It’s hard to believe that more than 30 years have passed since dark-horse presidential candidate Ross Perot made the national debt a central issue of his campaign. At the time, the debt hovered around $3 trillion—a staggering sum by the standards of the day, to be sure, but hardly the existential threat it represents today.
Since then, nonstop federal spending has catapulted the national debt to more than 10 times that quaint figure. Our enormous debt has eroded the value of the dollar with out-of-control inflation. The debt has emboldened our adversaries to create competing reserve currencies. And it looms like a time bomb over the world’s financial systems.
And while overspending on the military or so-called pork barrel projects have contributed to this, the No. 1 reason our debt is so high is the crazy cost of American healthcare. Every year, Uncle Sam spends almost $2 trillion on healthcare – 27 percent of the federal budget!
You would think that if the richest country in human history were to spend this much on healthcare that we’d all be super-humans living to age 100. Alas this is not the case. For a country that outspends every other nation per person on medical care, Americans have shorter lifespans than nearly everyone else in the developed world.
We’re getting the worst healthcare money can buy.
Part of this is the nature of chronic disease. About three in four American adults live with at least one chronic disease, which accounts for about 90 percent of U.S. $5.3 trillion total medical costs.
The catchphrase is a bit of a cliché at this point, but it’s apt. We don’t have healthcare in the US, we have sick-care because it’s more profitable.
So then instead of spending ourselves into oblivion treating chronic disease, maybe we should spend (and live) smarter to prevent chronic disease. This is the fundamental philosophy of President Trump and Secretary Kennedy’s Make America Healthy Again (MAHA) movement. Built on the pillars of preventative care and better lifestyle choices, MAHA is trying to create a country that’s both healthier and fiscally solvent.
MAHA hasn’t reinvented any proverbial wheels. Its prevention tools are pretty obvious: checkups, exercise, better diet, routine screenings, and so on. Routine screenings are particularly valuable because then doctors can catch a problem like hypertension before it becomes a catastrophe like kidney failure.
Chronic kidney disease may be the clearest example of a disease positioned to benefit the most from MAHA’s focus on prevention, but it doesn’t get included in healthcare conversations like it should. It doesn’t have an entire cottage industry dedicated to it, like say, cancer.
But it’s a huge problem. More than one in seven American adults are living with chronic kidney disease and nearly nine in ten patients don’t know they’ve contracted it. Up to half of kidney disease cases remain undetected, despite the availability of simple urine and blood tests. If we can’t change course, the disease is projected to become the fifth-leading cause of death globally by 2040.
The U.S. Preventive Services Task Force has not issued a kidney disease screening recommendation since 2012. Fortunately, Secretary RFK is aiming to fix this.
If kidney disease is caught too late, a patient faces awful maintenance dialysis therapy or a gruesome kidney transplantation. Maybe someday we’ll live in a world of Star Trek biotech where a doctors can just hand out pills to regrow kidneys, but alas that day is not today. However, if we can up our detection and prevention game, we won’t need to regrow kidneys.
The fix for kidney disease is sitting right before policymakers. We need to reverse the Biden-era Medicare bundled payment decision made it harder for patients to access life-changing therapies. This pushed care downstream toward dialysis instead of upstream toward prevention. (Again: sick-care vs. healthcare.) Reversing this misguided policy would incentivize breakthrough treatments that slow disease progression, rather than drain patients’ quality of life while heaping ever more billions on the national debt.
A system that rewards sick-care has never been sustainable – the MAHA paradigm shift is long overdue. In the short term, success is measured by finally changing the incentive structure of our healthcare system. In the long term, it’s a healthier, wealthier country.
Jared Whitley has worked in the US Senate and White House. He has an MBA from Hult business school in Dubai. Recently the Top of the Rockies competition named him the best columnist in the Intermountain West.
