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Letter: Our Major Economic Problem

To the Editor:

As an economist, I am interested, though not surprised, that none of the candidates for public office directed attention to what is fundamentally the major economic problem facing our country today: the ever-rising cost of health care. This, more than any other factor, is driving the long-term deficit and debt crisis. It has a major impact on the demise of the middle class, and the cost and accessibility of health care get at the heart of what kind of a society we are.

While solutions can be highly partisan, examining the causes is not. I recently underwent bilateral knee replacements. The care I received from an Upper Valley hospital, an area rehab center and the visiting nurses has been A-plus.

What has jumped out at me, however, is how much more costly this procedure is for those who are overweight and not in decent physical shape. One does not have to be a triathlete to successfully undergo this or similar kinds of surgery. However, while I spent three days at rehab (after three days in the hospital), it was clear to me that there are many who will spend 10, 15, 20 or more days at rehab simply because they are in poor physical condition and/or overweight. And such extended rehab does not come for free. All of this has been a reminder to me that not only is obesity and lack of physical fitness a cause of numerous illnesses and injuries, but they greatly increase the cost of being treated for most any illness.

There is been much criticism of New York Mayor Bloomberg’s position and mandate on the sale of giant-sized sodas, and I would be the first to defend the right of individuals to eat and drink what they desire. But it is also clear that these individual decisions have a direct impact on the larger community through higher health care costs; economists call these effects “negative externalities.” It is not unlike driving drunk through a congested neighborhood. Unfortunately, this is a conversation we are, so far, unwilling to have in the public arena and unable to conduct in a civil tone.

Jim Wilson