Opinion: Health care debate has little to do with health

David Kopp

America's health care reform debate reflects the growing division in our country today.

Progressives are agitating for Medicare for All, which would ban private health insurance and enroll everyone in a new government-run plan. Moderates prefer a "public option,” a government-chartered health plan that would compete against private insurers. Conservatives still hope to repeal Obamacare and expand the availability of lower-cost private plans.

Democratic presidential candidate former Vice President Joe Biden, speaks as Democratic presidential candidate Sen. Bernie Sanders, I-Vt., listens during a Democratic presidential primary debate, Wednesday, Nov. 20, 2019, in Atlanta.

This partisan squabbling boils down to a simple question — who should pay for our healthcare? We're spending little, if any, time tackling a far more important question — how we can make Americans healthier so they don't need as many costly surgeries, hospital stays and medications in the first place?

Addressing that question could have a far greater impact on public health and well-being than our current debate over who should foot the bill.

We can start by changing the nature of our relationships with our healthcare providers so that we're interacting with those providers before we get sick.

Most physicians are ill-prepared to offer coaching on nutrition and exercise. Just 1 in 5 U.S. medical schools requires students to take any nutrition courses. More than half of doctors trained in the United States receive no formal education in physical activity. That's a shame because it's no secret that Americans eat poorly and spend too much time vegging out. Less than 20% of adults consume the recommended amount of vegetables each day. Less than one in four gets enough exercise. And the average adult ingests 57 pounds of added sugar a year — nearly twice the recommended amount.  

Poor diets and physical inactivity often lead to obesity, heart disease and diabetes. Such chronic conditions kill hundreds of thousands of Americans each year and account for 90% of all healthcare spending.        

Conditions like these could be prevented if healthcare providers invested more time and energy promoting better nutrition and lifestyle changes — and then held their patients accountable for adhering to their treatment regimens.

Less than one in four Americans get enough exercise, Kopp writes.
Less than 20% of adults consume the recommended amount of vegetables each day, Kopp writes.

Imagine if medical schools made nutrition and exercise science core parts of their curricula. The next generation of doctors could prescribe diet and exercise plans as frequently as the current one prescribes pills. Soon, we'd have a true healthcare system, rather than our current "sick-care" system.

Second, we need to change the way doctors work with each other.

Right now, most American physicians pursue careers as specialists. This hyper-specialization leads to frequent communication breakdowns. People get poked by the cardiologist, prodded by the endocrinologist and scoped by the enterologist — but there's no one in charge of coordinating their care.  

When providers work as a team, their patients prosper. To cite just one example, research from the Johns Hopkins Community Health Partnership has found that pairing primary care physicians with community health workers and behavioral health specialists significantly reduces hospitalizations, readmissions and trips to the emergency room.  

Third, we need to build cultural norms that encourage and empower people to take greater ownership of their health.

Consumers spend hours scouring the internet for the best deals on the latest gadgets, or for details on their family tree. We should do the same with our health.

Doctors may fear that people will march into their offices with fistfuls of medical misinformation. But research shows that people who consult the internet for health information are more confident in and comfortable with their physicians' advice.

America's reactive, sick-care system has failed to improve the health and well-being of millions of people. Yet our leaders are bickering over who should pay the bills generated by the dysfunctional status quo.

Far better to reduce or eliminate the need for all those bills — by re-orienting our healthcare system around prevention, care coordination and patient empowerment.

David Kopp is the CEO of Healthline Media.