next drug or denying the next claim. I’ve been a victim of both and been pushed to the brink of bankruptcy just to provide basic medical care to my children while having never abused the system or even having chronic illnesses.

    • Karen, you didn’t need to toss in the obligatory anti-Rush comment to let us know your political leanings. And Dr. Sears’ comments are hardly Republican, although they may be considered (by some) to be conservative. My parents were Democrats before “conservative Democrat” became an oxymoron. What bothers me most is your condemnation of our health care in the US. Things that you label as “fact.” Is it really true that our infant mortality rate is high in the US? Where did you find this “fact? My family’s low-cost health provider is the Mayo Health System of Mayo Clinic fame. We have, I believe but it is my opinion, health care second to none. Would we have the same level of care in a national system? I find that rather hard to believe.

      My father is in a nursing home at age 86 after losing my mother to cancer six 1/2 years ago. He is there solely because he cannot care for himself. It and his medication are very expensive–so much so that my parents’ entire life savings will soon be gone and then the taxpayers will be called upon to pay for his care. Luckily, he does not have Alzheimer’s disease. I am constantly fighting with his physicians to wean him off of these medications which do little to improve or maintain his quality of life, only to lengthen it. Praise God that he has completed an Advance Directive when completely sane to avoid artificially prolonging his life. Comments about the end result of medications and the financial cost of care are indeed relevant in this debate. My father always told me that if you can’t afford something, you learned to do without. We all need to look for lower-cost health care or–shocker here–alternative approaches that are not only less expensive and add to the quality of life, and maybe even the length of that higher-quality life.

  4. Chronic illnesses such as diabetes are a huge health cost time bomb in Australia also. As is aged care in general. Here health and aged care are government subsidised, they are also means tested but most people still expect they will get treatment or care for free till they die. Unfortunately the health bill is blowing out so fast, particularly with chronic diseases, that in the future this can’t happen. In the end the European model is the only sustainable one and if you want more, then basically you will have pay for it yourself. I personally do not believe that not having private hospital insurance on top of what is Medicare is an option if you want to be assured of good health care. As for aged care that is facing real problems in the next few years also.

    I live in a retirement area where it seems there is a nursing home or aged care facility on every corner and they are building more every day. But here we also have a good array of services to keep people in their homes as long as possible.

    A problem with government subsidised health care, that is even more heavily subsidized for those on the aged pension, is over-servicing. Many elderly people are on too many medications. Also, as the bill can be sent straight to the government, there is also a lot of over servicing with other services such as ultrasounds, scans, and blood and eye tests.

    In a time of recession, and increasing costs, health and aged care are government outlays that need to be looked at with a bit less altruism and more with an eye to the benefits and costs. And people need to take more responsibility for their own future health

    • Stephen…well said! I live in Italy and have been paying into the national health system for over 40 years. The waste in prescribed medication is terrifying. If you need 10 pills, you get a whole box anyway. The elderly are the worst offenders in that they will rush to the emergency or doctor at the drop of a hat. Almost everyone reasons that if they are paying for it…they are going to milk it! Result? When you really do need care, you have to wait…and wait…and wait…unless you pay privately.

  5. How can anyone in the US believe that their healt care is reasonable if the payments go toward the profits of insurance companies – with the associated useless overhead. The US is the only industralized nation that does not provide health care for its citizens – and the population health statistics quoted above prove that. Governments may not be wonderful but the goal is to get you back to work and paying taxes. Insurance companies are better off if you die young after paying premiuns. Really – who would you rather have making health decision for you?

  6. Your wrong, Barry, when you say about Social Security: “But you are definitely entitled to at least get back the money you put into it.” If you don’t live to at least 62 you don’t get diddily and neither do your heirs. Some “entitlement.”

  7. This posting was offensive to me. Anyone who advocates in any way dismembering Social Security and medicare is indulging in irresponsible thinking. Using a widely respected audience to encourage wrong thinking that can cause the well-being of our entire country to be put in jeapardy is not OK with me. While I respect advocating for the need for preventive action and investing in better eating, I’m done with the Zone e-mails.

    • I don’t believe I said anything about dismembering social safety nets only stating they have become incredibly generous considering the amount of money actually paid into them. Encouraging discussion is the goal of these blogs. Every developed country in the world is facing these financial obstacles of rapidly increasing health costs for a rapidly increasing aging population.

  8. 1 Unfunded wars are a huge drain on any economy–not to mention plane loads of cash dropped who knows where. Before these wars our Uncle Sam was in good fiscal health.
    2 Programs intended as a safety net for the poor and elderly were originally conceived as a tax to prevent unnecessary suffering in the population not as an entitlement for those who don’t need it. Even in ancient times sections of the fields being harvested were set aside for those less fortunate and not for those whose pantries were well stocked. Hospitals were originally nonprofit and doctors didn’t live like kings—Both treated needy patients regardless of their ability to pay. Many doctors do much wonderful pro bono work in third world countries but few regard their fellow Americans through the same lens. Now the first info that must be obtained before admission for treatment even for emergency care is not an EKG or vital stats but one’s insurance card. I know first hand.
    3. Service sector jobs and laborers contribute much to our quality of life but rarely earn anything near $200,000. They are subject to physical burn out earlier and are exposed to more dangerous work environments. That kind of life style will break down a body quicker than a cushy desk job. My dad was a shift worker from age 15 because of his father’s early death. We know what frequently changing shifts and the resulting sleep deprivation does to insulin and cortisol levels. But someone else made the $200,000. Even the shareholders made more and they could afford good health care.
    3. The Zone diet is a wondeful thing but not all that affordable to many–especially when organic produce is factored in or even the availability of it in some areas. Even less costly frozen fruits and veggies are pricey for some. Supplements aren’t inexpensive either, and health insurances will readily subsidize medicine for diseases but not healthy alternatives for prevention. One can get generic drugs if one can’t afford them at reasonable costs from some sources—not so for veggies and fish oil. Maybe vouchers for healthy diet choices would be a better idea than risking the availability of future health care for the less wealthy or less fortunate. Whatever happened to “There for the Grace of God go I”. There really are some misfortunes and diseases that befall even young Americans (if being old is becoming the new leper) that are not self inflicted. We had no say in our genetic heritage or our parents’ diet choices which we are learning are contributing to our chronic disease risks.
    4. Tax breaks for those that don’t need them, or for American corporations that don’t employ Americans, or for drug companies who sell drugs on foreign markets more reasonably than in the U.S. are simply unpatriotic. We all contribute to their success and security. Now they are throwing us under the proverbial bus rather than pay their fair share.
    5. China is building up its wealth and has some policies in place to improve the quality of life of its own populace not just to enrich the corporations, banking interests, and the very wealthy——and between China and us—who owns whom?

  9. Thanks to the first lady, we are embracing a healthier lifestyle. Also, at 15 trillion a year, we are still 3 times richer than the closest competitor. Eat natural, healthy foods? The big corporate giants don’t want that. Tax their asses to the max. Take care of our poor and educate the masses about nutrition. Educate our doctors for preventative methods. Try hCG and don’t worry about profiting on the backs of our sick and elderly. Get out of foreign wars and lick our wounds and take care of our own first and foremost. We are a socialist country. Anybody who thinks otherwise has their heads in the sand.

  10. I agree with Dr. Sears in the totality of his blog
    except for his discription of the U.S. Government as a “rich Uncle Sam” giving gifts
    because Uncle Sam hasn’t a penny and never had a penny and never will have a penny
    because every penny Uncle Sam gives is TAKEN from others and simply redistributed.
    According to the Constitution of the U. S. all these entitlements are basically
    unConstitutional as is socialism.

  11. Dr. Sears,

    I woke up this morning, checked my e-mail, clicked your link and viola, I land on your page. I am sipping my first cup of coffee, barely have my eyes open and I begin reading – only to find that I’m read an unwanted political article cloaked by 3 1/2 lines of a zone lifestyle at the end!

    Just because you have dedicated readers, and a large platform, doesn’t mean you should abuse it. I highly respect you for your credentials, work, and intelligence, to be sure – but I am starting to question your motives when a man of your caliber is sending out e-mails selling supposedly “zoned” Cinnamon buns and “zoned” bagels for profit. A stark departure from the impeccable scientist that I discovered back in 2003.

    I truly wonder about profit entering the picture. I lost a great deal of weight on the zone, but it wasn’t done by eating cinnamon buns and bagels, no, it was from eating 4 oz of freshly baked chicken, 4 blocks of combined broccoli, cauliflower, a cucumber, a tomato, plus 4 macadamia nuts for lunch and dinner – plus 2 to three zoned snacks per day consisting of the same combinations of healthy foo, but in 1 block amounts – together with a breakfast of 1 egg plus egg whites, two apples, and 12 olives. That is real food.

    I know that people will eat a cinnamon bun before they will eat the above types of foods, and you are turning that to your advantage for profit. I shake my head in disappointment at this and hope you get back to the basics of what is real, not manufactured crap sold as food for profit. No offense, Sir, but I’m just fed up with it. Get real and get back to what’s real – real food, the basics, a solid foundation.

    • This bothers me as well and like you, I’d like to hear Dr. Sear’s reply to this. I agree with what you were eating on the zone – not sure I agree with all these grain choices (cinnamon buns,etc), no matter how they are manufactured. I suspect it may be that Dr Sears feels this is the only way to move Americans from their diet of Twinkies, Ho-Ho’s,etc into something that will at least produce less of an insulin response, since so many seem to be incapable of eating veggies,fruit, and lean meats and fish.

  12. Personally, I think Zone bagels, or any product spiked with protein powder is clever. In fact so clever, I encourage others to try it when they bake their own bread. His dietician also figured out a way to make pastries spiked with protein powder, something that I haven’t figured out how to do. The fact is Americans are so addicted to their processed grains that any diet that recommends doing away with them as the Zone diet does is unlikely to be embraced on a massive scale. While I agree that profit may be behind these spiked protein products, I say so what? There is nothing wrong with profit as long as the profits are reaped in a responsible manner.

    The difference between what Zone Diets sell and other online schemes or big Pharma is that consumption of Zone products are really better for you… simply because they are things Americans like to eat. Compliance is a big issue for any diet program; if spiking bagels increases compliance, so be it.

    I love to cook and balancing macromolecules is not that big a deal. I, too, spike my Indian vegetable curries with things like cottage cheese to increase the meal’s protein content. I think that is fun. My friends think I’m nuts, which suggests that many people will not be that compliant. To actually improve the nation’s health, those interested in it must figure out ways to make people comply without forcing them. Telling them to eat a leafy green salad with baked salmon every meal just isn’t going to work.

  13. I am surprised as to your labeling Ryan’s proposal as having some “intellectual merit”. As with a lot of other private industries in this country they put in place policies that can dramatically affect the average citizen at which time the US Gov has to step in and help. People seem to forget the days before we had the FDA, OSHA, FAA, and the list goes on. I for one feel these agencies protect average citizens from abuse of all sorts as they as individuals have no where else to go for help. Such is true of the medical and medical insurance industry. Costs have skyrocketed over the years that far exceeds inflation rates. Corporations and small businesses can not even keep up with these rates and as such either dropped coverage for their employees or required employee participation in coveraing the premiums. And the employee contributions have risen steadily from year to year. Corporate contributions for their retirees have gone up at excessive rates which dramatically affects the retirees and their fixed incomes.

    So to suggest designing any medical insurance solution around a private sector insurance company is absurd to say the least. The problem with any voucher program is that there never is a control put in place that will limit what insurance companies will charge for their services and we all know how this has gotten out of hand. Funds were paid into the Medicare system with the projection (at its inception) that this would cover the costs of premiums when the individual was at retirement age. As it turns out the funding turned out to be no where in sight of the actual costs. That is exactly what will happen with a voucher program. Yes the retiree will get a premium but I would almost gaurantee (given history) that this amount will not even be close to the actual premium AND that premiums will significantly increase as a function of your present medical condition. Bottom line is that many retired citizens will clearly not be able to afford medical insurance. Then where do they go? Just like the current system which denies people insurance. As an example I consider myself to be very healthy but got denied insurance due to one of my blood numbers being at the bottom of the acceptable range. Three doctors said they see this all the time and that it is NOT a problem and one doctor even wrote the insurance company but they stood their ground. THIS is what the voucher program will turn into.

    IF the insurance and medical industry would control their costs then going private would be an acceptable solution. However, unlike other industries such as the electronic industry where the goal is to constantly reduce the cost of their products (remember the initial cost of an LCD TV and then what it is today?) the medical and medical insuraqnce industries have traditionally proceeded in the opposite direction. THEN add to the FACT that too many tests are run these days and that too little solutions are gained when visiting a doctor’s office which results in the gross cost of medical insurance that we have today. I can honestly say that I have helped MY health significantly from reading books like those from doctors like Doctor Seers and others whose main goal is to keep a person healthy than any visit I have had to a physician’s office. Our medical industry should take note and change the way they practice as I’m positive this would save huge amounts of costs in the current system. Unfortunately during my medical visits all I get anymore is a reading of my blood results and a listen to my heart beat. This is something a nurse can do and at a significantly lower cost. And of course we all know of the excessive costs of treatments, pills, procedures, etc. That’s a whole other issue.

    The SYSTEM has to change and not the way we pay for it. Also the individual has to do their part in staying healthier. Then our food industry has to do their part in providing us with healthy food products rather than the junk foods they put on our tables every day. But then again this requires monitoring or controls by the US Gov which draws political complaints. “We don’t want the US Gov involved……….” ………or do we???

    • The Dutch government also thought a voucher system similar to the Rivlln-Ryan plan (Alice Rivlin is former member of the Clinton administration and a member of the liberal Brookings Institute) as they instituted a plan similar to it in 2006. Obviously the Dutch government thought a voucher system may have some intellectual merit. In an article in the New England Journal of Medicine on June 19 described some of the unintended consequences of the plan in terms of consolidation of the private health insurance industry. I go back to my basic premise of the blog, that the only way to protect your health future is by focusing on today’s diet and lifestyle.

  14. I’m writing from Canada where we’ve had socialized medicine since the ’60s. The system we have is certainly not the answer, but Canadians are unwilling to return to a purely private system. A combination of the current private US system and the Cndn public one is the solution. What the design would be, I don’t know. What I do know is that the key to success of any type of system is having the individual be responsible for his/her own health. The social programs are wonderful and contribute to a stable country and secure, safe, somewhat predictable lifestyle, but you must be able to afford them. Slowly but surely Canadians are coming to this understanding and hopefully this understanding will go one step further to the realization that everyone must make lifestyle choices that contribute to their own health.

  15. “The primary beneficiaries of this shift in medical thinking should be children followed by working adults, with the lowest health-care priority going to those over age 80. It sounds harsh, but that is exactly how socialized medicine works in Europe. ” Britain will not provide dialysis for patients over 55 yrs old. 21 week, 6 day old babies will not receive healthcare to get them over the critical hump.

    That is the shift in Obamacare, provided they’re not disabled and younger than two years old. In a socialized, utilitarian healthcare system, the young and the old are always the least important. Some of us out here still believe in a Biblically based “Sanctity of Life” philosophy, even extended to healthcare. The Peter Singer’s and Ezekiel Emanuels of the world may be designing our present and soon to be single payer plan, but it will collapse over time. Unfortunately not before it claims millions of lives. The price of living in a liberal, postmodern world…

  16. Again,,,,,,,the question isn’t, “Who is responsible for everyone else’s healthcare?” The least drain on any system and the most predictable, stable outcome for any one individual is to be responsible for one’s own health. No one is “entitled” to abdicate responsibility for their lifestyle choices, no matter what system they find themselves in.

  17. I appreciate Barry speaking up and I do think that some of his remarks were misinterpreted. The one thing that everyone and I mean everyone on this thread ought to agree with whether they are libertarians, conservatives, liberals, socialists or Rosacrucians is that an ounce of prevention is worth a pound of cure. And I believe that is the crux of what Barry is saying.

    We can argue forever as to whether a market based or social insurance approach is best, but no mechanism will work well until the focus shifts to prevention.

    Thanks to Barry and all for some very thoughtful observations and comments.

  18. Are we back to the times when folks believed that they were punished with poor health or accidents solely because of bad lifestyle choices? I’m all for educating the young and not so young about healthy lifestyles but that’s no free lunch either. Do bad things only happen to bad people? Should health care only be affordable for the very wealthy? Yes, individuals are and should be responsible for taking good care of themselves and making healthy choices…but sometimes even that is not enough to guarantee a disease-free life. For most, if one lives long enough, care will be needed even if only palliative or custodial. That care is expensive, yet the caregivers are paid very little and have a difficult job. Long term care insurances are pricey but even scarier is the fact that one can’t be sure that they will still be in business when it comes time to collect on the policy–even if one can afford one.

  19. Politics gets people polarized quickly. When you see comments like “So, all these people get these wonderful ‘entitlements’ that do not deserve them on the backs of those that work hard our entire life.” you see what I mean. The fact that entitlements are a VERY small fraction of the pie doesn’t matter. They have many of us focusing on it anyway. For the upper 1% their income has been going up dramatically in the last 30 years while their tax obligation has been going down. The middle and lower class is bearing the burden and when they screw up (banks) our tax dollars bail them out with billions. That’s what’s really going on and it’s a shame that so many people don’t realize it. The measure of a just and civilized society is how they treat their people, especially “the lesser of those..”. It saddens me that they want to cut a few million in entitlements yet hand out hundreds of billions in tax cuts to those at the top. That being said, unfortunately services are likely to continue to be cut and healthcare costs will rise so we really do need to take care of ourselves and be proactive with diet, exercise and life style. Otherwise you’ll find your hard earned resources and savings gobbled up by medical bills. Government should be a dynamic force in the lives of people run by elected officials dedicated to serve their country and its constituents’. Unfortunately that’s not what we have nor do we have a society of people who take good care of themselves. That however is where we will have to go.

  20. Three issues that remain unaddressed and have contributed to the rising cost of healthcare are medical litigation, illegal immigrant care, and expensive drug treatments that are approved through clinical trials devised and overseen by the drug companies. The “gold standard” today seems to be the gold that comes from ensuring the study outcome is slightly better than placebo. And once a drug is FDA approved it can be prescribed off-label for unrelated conditions without doing efficacy studies. Most people are unaware of this and assume the drugs they are taking have been vetted for their condition.

    Litigation attorneys and pharma have powerful lobbyist so politicians see little upside to taking them on. This is too bad because we can’t have the “comprehensive reform” they speak of until they do.

    Lastly, I agree that the best thing one can do is take charge of their own health by adopting good eating and exercise habits and maintaining social and family connections. It is interesting to note that older immigrant Hispanics live longer than Caucasians and African Americans in the US despite having lower levels of education and incomes. The data suggests they smoke less, walk more, eat healthier foods, and more home-cooked meals as a family. They eschew processed food and favor fresh fruit, vegetables, rice and beans. Hispanic immigrants also eat less meat, instead consuming less expensive chicken. They also have strong social bonds with family and friends. Seems like a great way to reduce inflammation.

  21. Everybody . . . misSes the true intent of Obamacare. It’s not about health.
    IT’S ABOUT CONTROL OF THE MASSES UNDER THE GUISE OF HEALTH CARE.
    WAKE UP!
    MOREOVER, obamacare and government health care is against the Constitution of the United States. The Government has no business in health care. Are you all morons?

  22. @Jockobono:

    I understand that there are very good arguments for many points of view related to how our nation should handle health care. Yours is not one of them. You’ve successfully responded with a comment that is less than irrelevant. I wish people would at least display the ability to keep the comments in line with the intent of the post. Dr Sears is kind enough take the time to provide well reasoned arguments that have great potential to improve everyone’s health. Please have some respect for that and keep the conspiracy theories to appropriate corners of the web.

  23. The United States of American did not become the greatest most powerful most successful most wealthy of any other nation on earth by copying what all the other failed nations did in the past.
    NOW, half the nation of the United States want to give everything up and ignore the
    Constitution and copy what all the other failed nations have done, all because of free entitlements and free handouts. And you call it a conspiracy theory?
    Canada proved their health care system failed undel liberal rule. Now a new Conservative PM is changing it back to following the United States format and the United States President wants to change the U.S. health system to follow the failed Canadian system.
    Yee gads!

    • If the Canadian PM wants to emulate our health system, God help him and his people. Me thinks he might look around at a few other successful systems before embarking on what is obviously one huge mess here. Agree with Dr. Sears – we have to preach the message of individual responsibility in terms of taking care of one’s own health and that means learning how to eat correctly. Think lots of veggies, small amounts of fruit, lean fish,chicken,meat and healthy fats – it’s not all that difficult really.

  24. Mark Holmes,
    Name just one successful health care system in the world, just one, better than the American system?
    The American health care system was a free capitalist system which was the best in the world until Obama got his Obamacare system passed. Granted, the American system was costly to the consumer but still the best and still is presently as Obamacare systematically takes over.
    Hopefully a Conservative will be elected as the new U.S. President and disband Obamacare.
    The U.S. Constitution does not give the U.S. Government any right to control health care in America. Nothing is ever perfect but liberal socialist Government run health care around the world has failed miserably and most Americans don’t want an Obamacare cloned failed system
    with the exception of those who rely on freebies and handouts.

  25. My husband & I have worked hard all our lives, we have paid our taxes and raised our children. We have tried to eat a healthy diet & have always exercised. We reach 65 this year &i don’t think that we are only entitled to what we paid in in social security or Medicare. For one thing when the government took those funds from our pay checks we were not asked if we wanted to contribute. Those same dollars bought a lot more when they were taken than they do now. Plus if they were held for us until now where is the interest that we could have made on the money? Last but not least when the government with held those funds it was with the understanding that we would receive social security & Medicare after a certain age. In my view this is a contract & uncle Sam can be sued if he renags.

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