Healthcare in the US is expensive. There's little doubt in my mind that much of this cost is the result of corruption, born of our corporately dominated society, healthcare industry lobbying to congress (Medicare part D anyone?), pharmaceutical industry bribing of doctors, or a populace willing to look the other way because they want their health industry retirement investments to grow.
However, there is a much overlooked and often completely ignored aspect to our healthcare costs. We're not healthy, and because we're surrounded by people in the same condition, we don't seem to have noticed our long descent.
Moving to the midwest from Washington state was a real eye opener for me. It was, in effect, like time travel to an increasingly obese future. Check out the animated CDC chart at the bottom of this page showing obesity rates by state in the US since 1985. I remember standing in line at the grocery store one day shortly after we'd first arrived. I could see roughly 30 people around me, and it struck me that each and every one was obese!
There are numerous reasons for this problem. Midwesterners, as a rule, live in a somewhat harsher climate than those on the west coast where I formerly lived. As a result, outdoor exercise is a bit less appealing. Michigan is ground zero of the car culture, and much of the culture here seems to view walking as a cruel task to which no human should be subjected to. "Sports" are for spectators only, unless they involve a jetski or some other motorized form of transport. Most men here seem to aspire to the ownership of a Harley rather than to climb a mountain or do something which requires physical activity.
All exercise aside though there is a perhaps greater problem that is not limited to the midwest, and one which grows worse each year.
We eat crap. Crappy food leads to crappy health, both directly through actual consumption and perhaps more importantly by creating a crappy planet. Let's analyze the ubiquitous Subway sandwich (you know - the sandwich that made Jared skinny!) and see just how crappy our food is. (the analysis is of course representative of most food consumed in the US, not just Subway's product).
First of all, you're probably expecting me to talk about bleached flour, excessive salt, dangerous preservatives, high cholesterol, or empty calories. Those may all be true, but since you already know about them, we'll just take that as a given.
The sandwich has four primary components: buns, meat, cheese, and veggies. Each one is probably directly harmful for you to consume, but also harmful to you because you happen to be unfortunate enough to live on the planet where they're produced. The folks that produce them are effectively forced to do it the "wrong" way because they're part of a centralized corporate system where doing otherwise is a sure prescription for going bankrupt.
For all practical purposes, the bulk of the sandwich comes from four crops: corn, soy, wheat, and vegetables (tomatoes, lettuce, etc -- which I'm grouping together because they're similarly grown).
Each of these crops likely involve the use of glyphosate (Monsanto's "Roundup"). All of the crops likely received glyphosate to kill weeds before the crop was planted, with the corn and soy receiving it as the crop grew, being that they're genetically modified for herbicide resistance. The wheat can also be genetically modified, but is generally not. Much of the US's wheat is grown for export to countries that are smarter than we are, and won't accept genetically modified crops (like Japan, which recently rejected US wheat shipments found to be contaminated with gmo wheat). In fact, Monsanto recently petitioned the EPA to allow greater levels of glyphosate in our food, and was successful.
Glyphosate is designed to bond to chemicals required for the formation of an enzyme, which Monsanto famously touts as not existing in the human body. That's only *half* true. Our bodies don't directly need this enzyme, but the bacteria which are critical to our digestive and immune function DO require this enzyme, likely leading to many of the extreme allergies, autoimmune diseases, and nutritional deficiencies that result from damaged intestinal flora.
How important are your gut bacteria? Much more so than I was ever aware. Check out this recent eye opening article from Michael Pollan. Their presence and diversity are directly responsible not just for digestion and nutrition, but also comprises the bulk of our immune systems, such that damaging them damages us.
Moving along back to our crops, it's safe to assume that each of them were fertilized with synthetic fertilizers, which are manufactured from natural gas (much of which is now fracked), which we've decided is more important than our groundwater. The abundant nitrogen introduced in these fertilizers decays into nitrous oxide -- a potent greenhouse gas. The nitrogen (and phosphate) fertilizers which are applied to midwest farms are now the primary cause of the Gulf of Mexico "dead zone", which has grown significantly over the last few decades.
This hardly bears saying, but I should also point out that the crops were invariably grown with diesel fueled tractors (more CO2 to the atmosphere), tilling soils that were once very high in organic matter which, when exposed to the atmosphere through regular tillage, oxidizes into CO2. This destroy's the soils nutritional profile and drought tolerance, and is likely the single largest source of human caused CO2 emissions -- even exceeding our direct use of fossil fuels.
The wheat used in the buns is a new high-yielding dwarf variety, developed a few decades ago by Norman Borlaug during the "Green Revolution" (which has solved no problems that I'm aware of, but has created many). It now contains a brand new protein in part of the gluten chain (gliadin), which is believed to be a likely culprit in the widespread emergence of gluten intolerance. The same intolerance which sent me to the emergency room to the tune of several thousand dollars when my esophagus swelled from an allergic reaction. The flip side of this is that much of the intolerance is likely a result of glyphosate use as well -- which as I just noted is also responsible for the decline in intestinal flora. Antibiotic use also plays a likely role (as it likely did with my own gluten intolerance).
Let's move on to the corn and soy, which greatly dominate all farms here in the midwest. These manifest in the sandwich's meat, or milk (for the cheese), for which they provide the livestock feed. The corn was most likely also sprayed with Atrazine, a potent endocrine disruptor suspected of causing a number of different metabolic problems as well as breast and prostate cancer, and which is found in harmful levels in most midwest drinking water. Strangely enough, it's banned for use in the home country of the manufacturer (Germany) and most of europe for precisely this reason.
So the corn and soy are animal feed, and are almost invariably fed to hogs, chickens, and cattle in CAFOs (confined animal feeding operations). This is done because it's the cheapest way to raise livestock, at least so long as the diesel fuel keeps flowing. There are a few downsides, aside from the obvious cruelty of crowded and unnatural conditions. Concentrated populations of animals are highly susceptible to diseases, requiring the regular use of antibiotics, which leads to the antibiotic resistance that now regularly kills people in hospitals. A friend of ours has a daughter who was nearly killed by a MRSA infection -- from a superficial scratch on her cheek.
Finally, we come to the veggies. As a result of the requirement for near-perfect appearance, most vegetable crops in the US are subjected to heavy insecticide use, often being in the dangerous class of organo-phosphate pesticides. Living in a rural area where such pesticides are often used results in an 80% increase in chances of developing parkinson's disease. Workers in these fields (typically California or Florida) are regularly exposed to the pesticides, yielding horrible birth defects, as with the "Immokalee Three". They've also been shown to end up in the bodies of people eating them at brain damaging levels, such as one study of Mercer Island (that's Bill Gate's neighborhood near Seattle) children showed.
So how do we solve these problems? To sum it up, we need to de-industrialize our food system (and our entire society, but that's a topic for another day). Remove the centralization. Stop eating fast food (which as a matter of cost essentially *requires* the industrialized model). Buy your food from small producers who (unlike large industrial producers) look you in the eye when they sell you a product, and who are more likely to have a conscience. Buy meats and milk from animals that are pastured rather than fed chemically grown diets of grain. Yes, it'll seem expensive, if you can ignore the externalized costs of the current system.