What Makes Life Worth Living

Someone you love  who loves you in return

Something to look forward to

Work that you enjoy

Cultivating a Life of Quality

Walk 30 minutes 3 x weekly

Stretching 15 minutes 3 x week

Strength training 15 minutes 3 x week

Get out of chair using leg muscles 10 x day

Maintain ideal weight

Eat vegetables, fruits, bread

Vitamin and Ca supplementation

8 glasses of water daily

81 mg aspirin daily

Puzzles and thinking games daily

Limit television and other passive activity

Party once a week/laugh daily/be a friend

Avoid negative people and negative talk

Serve others

Pray and read the scriptures everyday

Worship weekly

2000 Census Figures

Largest 5-yr. age group = 35-39 year olds

Second largest = 40-44 year olds

Largest percentage growth = 50-55 

Over age 65 = 35 million 

12% of the population

1,019,928 over age 90 (0.4% of population)

55,000 over age 100 (in 2005)

United States Life Expectancy

In 1900 the U. S. life expectancy was 47.3

At birth (Actuary Tables July 9, 2007): 

Male = 74.4 Female = 79.6

At 50 years of age:

Male = 78.09 Female = 81.91

At 60:

Male = 80    Female = 83.21

At 65:

Male = 81.33 Female = 84.2

At 70:

Male = 82.98 Female = 85.45

At 80:

Male = 87.43 Female = 89.00

Life-sustaining Treatments from the AMA

• Life-sustaining treatments should provide medical benefits and should respect a patient’s preferences, as communicated by the patient or a legally recognized surrogate.  Treatments such as mechanical ventilation and artificial nutrition and hydration should be provided only with appropriate authorization from a patient, a surrogate, or a court.  Once initiated, life sustaining treatments may be ethically withdrawn upon request of the patient, or a surrogate or court acting on the patient's behalf.
• To assist patients and surrogates in the decision-making process, physicians have an obligation to provide medical expertise, competent diagnosis based on an appropriate evaluation of the patient, and therapeutic options that are in accord with accepted professional standards of care.

Health Care Cost in the United States From the AMA

Health care costs in the United States hit a new mark in 2006, increasing 6.7 percent to $2.1 trillion, or $7,026 per person, according to the most recent issue of Health Affairs. That’s more than 16 percent of the nation’s gross domestic product (GDP), highest among developed countries. And it’s nearly double the median average of GDP that the Organisation for Economic Cooperation and Development, which includes 30 countries (including the U.S.), reported in 2004.

It’s easy to see how the money adds up. According to the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey, the nation’s 10 most expensive medical conditions cost about $500 billion to treat in 2005. That includes visits to doctors’ offices, clinics, and emergency departments; hospital stays; home health care; and prescription medications. Heart conditions top the list at an estimated $76 billion, followed by trauma disorders at $72 billion and cancer at $70 billion. It’s important to note thatspending on physician and clinical services accounted for only about 21 percent of total health care costs in the U.S. in 2006.

Increases in chronic disease and unhealthy behaviors are partly to blame for these skyrocketing costs. For example, the prevalence of obesity and diabetes has doubled during the past 25 years, and more than a quarter of health care spending growth in recent years is attributable to the rise in obesity and related growth of diabetes, high cholesterol, and heart disease. Modifiable lifestyle behaviors such as unhealthy nutrition, physical inactivity, smoking, and alcohol abuse, as well as motor-vehicle collisions, gun violence, domestic violence, and other forms of trauma, are contributing to the problem.

Meanwhile, inefficiencies in the nation’s health care system continue to drive up costs. One study found that unnecessary medical tests are costing the U.S. health care system millions—and potentially billions—of dollars annually. According to the study, the estimated annual costs of unwarranted use of just three low-cost tests alone—urinalysis, electrocardiograms, and X-rays—cost $50 million to $200 million a year.

Overuse of medical services also occurs because of the high risk of medical liability lawsuits. A March 2003 report from the U.S. Department of Health and Human Services estimated that defensive medicine cost the nation between $70 and $126 billion in 2001.

End-of-life care has been cited as a source of significant overuse. A quarter of the cost of Medicare services is for patients in the last year of life, but reducing these costs is challenging.

Other research suggests that services known to yield savings aren’t being used enough. One particular study found that patients only receive 55 percent of services recommended by clinical guidelines, including preventive services and care for chronic conditions such as hypertension, high cholesterol, and diabetes.

Fragmentation of care is an issue, causing repeated medical histories and duplicative diagnostic tests because patient records are not readily available. In addition, administrative costs, profits, marketing, and other nonclinical spending often add to health system costs without contributing demonstrable value to patient care.

These are some of the root causes. Now what are the solutions? The AMA has pinpointed several broad strategies (PDF, 58KB) that would address these rising costs and generate better value for what the nation spends on health care.

First, we must reduce the burden of preventable disease. To accomplish this, we can lessen risk factors for illness and injury and prevent the onset of chronic disease, by improving patient compliance with medications andpreventive care recommendations; by helping patients avoid tobacco use and alcohol abuse; by encouraging patients to eat better and exercise more; and by preventing intentional and unintentional injuries. Public health programs and policies can go a long way toward getting the message across on this front.

Second, health care delivery must be more efficient. Better efficiency will result from improving the coordination of care, using unnecessary services less often, and increasing our use of services that are proven to have a positive return on investment in terms of reducing future disease and costs. We also need to better manage chronic illnesses, reduce medical errors, and shift care to cost-effective sites of service.

Third, we must reduce nonclinical health system costs that do not contribute to patient care by eliminating excessive spending on administration, profits, and marketing (PDF, 67KB).

Fourth, we should promote value-based decision-making at all levels. That means improving the processes by which decisions are made so that they take into consideration both cost and benefit, particularly clinical outcomes. Examples of value-based decision-making include physicians and patients choosing among drug therapies, insurers designing health plan cost-sharing features, and legislators determining public health budgets and considering mandated insurance coverage of particular benefits. The AMA Council on Medical Service is developing a report on this subject that should be ready for the 2008 Annual Meeting of the AMA House of Delegates in June.

The AMA also has identified a list of specific actions to put these four strategies into effect. Among them are promoting patient lifestyle counseling and treatment, supporting cost-effectiveness research, and using clinical performance measurement, as we’re doing through the Physician Consortium for Performance Improvement, to improve efficiency. More details on the AMA’s broad strategies and a complete list of these specific actions can be found in a report from the AMA Council on Medical Service (Word, 171KB) issued last year.

That’s the AMA’s stance on how to limit the nation’s health care spending; now I’d like to hear what you think. What are your views on these broad strategies and specific actions?

Lowering Health Care Cost

by Ron PaulRon Paul

As a medical doctor, I’ve seen first-hand how bureaucratic red tape interferes with the doctor-patient relationship and drives costs higher. The current system of third-party payers takes decision-making away from doctors, leaving patients feeling rushed and worsening the quality of care. Yet health insurance premiums and drug costs keep rising. Clearly a new approach is needed. Congress needs to craft innovative legislation that makes health care more affordable without raising taxes or increasing the deficit. It also needs to repeal bad laws that keep health care costs higher than necessary.

We should remember that HMOs did not arise because of free-market demand, but rather because of government mandates. The HMO Act of 1973 requires all but the smallest employers to offer their employees HMO coverage, and the tax code allows businesses – but not individuals – to deduct the cost of health insurance premiums. The result is the illogical coupling of employment and health insurance, which often leaves the unemployed without needed catastrophic coverage.

While many in Congress are happy to criticize HMOs today, the public never hears how the present system was imposed upon the American people by federal law. As usual, government intervention in the private market failed to deliver the promised benefits and caused unintended consequences, but Congress never blames itself for the problems created by bad laws. Instead, we are told more government – in the form of “universal coverage” – is the answer. But government already is involved in roughly two-thirds of all health care spending, through Medicare, Medicaid, and other programs.

For decades, the U.S. healthcare system was the envy of the entire world. Not coincidentally, there was far less government involvement in medicine during this time. America had the finest doctors and hospitals, patients enjoyed high-quality, affordable medical care, and thousands of private charities provided health services for the poor. Doctors focused on treating patients, without the red tape and threat of lawsuits that plague the profession today. Most Americans paid cash for basic services, and had insurance only for major illnesses and accidents. This meant both doctors and patients had an incentive to keep costs down, as the patient was directly responsible for payment, rather than an HMO or government program.

The lesson is clear: when government and other third parties get involved, health care costs spiral. The answer is not a system of outright socialized medicine, but rather a system that encourages everyone – doctors, hospitals, patients, and drug companies – to keep costs down. As long as “somebody else” is paying the bill, the bill will be too high.

The following are bills Congress should pass to reduce health care costs and leave more money in the pockets of families:

HR 3075 provides truly comprehensive health care reform by allowing families to claim a tax credit for the rising cost of health insurance premiums. With many families now spending close to $1000 or even more for their monthly premiums, they need real tax relief – including a dollar-for-dollar credit for every cent they spend on health care premiums – to make medical care more affordable.

HR 3076 is specifically designed to address the medical malpractice crisis that threatens to drive thousands of American doctors – especially obstetricians – out of business. The bill provides a dollar-for-dollar tax credit that permits consumers to purchase "negative outcomes" insurance prior to undergoing surgery or other serious medical treatments. Negative outcomes insurance is a novel approach that guarantees those harmed receive fair compensation, while reducing the burden of costly malpractice litigation on the health care system. Patients receive this insurance payout without having to endure lengthy lawsuits, and without having to give away a large portion of their award to a trial lawyer. This also drastically reduces the costs imposed on physicians and hospitals by malpractice litigation. Under HR 3076, individuals can purchase negative outcomes insurance at essentially no cost.

HR 3077 makes it more affordable for parents to provide health care for their children. It creates a $500 per child tax credit for medical expenses and prescription drugs that are not reimbursed by insurance. It also creates a $3,000 tax credit for dependent children with terminal illnesses, cancer, or disabilities. Parents who are struggling to pay for their children's medical care, especially when those children have serious health problems or special needs, need every extra dollar.

HR 3078 is commonsense, compassionate legislation for those suffering from cancer or other terminal illnesses. The sad reality is that many patients battling serious illnesses will never collect Social Security benefits – yet they continue to pay into the Social Security system. When facing a medical crisis, those patients need every extra dollar to pay for medical care, travel, and family matters. HR 3078 waives the employee portion of Social Security payroll taxes (or self-employment taxes) for individuals with documented serious illnesses or cancer. It also suspends Social Security taxes for primary caregivers with a sick spouse or child. There is no justification or excuse for collecting Social Security taxes from sick individuals who literally are fighting for their lives.

August 23, 2006