Eating to live. A simple solution to the problem of rising US healthcare costs.

Heart health 72ppi

A once proud stallion, its back broken, lies dying.

Nearby, a bruised rider staggers, struggling to regain balance after a concussive fall.

The wounded horse, the US healthcare system, is the largest, most elaborate and most costly medical machine in the world.  The rider is our struggling economy, ailing under the weight of soaring healthcare costs with no ceiling in site.

Populated by brilliant scientists and filled with the promises of techno wonder, the US healthcare system nevertheless ranks poorly when assessed by metrics such as infant mortality and the prevalence of obesity, diabetes mellitus, and heart disease.

You’ve heard this before… I know.

But please bear with me.  I’d like to share my take on why it’s failing… and more importantly, offer a truly effective solution.

Am I biased?  Without question.

Naive and impractical?  Perhaps, “reality” being what it is.

For over a decade the US healthcare system has been labeled as “broken”.  The more indicting term, “disease care system”, is now in vogue.

These descriptions – catchwords really – do little more than vent frustration or point to a growing threat.  They shed no light on a possible solution while directing attention away from the root cause.

But the cause is clear and the solution is simple.

And not just recently proposed, but going back at least several decades with the 1977 publication, “Dietary Goals for the United States”, widely known as “The McGovern Report.” The document was produced by the United States Senate Select Committee on Nutrition and Human Need.  It openly challenged widely held dietary beliefs… the same dogma that drives mainstream eating behavior today.

“Major health problems are diet related.  Most all of the health problems underlying the leading causes of death in the United States could be modified by improvements in diet.”

The report recommended that our diets contain less animal foods and more fruits and vegetables.  Not surprisingly, the backlash from agribusiness and the medical establishment was fierce. The American Medical Association even claimed that widespread dissemination of nutritional information would interfere with the doctor’s right to prescribe.  This, despite the fact that few medical doctors had then or now the expertise needed to give sound nutritional advice.

So the USDA canned the recommendations and instead bowed to the will of the meat, dairy and egg industries and institutionalized medicine.  And the economic concerns of these organizations prevailed over the interests of the public.

So today, you and I are still stuck with the problem of poor diet and its offspring, disease and unbridled healthcare costs.

“Oh yeah”, you say.  “I know about low fat and low cholesterol.  Fewer sweets too.”

I hear this all the time from my patients with coronary heart disease, along with ”How could this have happened to me? I eat a good diet.”  On careful review we find this is not so.

When a new patient comes into my office often after having suffered a heart attack, I suggest a reading of Prevent and Reverse Heart Disease by Caldwell Esselstyn, MD or Reversing Heart Disease Dr. Dean Ornish. The programs outlined in these manuals have been proven to stabilize and actually reverse coronary heart disease.

What’s remarkable about these programs, both of which advocate consumption of a plant based diet, is that they work far better than any known heart medication… better than coronary stents… and better than coronary bypass surgery. In fact, except in the context of an actual heart attack or the most perilous cases of coronary disease (e.g., involving the left main coronary artery), it’s difficult to justify the usual interventions without first giving their programs a try.

But that’s not standard practice.

So what’s the problem?

Again, it’s really very simple.

Much of our economy is based on a food industry and practices that promote coronary heart and vascular disease… and the expensive pharmaceutical and mechanical approaches we’ve come to rely on as medical miracles and the treatments of choice.

Put another way, there’s money to be made both in promoting illness and in providing expensive, temporary solutions.

The same can be said of other debilitating, deadly, and expensive but familiar diseases like diabetes and cancer.  And the solution for these… well it happens to be the same.


What kind of diet?  The data are clear.

If we as a nation were to adopt a whole foods, plant based diet, many chronic diseases of middle and older age would largely disappear.  And the cost to our nation for healthcare would plummet.

So I say again, the solution is simple.  And not just in theory.  But unfortunately difficult to implement.

Because this solution, the only real solution, will require a massive change in our views about what constitutes healthy eating.  And the willingness to take responsibility for our own health.

And perhaps mostly because it will lead to the collapse or at least major restructuring of the food industry as we know it.

Not just soda and fast food – which could become extinct or at least marginalized – but the meat, egg and dairy industries might suffer a near collapse.  With great hardship from ensuing job losses.

The consequences for pharmaceutical companies and surgical equipment manufacturers would be catastrophic.  And the predicted physician shortage would dissolve.  Some, perhaps many medical practitioners would need to be retrained as the need for their services vanished.

Actually, I suspect that the economic repercussions would be even far more wide-ranging than are hinted at here.

But failing to adopt this simple, sensible strategy isn’t an option if we’re going to restore health to our citizens and our nation’s healthcare system.  Staying on the current path will promote more disease and expense.  Any further delays to implementing the fix will be that much more painful.

Perhaps inspiration can be found in our national history of courage and accomplishment from which I take hope.  If we can commit to making fundamental changes in something so essential as how we eat, surely we can find solutions to the short-term problems bound to follow.

So let’s saddle up.  It’s time to ride a new horse.

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