Sometimes the truth just hurts.

As we continue to struggle as a community, state, and nation under the heavy burden of health care, the ongoing "elephant in the living room" continues to be us.

The Daily Sentinel is doing a good job of covering the local issues related to primary care shortages and the high cost of health care. However, whether it be the press or the health care industry itself, the focus is heavily centered upon the health care system and the corresponding political and policy debates.

A more comprehensive plan would include a focus on the patients that the system serves. After all, there are much greater influences on our health than the health system or primary care access available to us as patients.

Multiple research organizations have published articles outlining what factors truly effect our health. Forty percent of our health is related to personal behaviors. Thirty percent is based on family history and genetics. Environmental and social factors come in at 20 percent. Then, in last place as a 10-percent factor, lies the medical system and medical care.

The facts speak for themselves. Healthy people don't need as much health care and they are increasingly spending more money via taxes and premiums to pay for those that are unhealthy.

In other words, our community could design the world's best health care system with world class access to primary care and five-star specialty care and we would still only address 10 percent of the problem with health care and its exploding costs.

Smart employers have figured this out. Smart countries have figured this out. Smart parents and smart patients have always known the truth. An apple a day does keep the doctor away.

Of all the modifiable factors in the health of us as individuals, our behaviors stand out above the rest. And, as a population, we are performing in an abysmal fashion.

Alcoholism continues its devastating impacts on our families and communities. Even if you avoid alcohol altogether, you likely have a family member touched by someone with alcoholism.

Obesity is at epidemic proportions. It represents an ongoing proverbial explosion rocking the health of Americans and the health-care system. Obesity leads to more diabetes, more cancer, more heart disease, and more very expensive orthopedic procedures.

Smoking and chewing tobacco remain one of the most avoidable causes of death on the planet. And now, Colorado has decided that we should experiment with more smoking of other substances without truly understanding the long-term consequences.

The opioid epidemic is ravaging our young adults and forcing grandparents back into parenting.

Poverty, highly associated with poor health, is a growing problem as we lose more and more of the middle class in America. While not a personal behavioral issue, we all collectively decide how to address this highly relevant health care factor via our public policy decisions.

Ask yourself, what are you doing to reduce the health-care costs in this country? What are you doing to support public policy that can change the paradigm and address the true drivers of poor health? As a parent or grandparent, what habits are you teaching your children and grandchildren. Are you abusing alcohol, tobacco, marijuana, junk food in front of or with your children?

On the public policy front, we tax cigarettes to reduce consumption and pay for some public health projects. Would you support similar tax policy on other substances including alcohol or soda pop to help directly address these epidemics? American cities and some countries are having success in reducing the use of substances via tax policy so that they can more effectively address the overall costs of poor health. Often times, those same taxes support community-oriented health projects to further improve the health of the population.

These issues will not fix themselves. More importantly, a perfect health system will only spend more of your money trying to address the diseases they cause. It is your tax and health premium dollars. We can either use them wisely or continue this repetitious insanity generation after generation.

The truth does hurt. But, as they say, it can also set you free ... to address the root problems.

Michael J. Pramenko M.D. is the Executive Director of Primary Care Partners in Grand Junction. He is Chairman of the Board of Monument Health and is a Past President of the Colorado Medical Society.




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