Last year, Americans borrowed more than $88 billion to pay for health care. One in four Americans skipped medical appointments because of concern about cost. Medical debt is the number one cause of personal bankruptcy in the U.S. These statistics reflect a trend of increasing costs and declining health outcomes that has been plaguing America for decades.

Back in 1970, the U.S. spent $74.6 billion on health care, but by 2017 that figure had skyrocketed to more than $3.5 trillion. And yet, despite this explosion in health care spending, American life expectancies declined for the first time in 2015, and again in 2016.

Paying for health care has defined much of the political conversation over the past several years, but is our spending making us healthier?

Almost everyone alive has some concern about dying. Mostly, we are worried about the loud killers: Will we die from a catastrophic accident such as a car collision or plane crash, or perhaps as the result of some violent crime? Yet it is the silent killers that ultimately cause the vast majority of deaths in this country heart disease, cancer and stroke.

And then there are the other silent killers obesity linked to poor diet and lack of exercise, as well as habits such as substance abuse and cigarette smoking. Despite the trillions of dollars being spent on health care each year, these killers remain difficult to stop. Some of it has to do with awareness. Americans are not being educated by the health care system about these dangers in time for them to make preventative lifestyle choices that can extend their lifespans and the amount of time that they enjoy good health.

The monetary incentive for doctors and health care professionals to keep people well pales in comparison to that of treating sick people. After all, the cost of prevention is often a fraction of the price of the cure for a malady. But we have proven that, as a society, we could easily go bankrupt trying to cure diseases once theyve reached a critical stage. Our money and focus are far better spent on the activities we can control to keep illnesses from becoming so deadly in the first place.

It is difficult to have conversations about these issues when most of us receive our health care from either the government bureaucracy, which sees us as just a number, or a private health system that sees us as just another dollar. Real health care transcends economics and delves into the social and community realms. It is only when we have long-term relationships with our doctors and medical professionals that real progress begins to take place.

Consumers also need to start asking better questions. Rather than asking how we can cure what ails us, we need to ask how we can maintain our health. What steps can we take, in terms of our lifestyle and behaviors, that help keep us healthy so we dont end up relying on cutting-edge, expensive medical procedures and pharmaceuticals after one of the silent killers has struck?

Luckily, the answers are out there. Health comes from eating a good diet, exercising regularly, getting good sleep and maintaining good relationships and from avoiding harmful behaviors such as smoking and abusing drugs. Avoiding chronic stress is important, too. Prayer and contemplation can reduce stress and build emotional and spiritual wellbeing.

These answers are not hard to conceptualize, but these simple, effective habits may be difficult for many people to implement because of the stresses of modern life and cultural factors. We could learn a lot from other parts of the world where prevention may be the only option. In many countries, the lions share of health care spending is on primary care. This has proven to be a far more efficient and effective use of resources than a misplaced emphasis on emergency care.

While the silent killers may be responsible for many of the bad health outcomes Americans experience, it may be silence itself that ultimately kills us. Among men especially, there is a hesitancy to speak up about problems until they reach the point where we cannot help but scream. Many of us dont get regular screenings for common diseases as we age; we may assume that if we dont know about it, then it doesnt exist.

This plainly does not work. We need to become more vocal about what ails us, and begin to speak up and make ourselves heard before it is too late.

Armstrong Williams (@ARightSide) is the owner and manager of Howard Stirk Holdings I & II Broadcast Television Stations and the 2016 Multicultural Media Broadcast Owner of the Year. He is the author of Reawakening Virtues.

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Curing the silent killers: Speak up and ask the right questions | TheHill - The Hill