January 1, 1970 (Vol. , No. )

Taralyn Tan Ph.D. Curriculum Fellow Harvard Medical

“Healthcare” has certainly been the buzzword the past number of months, and the people of this country have been voraciously reading about and vociferously discussing its reform. Perhaps it is a travesty that this conversation didn’t begin years or decades ago. Well, no matter—while it may be disappointing that we are only now getting around to fixing such a broken system, the glass is certainly half full in that we are, in fact, fixing it.

Yes, unless you’ve been living in a cave this past month, you are aware that President Obama signed his healthcare legislation into law on March 23 amidst fanfare and celebration. It was an act that was definitely worthy of celebration—the culmination of months of heated debate and long, long hours for the men and women on Capitol Hill. Champagne was surely poured and (at least part of) the nation breathed a collective sigh of relief. Our age-old healthcare system is getting a serious facelift, and many Americans will be better served by the revisions the bill entails. Coverage will be expanded to 32 million Americans who currently don’t have health insurance. Seniors on Medicare will no longer have to worry about paying for their own prescription medications during a “donut hole” gap in coverage. Medicaid will be expanded. Children (and, in 2014, anybody) with preexisting medical conditions cannot be denied coverage by insurance companies. Cause for celebration, indeed.


(And there is always a “but”…)

I said the glass is half full, and it is only half full. We should definitely laud the passage of this historic legislation, but that sigh of relief heard ‘round the nation on March 23 should have been followed by a deep breath in preparation of a continued campaign for change. For you see, this battle is far from won. So if you’re one of those people who still has his/her party hat on, let me sober you up out of your jubilation hangover. With this new legislation, our situation regarding healthcare is better, but it is not fixed. Certain issues remain that are indicative of a flawed healthcare system, such as rising costs of healthcare, the practice of “defensive” medicine to avoid malpractice suits, and the lack of incentives for young physicians fresh out of medical school to specialize in primary care. Yet, perhaps the largest, most negative component of the healthcare equation stares back at us in the mirror every morning. That’s right—it’s us.

Healthcare is, after all, all about us. And while we can tweak insurance policies here, or expand coverage there, we cannot expect our healthcare system to function properly if the people at the heart of the system are constantly eroding it. And we are. As a society—as a nation—we areputting undue strain on healthcare because of our choices and lifestyles. We have high blood pressure. We have atherosclerosis. We are grossly obese. (So much so, that senior retired military leaders are calling the obesity epidemic among America’s youth a threat to national security, as many young adults are too obese to join the military.) Our leading cause of death is heart disease. In short, we are plaguing the healthcare system with chronic conditions that could, to a large extent, be managed on our own…if we so chose.

And that why this recent healthcare legislation is only one piece of the puzzle. We must address the pervasive disease of this nation’s people (namely, preventable health woes) before we can hope to cure the healthcare system of its ills, no matter how much legislation is signed into law. In an ironic analogy, the unhealthy lifestyles of people in this country are to our healthcare system what heart disease or obesity is to us. The increasingly rapid accumulation of chronic health conditions resulting from lifestyle choices puts strain on the framework of our healthcare system—more people are needing treatment, more treatment is required, and there are more costs associated with treating long-term health problems that could have been avoided. This is much like how an atherosclerotic plaque hinders blood flow and strains the heart, or how carrying a substantial excess of fat eventually strains the body and causes various systems to malfunction.

So thank you Mr. President and all of the politicians who pushed through the historic legislation, but I’m afraid I must save this last bottle of champagne for the day when we, the people, help to heal our healthcare system by changing our ways.

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