Overton: Fund social science to boost health

BY JON OVERTON | APRIL 25, 2014 5:00 AM

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Love it or hate it, the Affordable Care Act changed parts of our health-care system that were really stupid. It seems backward, arguably barbaric, that health-insurance companies could deny coverage because of pre-existing conditions.

Even with the fixes that have been made, this country still approaches health care in a way that makes zero sense.

The University of Iowa Public Policy Center hosted a public forum on Tuesday night called “What if … everyone had health insurance?”

It would probably improve health outcomes a little. Seeing as we spend about $3 trillion on health care every year and compared with much of the developed world, still suffer from high rates of infant mortality, obesity, homicide, teen pregnancy, disability and a cavalcade of other health problems, surely, insuring more people would help, but it would only do so much.

One-third of America’s colossal health-care bill is utterly wasted, said Peter Damiano, the director of the UI Public Policy Center. Excessive tests, mountains of arcane bureaucratic paperwork, fraud, and other financial parasites are sucking loads of cash from our wallets.

If self-proclaimed fiscal conservatives really are the tightwads they claim to be, boy oh boy, does the health-care industry have a project for them.

There’s no half-baked pipedream of social engineering here. Just find ways to encourage health-care companies to cut unhelpful expenses. It would help curb exploding costs and free up money in everyone’s budgets.

But if we actually want a healthier country, which would cut health-care costs even more, we have to look beyond just health insurance.

Elizabeth Momany, assistant director of the Public Policy Center’s Health Policy Research Program, cited a study that showed only 10 percent of what influences health outcomes is access to that health care. Behavior affected 40 percent, 30 percent is attributed to genetics, 15 percent is determined by the social environment, and 5 percent includes the physical environment.

Yeah, behavior. Forty percent. That’s a lot. It’d be really nice to know a thing or two about human behavior before crafting policy to encourage healthy habits. Unfortunately, the National Science Foundation directs just $267 million to fund social, behavioral, and economic sciences. That’s not quite 4 percent of the agency’s entire budget of $7.5 billion.

Any government that wants to develop smart public policy should invest in the social sciences. It’s especially concerning that House Republicans keep trying to cut funding to the National Science Foundation  when its role has never been more vital. One of the biggest threats to this country’s future financial security is the mounting cost associated with Medicare. If policymakers don’t understand human behavior when they inevitably have to fiddle with this program, they may very well launch an entire generation of elderly people into poverty.

Encouraging healthy behavior is not some deranged left-wing plot to destroy freedom. In many ways, it actually boosts freedom. There’s very poor access to healthy fruits and vegetables across inner city neighborhoods and even in rural Iowa. Couple that with a crummy income, and it seems ridiculous to drive 20 miles to the nearest real grocery store to buy expensive, non-filling health food. Shouldn’t everyone have the option to eat food that won’t slowly kill them with artery-clogging grease?

Make no mistake, we’ll be talking about changing health care for decades to come. The Affordable Care Act was just the beginning.

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