The first failure point in the health situation of the US is the declining health of the US population on a number of measures. For half a century, we enjoyed rapid increases in health and life expectancy due to advances in medicine (like vaccines, antibiotics, better surgical techniques, better imaging, and new drugs) and because of progress on sanitation and public health issues (like reduced smoking, safer cars, cleaner air and water, and a substantial reduction in violence in the 1990s). In recent years, however, we have seen substantial long-term increases in a wide variety of so-called “first world” disorders that are counteracting some of that gain in life expectancy and substantially hurting productivity.
These problems include a range of disorders that don’t appear to have a lot in common except that: they are growing rapidly in advanced industrial nations; many of them kill slowly, if at all, instead disabling people for long periods; they are expensive to treat; and there is generally no clear-cut causal agent, such as a virus or bacterium. Some of the better known examples are obesity, diabetes, autism, Alzheimer’s and other dementias, asthma, severe food allergies, lupus, MS, ALS, Crohn’s disease, and a wide variety of other developmental, degenerative, auto-immune, and immune deficiency disorders.
In all of these cases, what is new is not the disease, but the epidemic-like pattern of increase. For some, it is still unclear how much of the increase is real, and how much is due to changing definitions, better tests, and/or more complete reporting. In most cases, however, the evidence strongly suggests that the increase is real, even after allowing for social and demographic changes like an aging population.
The costs can be as horrifying as the diseases. A single case of Alzheimer’s typically costs over a million dollars to treat, plus lost wages for family caregivers, and one eighth of the baby boomers are now expected to come down with it. Even more disturbing has been the explosion in autism, asthma, and extreme allergy problems among children, creating a heavy lifetime burden of disability and treatment for their families and for our whole society. When elementary teachers talk routinely about having to keep track of multiple students’ “epi pens” for treating anaphylactic shock, there is something decidedly strange going on.
The total effect of all this is a large and growing new burden on the medical resources that are available to us, as a population, which would be bad enough even if the rest of the medical system were functioning properly.
Next page: The wrong kind of medicine
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