When Sweat Isn’t Enough
Cardio is good for your heart — but it won’t save you from a broken system. In the United States, fitness is too often seen as a badge of honor, a symbol of individual discipline and moral virtue. Jogging before sunrise, posting your VO2 max on Instagram, tracking every step and calorie. But underneath this curated health consciousness lies a darker truth: preventive fitness, in America, is a luxury. And luxuries are not scalable public health solutions.
Privilege in Running Shoes
In Canada and France (mostly allover Europe! ) , access to basic healthcare isn’t some employee benefit or corporate perk — it’s a civic right. It’s baked into the system. You don’t need a six-figure job title or a PPO plan just to get your blood pressure checked. In the U.S., meanwhile, the emergency room has become the nation’s primary care provider — not because people are dying, but because they have nowhere else to go.
That’s not healthcare. That’s policy failure dressed as free-market freedom. And here’s where it gets grotesquely ironic: The same folks who praise capitalism and conservative Christianity as the twin pillars of American greatness suddenly discover the joys of collectivism the moment life hits back.
A wildfire breaks out in MAGA country — suddenly it’s “Where’s FEMA?”
Even though their governor struts around like a cattle-fundrasing cowgirl at a campaign rodeo, slashing public services like she’s gutting a deer — and speaking of gutting: she literally shot her own dog, Cricket, because it didn’t behave on a pheasant hunt.
But when the flames come, they scream for federal help faster than you can say “socialism for me, bootstraps for thee.”
Get cancer without insurance? Time to fire up a GoFundMe and pray for “generous strangers.” But mention universal healthcare in a debate? That’s communism. Until the hospital invoice lands. Then socialism becomes not only tolerable, but GoFundMe becomes the new Medicare — just with worse UX and a lower survival rate.
The Illusion of Control
Fitness culture in the U.S. often operates as a comforting illusion — that you can outwork the system, outlift poverty, outrun the food deserts. But the truth is brutal: your fitness tracker won’t help you if you’re uninsured. Your macros won’t save you if your neighborhood lacks clean water, stable housing, or basic health services. Cardio might build resilience, but it can’t substitute for a functioning public health framework.
And it’s about to get worse: by 2026, an estimated 16 million Americans are projected to lose access to Medicare and Medicaid. Welcome to the Third World — and that’s not even counting the rural districts.
Some U.S. rural communities — the kind romanticized in Hillbilly Elegy as rugged and morally upright — are now living in conditions that would make postwar Germany seem like a socialist wellness retreat. And while J.D. Vance writes about bootstraps, backbones, and broken families, he somehow skips the part where insulin costs $300 and FEMA forgets your county exists unless there's a viral wildfire. Self-reliance makes a great memoir, but a terrible healthcare strategy.
Gyms vs. Community Health
Consider the contrast: luxury gyms filled with LED mirrors and biometric scanners versus underfunded community health centers that offer mental health support, diabetes education, and domestic violence intervention. The former sells optimization; the latter saves lives. And yet it’s the glittering gym that dominates public discourse, while the clinic in a trailer park remains invisible. It’s not a coincidence — it’s a reflection of where we place value.
Meanwhile, politicians like Senator Joni Ernst warn that “we’re all going to die” if the national debt rises — yet show no such urgency about rising maternal mortality in rural Iowa, insulin rationing in Tennessee, or the mental health crisis unfolding in America’s forgotten ZIP codes. Fiscal cliffs are terrifying. Broken communities? Apparently less so.
Global Health Infrastructure Compared
To understand the full picture, look abroad. In Canada, community health centers are integrated into the urban fabric. They offer walk-in access, multilingual staff, and a preventive philosophy. In France (and mostly allover in Europe) , general practitioners act as long-term partners — not just diagnostic technicians. They know their patients. They follow up. In the U.S., the average doctor visit lasts 13 minutes. Then it’s on to the next chart, the next code, the next denial from insurance. This is not a healthcare system — it’s a billing system with stethoscopes.
| Country | Primary Care Access | ER Visits per Capita | Fitness Club Penetration |
|---|---|---|---|
| USA | Fragmented, expensive | 0.44 | 21% |
| Canada | Universal, local clinics | 0.29 | 16% |
| France | Universal, GP-based | 0.25 | 14% |
Health by Design, Not Default
America doesn’t just have a healthcare problem — it has an infrastructure problem. Cities are built around cars, not feet. Safe sidewalks are rare. Green spaces are limited. And if you think you can compensate for that with a Peloton and a greens powder, you’re missing the point. Fitness as a private solution to a public crisis is a flawed strategy. It's the equivalent of handing out umbrellas during a hurricane and calling it policy.
Policy, Not Willpower
We often hear that people just need to take responsibility for their health. But responsibility requires access. Willpower doesn't build clinics. Determination doesn't reduce insulin prices. And self-discipline won’t create clean air or safe housing. Real prevention isn’t tracked in reps or steps — it’s legislated. It’s funded. It’s distributed with equity in mind. That’s why preventive fitness needs more than motivation. It needs a mandate.
The Economics of Neglect
Here’s the cruel irony: preventive care is cheaper than emergency care. Yet the U.S. spends disproportionately on the latter. Hospitals are flooded. Ambulance wait times stretch. Meanwhile, community health initiatives — walk-in blood pressure clinics, mobile dental units, addiction support groups — scrape by on grants and charity. These programs deliver ROI, not just in dollars saved, but in lives stabilized. But they rarely get headlines. Treadmills do.
Table: Where Lives Are Saved
| Setting | Preventive Value | Cost per Person (Est.) |
|---|---|---|
| Luxury Gym | Low (individualized) | $1,200/year |
| Community Health Center | High (population-based) | $400/year |
What Real Prevention Looks Like
It’s messy. It’s local. It’s often boring. It doesn’t come with six-packs or smoothie discounts. Real prevention looks like housing-first programs, school nurses, safe parks, clean water, affordable mental health care, free contraception, and food security. It looks like trust between a patient and a provider. It looks like showing up before the crisis, not after.
No More Excuses! No more get over it!
No more excuses. No more “get over it.” The next time someone tells you that cardio is the key to better health, ask them where the nearest clinic is. Ask if the local school has a nurse. Ask if fresh produce is sold within walking distance. Ask if uninsured patients are turned away.
Because if the answer to those questions is no, then cardio won’t save you. What will save you is a society that chooses prevention over performance, equity over ego, and systems over slogans. Or as Senator Mitch McConnell once put it when discussing Medicaid cuts: “I know a lot of us are hearing from people back home about Medicaid. But they’ll get over it.” That’s not health policy. That’s abdication.
Sources
1. Woolf SH, Masters RK, Aron LY. “Effect of the COVID-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data.” BMJ. 2021;373:n1343.
2. Washington Post. “Life expectancy in U.S. is falling amid surges in chronic illness.” By Akilah Johnson and Dan Keating. August 30, 2023.
3. National Center for Health Statistics. “Health, United States, 2022 Annual Perspective.” U.S. Department of Health and Human Services, 2023.
4. Kaiser Family Foundation (KFF). “Status of State Medicaid Expansion Decisions.” Updated August 2025.
5. Centers for Disease Control and Prevention (CDC). “Chronic Diseases in America.” Last reviewed 2024.
6. OECD Health Statistics. “Health at a Glance 2023: OECD Indicators.” Paris: OECD Publishing, 2023.
7. Vance JD. “Hillbilly Elegy: A Memoir of a Family and Culture in Crisis.” Harper, 2016.
8. Congressional Record. Statement by Sen. Mitch McConnell regarding Medicaid reform. July 13, 2017.
9. U.S. Department of Agriculture (USDA). “Food Access Research Atlas.” Updated 2024.
10. World Health Organization. “Social Determinants of Health.” WHO Fact Sheet No. 318. Updated 2024.
