As the cynical optimist, I see obesity as the next frontier.
For months, congressmen have explained that through “health behaviors,” we can make healthcare reform cost neutral.
The Lewin Group report suggests that between $264 and $552 billion can be saved through behavioral modification of us, the users of healthcare. The report identifies 3 unhealthy behaviors: tobacco (35%), alcohol (26%), obesity (39%). Reducing the related health problems would unquestioningly be a blessing to millions of people and would reduce health costs, by as much as $1800 per man, woman, and child in the US per year.
The first catch is obvious, we cannot get rid of tobacco, alcohol, and obesity. The savings of some 17% of health expenditures, could only be realized if tomorrow it all stopped. How? And if tobacco and alcohol use ended tomorrow, and all obese people shed 25-200 pounds over night, the 17% reduction in national health costs would not be realized in the short term.
I have read articles mainstream that for the greater good, we could use our police and military. If Bush had troubles with phone calls . . . .
The second problem has to do with an unfair burden. I know several people who have adult onset diabetes. They went on the Atkins diet and within days no longer needed insulin. Anecdotal, yes, but this could be the story of the year in terms of health care cost reduction. But the Atkins diet is expensive. It requires access to good grocery stores, and time to plan and cook.
A frequent complaint about most inner cities, and about social, economic, and educational disparities between the poor and everyone else, is lack of money, lack of access to grocery stores . . . the lack of everything that would encourage or permit such a change of diet. A recent study reported on NPR, found that given $5 for food, the average poor person would buy a MacDonald’s hamburger and fries, than broccoli and lettuce. No surprise. Which is more filling?
And yet congressmen have unashamedly spoken on camera about how we should not pay for the health problems of people who knowingly abuse themselves by smoking, drinking, and over eating. Many of the people most at risk of preventable health problems are the least able to prevent them. Such comments are insensitive, insulting, and display the arrogance and ignorance within the Washington beltway.
The problem with “The first area, ‘unhealthy behavior’ is the largest in magnitude and is the subject of a large body of peer-reviewed research” (“Can We Reduce Health Care Spending?”)is that while it is true, as an argument for health care reform, it is irrelevant today and will be irrelevant tomorrow. (Lots of things are true but irrelevant in this way—the sun will someday burnout; the earth will be struck by a massive asteroid; since the dawn of life, climate has changed with or without man’s help.) It is an admirable goal; it is why we post warnings; it explains the often unexplainable nutritional information of packages of food; it is part of what should be taught in schools.
Without understanding just how specious such arguments are: how seductive but false, we’ll reform health care to the benefit of few, including organized crime, and the detriment of the many.
See “Prohibition: A Cautionary Tale,” WSJ, 01.04.10, http://tinyurl.com/ybwzcd3
Lewin Group: “Can We Reduce Health Care Spending?” (10.26.09)
http://www.lewin.com/content/publications/LewinReport-CostDrivers.pdf
For months, congressmen have explained that through “health behaviors,” we can make healthcare reform cost neutral.
The Lewin Group report suggests that between $264 and $552 billion can be saved through behavioral modification of us, the users of healthcare. The report identifies 3 unhealthy behaviors: tobacco (35%), alcohol (26%), obesity (39%). Reducing the related health problems would unquestioningly be a blessing to millions of people and would reduce health costs, by as much as $1800 per man, woman, and child in the US per year.
The first catch is obvious, we cannot get rid of tobacco, alcohol, and obesity. The savings of some 17% of health expenditures, could only be realized if tomorrow it all stopped. How? And if tobacco and alcohol use ended tomorrow, and all obese people shed 25-200 pounds over night, the 17% reduction in national health costs would not be realized in the short term.
I have read articles mainstream that for the greater good, we could use our police and military. If Bush had troubles with phone calls . . . .
The second problem has to do with an unfair burden. I know several people who have adult onset diabetes. They went on the Atkins diet and within days no longer needed insulin. Anecdotal, yes, but this could be the story of the year in terms of health care cost reduction. But the Atkins diet is expensive. It requires access to good grocery stores, and time to plan and cook.
A frequent complaint about most inner cities, and about social, economic, and educational disparities between the poor and everyone else, is lack of money, lack of access to grocery stores . . . the lack of everything that would encourage or permit such a change of diet. A recent study reported on NPR, found that given $5 for food, the average poor person would buy a MacDonald’s hamburger and fries, than broccoli and lettuce. No surprise. Which is more filling?
And yet congressmen have unashamedly spoken on camera about how we should not pay for the health problems of people who knowingly abuse themselves by smoking, drinking, and over eating. Many of the people most at risk of preventable health problems are the least able to prevent them. Such comments are insensitive, insulting, and display the arrogance and ignorance within the Washington beltway.
The problem with “The first area, ‘unhealthy behavior’ is the largest in magnitude and is the subject of a large body of peer-reviewed research” (“Can We Reduce Health Care Spending?”)is that while it is true, as an argument for health care reform, it is irrelevant today and will be irrelevant tomorrow. (Lots of things are true but irrelevant in this way—the sun will someday burnout; the earth will be struck by a massive asteroid; since the dawn of life, climate has changed with or without man’s help.) It is an admirable goal; it is why we post warnings; it explains the often unexplainable nutritional information of packages of food; it is part of what should be taught in schools.
Without understanding just how specious such arguments are: how seductive but false, we’ll reform health care to the benefit of few, including organized crime, and the detriment of the many.
See “Prohibition: A Cautionary Tale,” WSJ, 01.04.10, http://tinyurl.com/ybwzcd3
Lewin Group: “Can We Reduce Health Care Spending?” (10.26.09)
http://www.lewin.com/content/publications/LewinReport-CostDrivers.pdf
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