How the Green New Deal Would Save Us Billions in Health Care Costs
As the Medicare-for-all proposal moves into mainstream conversation, one question comes up again and again: how will we pay for it? What gets lost in the shuffle of short-term cost analysis is the opportunity this proposal presents for society to improve our health, our quality of life and save money in the long term. This is even more true in the context of the Green New Deal.
The Green New Deal isn’t quite in the mainstream conversation yet, but with most democratic presidential nominees supporting it, it soon will be. In this article, I want to focus on the opportunity the Green New Deal presents us to drastically lower our health care costs. For a full breakdown of that set of policies, I’d encourage you to read this article.
When we compare the costs of different health care systems (private, single-payer, or any other), the defining number isn’t the cost of treating the individual person, it’s the total money spent by the country on all of its sick people. While there is room to lower the individual cost of health care, what we could save by decreasing disease is far greater. The amount that our country spends on health care is the individual cost multiplied by disease prevalence. It continues to amaze me how little conversation I see around lowering disease prevalence, as it relates to Medicare For All and the Green New Deal.
The debate around Medicare-for-all focuses on the cost of individual care. While most experts agree that a nationalized health care system would reduce those costs, the focus on the cost of individual care ignores the other half of the equation. The best way to lower health care costs is to keep people healthy and out of the hospital.
When assessing how to lower disease prevalence, you identify the factors that contribute to disease. If you can lower any of these factors, you will lower disease. What’s exciting about the Green New Deal, from a public health perspective, is how many disease factors would be lowered at once. These policies encourage healthier lifestyles, lower stress, and lower environmental toxins. That sounds simple enough, but those are the main adjustable factors leading to chronic disease.
Encouraging Healthier Lifestyles
Medicare For All would allow our medical system to focus on disease prevention in a way that it never has before. It’s estimated that 95% of cancer can be avoided by lifestyle as well as 80% of heart disease and 90% of diabetes. These chronic diseases are the ones that are causing the most deaths and costing the most money. Our current privatized system doesn’t provide tangible ways to reduce chronic disease, other than printed handouts and webpages with tips on staying healthy. The reason? Chronic disease is best prevented through lifestyle and health care providers aren’t trained or paid to help with lifestyle.
The cost of creating programs and providing hands-on education around lifestyle changes are only profitable to an insurance provider if the person being educated will remain insured through that provider for years to come. In our current system, insurance companies don’t know when when a customer will change insurance carriers. From their perspective, paying for preventative measures will be money wasted if that customer leaves.
In a single-payer system, customers are there for the long haul, which allows the system to make long-term investments and recoup those costs. In this system, preventative medicine isn’t just possible, it’s a good investment. This saves society money while improving quality of life.
Medicare is extremely popular, but it is only providing a fraction of what it could. As it was designed for the elderly, there is understandably little in the way of preventative care based around lifestyle. If the population that Medicare serves shifts to different ages, it would become cost effective to provide lifestyle-based preventative techniques to younger people. Things like gym memberships and cooking or meditation courses are much cheaper than treating diabetes. This is exactly the type of change that stands to save us enormous sums of money while improving lives.
Many of the best ways to lower disease prevalence lie outside the health care system itself. These preventative measures require some level of government intervention (subsidizing healthy foods, taxing unhealthy foods, disallowing soft drinks and fast food from schools, restricting corporate campaign contributions, encouraging clean farming practices, etc.). Nationalizing the health care system would allow these programs to be developed strategically in a way that isn’t possible in our current system.
A Cleaner Environment
The Green New Deal’s main function is to combat global climate change, which will lead to most of the debate being around the existence/threat of global climate change. What will likely get lost in the shuffle is that money spent on a cleaner environment will be money not spent treating diseases that come from a dirty environment. Clean air, clean water and clean food would lower our health care costs enormously. While we can debate how much, that premise is unarguable. These benefits remain whether climate change is a threat or not.
If we accept that climate change is real, siding with 97% of scientists, the threat of disease skyrockets with rising temperatures. Rising temperatures allow bacteria, viruses and disease carriers like mosquitos and rats to move into new environments, where the people have not developed immunity. Malaria and dengue fever haven’t made it onto mainland U.S., but they’re getting closer. These are just a couple of examples of which we know. It’s a safe assumption that many new, dangerous diseases would hit the U.S. in a shifted climate. The cost of these diseases would only further push a health care system that’s already near breaking.
Reducing Stress
An investment in stress reduction stands to save society enormously in the long run, while improving lives. It’s hard to put a price tag on the effects of stress on our population. It is a contributing factor to almost every disease, but most Americans don’t even understand what it is, let alone how to lower it. This is something I’ve seen firsthand in nearly 20 years of working with people and stress.
The hands-on education opportunities I touched on earlier could be used to teach people how to actively lower stress in a real and tangible way. Meditation has been shown in test after test to help people with stress and improve health. It also helps kids. A system designed around quarterly profits has no incentive to provide effective stress relief programs. A system designed around long-term results could easily do so.
A more powerful health effect of the Green New Deal involves income inequality. This ties directly into stress. The opioid epidemic has hit areas with high unemployment and poverty far harder than it has affluent areas. The Federal Jobs Guarantee program (properly implemented) would likely help the opioid epidemic more than treatment ever could, because it addresses the core issue. Opioids are only one example of health conditions that come from income inequality.
Along with the simple truth that poor people can’t access the system properly, there is a more complex truth: many of our diseases are born of hopelessness, which grows with the sense that there is no way to escape poverty. As with the other pieces of the Green New Deal, debate will center around costs, without acknowledging that the benefits (in money and quality of life) from these programs extend into other areas.
Wrapping up
Under all these ripple effects is a simple truth: the best way to lower health care costs is to keep people healthy and out of the hospital. Our current health care system fails at this. Our economic and environmental systems make it worse. The money that we stand to save in health care costs needs to be acknowledged and brought into public consciousness as this debate moves forward. The Green New Deal provides a once-in-a-lifetime opportunity to repair our environment, save money and improve quality of life across the nation.
