The biggest challenge for healthcare

American healthcare is the most expensive globally, but it’s not close to being the best. Our healthcare system has become like a mass-market retailer, in the door to treat the problem and out the door with an Rx or other treatment recommendation. What’s missing is the basic premise of any good care: the focus on the person, not just the condition.

I met my closest friend, Pete, in the third grade in Westchester County. We had a lot in common and stayed friends for half a century. After graduating high school, Pete went to work at the Post Office, walking the same route for more than twenty years in all kinds of weather. His route had one of the steepest hills in town, and eventually, his knees gave him problems forcing him to leave his job on disability.

As Pete’s movements became more restricted, he began to gain weight, leading to diabetes. His blood sugar was out of control, and eventually, he had nerve problems in both his hands. His doctors never warned him about the disease, and he would only give himself daily injections without checking his blood sugar.

When his mother passed away, he became a caretaker for his bedridden father, who became senile and often would tell Pete he wasn’t his son. Pete became more depressed after his dad passed away. He couldn’t play his guitars anymore because of the nerve damage to his hands. Eventually, he passed away from complications of a diabetic stroke at an age that was way too young.

There isn’t a day that goes by that I don’t think about him and his influence on my love of music. All Pete’s doctors did was treat his condition. They never asked about how he was doing or diagnosed his depression which was becoming more evident to all of us.

Pete used to joke “65 and out,” but he passed away long before that. New medications have us living longer, but society doesn’t know how to treat an aging population. Married couples, for example, who lose a spouse often will become depressed, which in turn leads to more health problems, including the challenges of getting older.

I’m an avid cyclist who rides 100+ miles a week because it helps clear my mind, and I love riding. Last month I rode to the beach with my friend Mike. We like to top the beach and look at the blue-green water and crowds. While we were there, two beautiful women stopped to talk to Mike about his bike and riding here in Naples. I could see that one of them was smitten with Mike, but after a few minutes, he just said, “there’s a bike store on the corner if you need more information.” I asked him why he didn’t offer to go riding with her, and his reply was, “Rich, I’m 68 years old. There is probably over a thirty-year difference between us, so what do we have in common? Guys in their late 60’s don’t go out with women half their age”.

That conversation set me back a little. As I got to know him more, he told me he was retired as a systems engineer and was forced out of his job. I wondered if his doctor ever took the time to talk to him about his mental health and asked him, “so, how are you doing besides the aches and pains?” I told him that maybe he needed to seek out some help to see the gift of life in a new light.

I’ve read the stories that 70 is the new 50 and how active Boomers are staying but what happens when they start losing friends, relatives, and spouses to old age? What happens when they get tired of dealing with the daily aches and pains of getting older? It wears you down and eventually, you stop caring and wonder if the next phase of life is better than living alone with medical and social isolated issues.

According to the CDC, “loneliness and social isolation in older adults are serious public health risks affecting a significant number of people in the United States and putting them at risk for dementia and other serious medical conditions.” Social isolation takes a heavy toll on those who suffer from it, both in health and overall well-being. An effort to quantify the cost of loneliness in the US also found that among Americans aged 65 or older, social isolation costs the US government nearly $7 billion in additional health care costs per year.

Loneliness and physical health

  • Loneliness increases the likelihood of mortality by 26% 
  • The effect of loneliness and isolation on mortality is comparable to the impact of well-known risk factors such as obesity and has a similar influence as cigarette smoking.
  • Loneliness is associated with an increased risk of developing coronary heart disease and stroke.
  • Loneliness increases the risk of high blood pressure.
  • Social isolation and loneliness are risk factors for the progression of frailty.

Loneliness is not thought of as a health issue, but it can lead to several physical health issues. How can physicians identify and treat patients who are in constant pain and socially alone?

Anyone can experience loneliness at any point in life. Still, it’s’ often triggered by significant life events – both positive (such as new parenthood or a new job) and negative (bereavement, separation, or health problems).

More than one-fifth of adults in both the United States and Britain said in a 2018 survey that they often or always feel lonely. More than half of American adults are unmarried, and researchers have found that even among those who are married, 30 percent of relationships are severely strained. A quarter of Ameri now live alone, and as the song says, one is the loneliest number.

Loneliness is terrible for our physical and mental heal h. Over six months, lonely people are more likely to experience higher rates of depression, social anxiety, and parano a. Being social and ous can also lead to more loneliness later.

Treat the person, not the health problem

So how can our broken healthcare system address this issue?

1ne: Treat the person, not just the health condition. HCPs should ask people about their social lives and ensure that they are not experiencing social isolation.

2wo: Employers need a guide to help them identify medical/social isolation risk factors, such as employees who seem to be working during off-hours.

3hree: Insurers need to treat their customers as individuals, not just a broad audience.

Our healthcare system doesn’t see the person: it considers the condition best treated with an. To me, that’s the biggest challenge in healthcare. We want healthcare for a person, not just another statistic.