Repealing Obamacare

Congress is taking steps to undo the Affordable Care Act (ACA or “Obamacare”). It’s not clear they have something in mind to replace it beyond shifting responsibility for healthcare from the federal government back onto the individual states. (Full disclosure: I support national healthcare, but I’m no fan of Obamacare. I was fully insured when I went through cancer in 2014 and it still wiped me out.) So healthcare in America will remain prohibitively expensive regardless of what happens over the next four years.

What can you and I do to get by? Here are a few suggestions:

1. Lose weight. Most of us are too fat. We know that. But we don’t fully appreciate that being overweight predisposes us to the two most expensive medical conditions, diabetes and heart disease. It plays a major role in the third, which is low back pain. Diabetes, ischemic heart disease, and back and neck pain are the top three conditions accounting for the highest spending on personal health care in the United States, according to a report published online Dec. 27 in JAMA.

2. Avoid doctors and medication. Medical mistakes and adverse drug events even when no mistakes are made are responsible for almost as many deaths as cancer, making death by doctor the third largest cause of mortality in the US. If you truly need the drug, try to buy generic. If you can, get it abroad from Europe or Canada where the same drugs are vastly cheaper.

3. Take prevention seriously. Get your age-appropriate screenings for the diseases most likely to kill you at your age. We all know people who died because the disease was discovered too late. Don’t be one of them.

4. Make fitness your hobby. Getting some exercise isn’t that hard and doing a little is better than nothing. People who get a little light exercise on weekends do better than those who don’t. People who get light exercise almost every day do even better. And people who do vigorous exercise do better than those who exercise only lightly. Joining a group that does something for fitness – like a yoga class, for example – also opens the door to a more robust social life, which is also an important factor in living long and well.

5. Eat better. Diet is what you eat, not what you don’t. Plan your food to be plant-based and from whole foods. Replace anything white and refined like rice and mashed potatoes with something better like barley and yams. Keep healthy snacks like fruit and nuts in reach while keeping the cookies and potato chips out of sight.

6. Enjoy what you have here and now. All we really have is the present. The past is just a memory of a by-gone present and the future is a present planned. Find something to be grateful for every day, something that gives you or others joy. Make a habit of asking yourself, “Am I doing right now what I want to be doing?”