Mark Fox and Waldo Mikels-Carrasco spoke about the issue of health care in the context of American politics and policy at the second installment of “Pizza, Pop and Politics,” a platform for political engagement sponsored by NDVotes’16, on Tuesday in Geddes Hall.
Fox, dean of Indiana University-South Bend School of Medicine, said the rhetoric surrounding health care throughout the presidential race raises two key points about health care in America.
“It poses some fundamental questions that I think all of us really ought to engage about,” Fox said. “How do we view health care in the context of the community, and what are our obligations to ourselves and our fellow community members? And then, at a different level, what’s the role of government in helping us meet those goals?”
Fox said one problem facing Americans are the risks that come with not having health insurance.
“Basically, you have between one and a half times and two and a half times the risk of being diagnosed late with … various types of cancers if you’re uninsured,” he said. “Uninsurance rates matter. They affect health access, they affect outcomes, they affect longevity.”
Fox said the main reason for lack of insurance and problems with health care is many people can’t afford health care rates.
“Politics aside, I think there are some things that we need to be honest about [concerning] American health and health care,” he said. “First is, it’s expensive. We have the most expensive health care without the results to justify it. The poor in the United States have very poor outcomes.”
The results of the health care system do not justify the amount of money spent on it, because only about 10 percent of premature deaths in the United States are caused by a lack of health care, Fox said.
“If our fundamental question as a society is how do we improve health … health care plays a very small role in that. And yet, we spend all this money on health care and perhaps much less on all these other problems,” he said. “We’re the most disproportionate with respect to what we spend on health care versus social services, compared to other industrial countries.”
Mikels-Carrasco, director of community and population health development for the Michiana Health Information Network, said because the level of frustration with health care is so high, candidates should be focusing on the “triple aim” of health care.
“The market-driven health care system that we have in the United States doesn’t work really well,” Mikels-Carrasco said. “The triple aim is improve quality of care, reduce the cost of care and improve patient satisfaction. That third one has never really been part of the equation, but as voters go to the polls, they should be supporting things that are improving what we think we should be getting out of our health care experience.”
Some of the responsibility for improving the health care system lies with voters, Mikels-Carrasco said.
“If you’re going to vote for a candidate, make sure that their party has some kind of platform that accounts for health,” he said. “There [are] problems with [the Affordable Care Act]. It could use a lot of reworking, but saying we’re just going to get rid of it and we’re not going to replace it with anything, that’s problematic.”
Mikels-Carrasco said because poor health in childhood leads to an increased possibility of problems later in life, he believes the focus should turn toward ensuring childhood health improves.
“I think the point is that we have to look at … head-start programs that provide education for parents and children and teaches them how to be well-resourced individuals, because if they’re better, they’ll be healthier,” he said. “Research has shown that they’ll have better educational outcomes, healthy children, and they’ll be better citizens in life. They’ll have better outcomes at lower cost to society in general, in a health care system that we can all manage, that we can all participate in and that we can all afford.”
