American Health Care Trends: Old, Fat and Lazy

The recent AMA Executive Summary of "Health in the United States: Health Care Trends" contains both small hopes and a lot of darkness.

Population Trends

By 2050 segments of the population of over 65 will double from today to 83.7 million. This means that the prevalence of chronic diseases will increase dramatically. Since 1990, smoking has decreased from 29.5% to 18.1% of the adult population. As a result, stroke has decreased by 34%, heart disease by 27%, and cancer by 17%. It sounds good but ...

Fat and moist

Since 1990, the rate of obesity in adults (defined as BMI over 30) has increased from 12% to 29.6%. At the same time diabetes increased from 4.4% to 10% of all adults. No adults, everyone. The CDC predicts that by 2050, thirty percent of adults will develop diabetes. As a result, obesity is now the leading cause of heart attacks. Physical failure is a major cause. Only 21% of adults in the US Department of Health and Human Services recommend 150 minutes of exercise per week. My observation is that most do not get exercise. Many employers now offer health programs that reward financially for healthy behaviors. This can be a big step in the right direction. Of course, penalties for providing health insurance to obese or uncontrolled diabetes patients can also come, especially if the federal government leaves the health insurance business to a private company.

Is There a Doctor in the Zip Code?

The AMA reports that primary care physicians close their practice and either retire early or move to non-clinical areas such as insurance, quality management, the pharmaceutical industry or medical informatics. As demand for health services increases sharply, increasing percentages of primary care will be provided by PAs and Nurses. I hope they will increase their independence. This is not necessarily a bad thing, many are excellent caregivers and offer loving and comprehensive care. The possibility of these side-effects may increase with the request for referral and subspecialty care, such as sending diabetics to endocrinologists and COPD patients to the lungs.

Take Responsibility or Other Other Will

A dystopian weaver where the cost of medical care is far greater than our manageable resources. In these scary situations, one has to be denied service, either by the authorities or by those who refuse to adopt mandatory health guidelines. It's not over yet. We still have time to make the recommended changes in diet and activity. Remember, who could have predicted that everyone would quit smoking?

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