Bill Bergquist (Bill B) asked Jeff if strong evidence of reduced costs coming from preventative health care practice can make a difference. Jeff notes that primary care physicians and others who are knowledgeable about preventive health care measures have tried to make this case for years—and have failed. There is no financial incentive in acts of prevention or in any strategy that improves health care outcomes. Over the years, there has been an ongoing struggle between those in public health (who are expected to be aligned with service) and those in the private sector (who are primarily interested in profit and take a more predictor approach in the formation of health policy).

Jeff notes that about $10,000 is spent per capita on health care in the USA versus about $2,000-4,000 per capita in many other companies. The primary reason for the higher costs in US health care is not waste and inefficiency. It is the push for profit.

Michael Applegate provides additional evidence of the decline in health care outcomes in the United States. He notes that life-span is going down. Fetal mortality is going in the wrong direction. USA health care is beginning to resemble that found in so-called “Third World” countries.

As a psychologist, Bill B asked if new evidence regarding this decline in the quality of USA health care produces greater dissonance. And if there is more dissonance, then is reform in health care more likely?

Perry Pugno responded by pointing back to Jeff’s observation that compelling evidence (which could create dissonance) has been presented for decades. We have tried to sell prevention for a long time—and have been unsuccessful. Perry suggests that young people in particular need to listen to the research evidence—for their quality of life and lifespan are being seriously impacted by contemporary health practices. However, most members of the younger generation today tend to focus on the present time and short-term benefits (including drug use). Preventative health care requires a longer-term perspective.

Bill B. commented that this lack of a long-term perspective may relate to the sense among many young people that the future doesn’t seem to be a very pleasant place in which to live. Many young adults have decided not to have children because they don’t want to bring children up in a world that is now so flawed and will probably be worse in the near future.

Jeff expands on his rather pessimistic outlook. There is not much incentive for change in American health care. Change theorists have suggested that we need a “burning platform” before we are motivated to make a major change. The platform of US health care is now actually burning, but we aren’t paying attention. There is strong political pressure to ignore the burning platform. COVID offers a perfect example of this politization of health care issues. Health care policies were becoming polarized. There was wide distribution of claims about cures that were not only false but often dangerous. Even dissonance and a burning COVID platform were not enough.

Bill B suggested that some significant steps were immediately taken by most people in the US to counter the COVID challenge – including getting inoculated and avoiding public interactions. These were often relatively small, incremental changes in their life—but these small steps were widely taken.