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The Iowa State Fair is coming up in about a month, and in case you're looking for ways to emerge from the Fair without looking like the Big Boar, here's a little hint: While the Iowa State Fair is best-known for food on a stick and fried, well, everything, cotton candy turns out to be practically a health food by comparison with everything else. Sure, it's really just a big pile of sugar, but at least that's where the damage stops. And a full-sized serving of cotton candy is only about a hundred empty calories.
Obviously, the State Fair is about the last place most people are thinking about their health, but about the time the fair rolls around, we're expecting to be looking at the new health-care system as proposed by the White House. There's lots of debate to go around about what to do with health care in America, but let's get two big ideas out there:
- First, health care represents something like 15% or more of GDP. In other words, for every dollar spent and/or earned in America, about 15 cents went to health care. Now, we complain (with good reason) about 7% sales tax rates here in Iowa. Health care takes up twice that amount and then some. Anything the government does to change how that's done needs to ensure that we're actually getting more (longevity, healthy living, and/or quality of life) for less. Otherwise, it's just making a bad situation worse.
- Second, if we really want to ensure that the health-care system works in the long run, we need to find a way to align the short-term interests of the people involved (like insurance companies, health-care providers, and, well, we the people) with the best long-term approach. A lot of what seems to be wrong with American health care is that we have private insurance, often through our employers, that we're not likely to keep in the long term. Sooner or later, many (if not most) people end up changing jobs and thus, changing health insurance policies. And then we all end up on Medicare. That means the insurance company covering you when you're 25 probably won't have you around when you're 45, and the one that covers you at age 45 probably won't have much to do with you when you're 65. Yet there are lots of things that can be done when you're 25, or 35, or 45 that will make you healthier when you're 65. Regular screenings for high-risk chronic conditions, exercise, good dietary guidance...you name it, there are plenty of ways in which investments in your health while you're young can pay off when you're older. But since the insurance companies generally don't expect to have anything to do with you later, they have little incentive to invest in your wellness today. But in treating health care as if it's only there for emergency treatment when something goes wrong, we do little to ensure that we keep things working when we're well. One approach may be to create wellness trusts in the names of every individual in the country, and balancing some of the short-term costs that insurance companies may incur while keeping you well while you're young with long-term benefits -- like a payoff for when people don't end up having heart attacks or lung cancer when they're older.