Coverage Does Not Insure Good Health

If you are counting on politicians to take care of you, think again. Universal health coverage is not a panacea, nor is good health one of those inalienable human rights. It is a choice that each of us must make, as the American Heart Association again reminds us with a just-released collection of studies on hypertension.

73 million Americans have high blood pressure. That is nearly one in four, and the problem is getting worse, particularly among women. After age 60, hypertension is more prevalent in women than in men. Only 60% of hypertensive women are getting treated, and of those only one in three have their blood pressure under control (<140/80). So what is the big deal, you ask? The big deal is that hypertension is a serious risk factor for heart disease and stroke.

Cardiovascular disease is the leading cause of death among women in the U.S., yet most women don't realize that. Only one in eight view it as a personal health issue. Before asking for HillaryCare, they should face the facts and take personal responsibility for their health through proper diet and exercise. And that goes for you too, gentlemen.

One of the AHA's studies focused on adults in Jackson, Mississippi--specifically on the prevalence, awareness, treatment, and control of hypertension in a largely African-American population. It was found that lack of health insurance was only marginally associated with poorer control, whereas use of preventive care was positively associated with prevalence, awareness, and treatment, particularly among men. Got that? Prevention trumps coverage. The same study found that comorbidities (diabetes, chronic kidney disease, and cardiovascular disease) correlated with hypertension prevalence. The common risk factor appeared to be obesity.

Given the fragmented delivery system now in place in the U.S. (not to mention the high-risk population), a national healthcare plan is likely to be more expensive than we could possibly afford. A national plan should emphasize the availability and continuity of primary care promoting awareness and prevention. Those who feel entitled to cost-sharing should also be willing to share in managing the risk through their own personal behavior.