Providing health care for all is a complicated situation. An area that needs much more discussion and advocacy is how well people take care of themselves. An old housemate of mine, Jeremiah Sable, is a primary care physician in another state. He entered the field enthusiastic to bring good health care to poor people. And he grew skeptical over time. He told me, "Even though they are told by their doctor how to become healthier many people do not change their ways and grow unhealthier."
The obesity crisis is an example of this. A 57 year old man, I heeded the words of my doctor at the Neighborhood Family Practice and finally cut out all fast food. My weight dropped over 10 pounds in three months. I may be in the minority. I could do this because I’m able to purchase healthy food. People with out the means to buy healthy food, and who live far from sources of wholesome food, often wind up buying processed foods from convenient food shops near their homes.
Even so, many people who do have the money and access to good food apparently don’t choose it. I work on the front line of retail in a local copy shop near several grocery stores that offer good food. At my counter I view unrelenting girth by a sizable portion of the customers. Sometimes it feels like I'm in a John Waters movie complete with an obese and dysfunctional cast. Obese Divines and other bulging people parade in on a daily basis. While some people have conditions that make them portly, for many this happened by choice.
I wish the proposal for the “Public Option” included the following sentiment: “And so my fellow Americans: Ask not what your country can do for you—ask what you can do for your country,” said President John F. Kennedy in his 1961 inaugural address. This would be altered to state: “Ask not what your country can do for your health care—ask what you can do to make your health better, help you feel better, and reverse the country’s sky rocketing health care costs.”
Providing a somewhat complicated product to the public, copies and photo reproductions, has made me privy to how much people pay attention to what they are about. A lady recently asked “why don’t you provide written instructions to doing these complicated tasks,” in self service copying. I knew the answer. “Mam, people don’t read.” I know this because people ask me where the color copier is while looking directly at a machine posted with big letters, “Color Copier.”
Often the expectation is that the staff will provide all that they consume. So, it is not unusual that someone brings in a mess of a copy job and state, “I can’t figure this out. Please do this for me.” Rather than thinking, many choose to consume. Apply this to health care, and see one reason why we have sky rocketing health care costs.
Just think of the huge savings in national health care spending that would occur if a majority of people changed their ways and ate healthy food. Of course large segments of the food industry would fight such a change. With the forces of habit and commerce against it, changing people’s eating habits can’t be done? With unrelenting pressure from the federal government, health care providers, advocacy groups, and numerous court cases, look at what has happened to tobacco consumption in this country since the 1960s. It took forty years. Now smokers are so much in the minority that governments feel free to tax them at higher and higher rates.
To get a handle on our behavior read Dan Ariely in his book Predictably Irrational. It provides numerous examples of how economic decisions made by individuals are often not rational. Behavioral economics must be addressed in any health care debate.
Unfortunately at this time, messing around with the issue of people taking lousy care of them selves is probably a distraction from the politics that are now playing out. President Obama’s Public Option is meant to address many health conditions that people have that diet will not control. Our elevating health care costs are also determined by CEO pirates leading private health insurance companies. Watch the brute force of advertising produced by the health insurers on your TV in the next month. This is paid for by people who have health insurance.
Fortunately TV provides another view of the situation. On July 10th Bill Moyers interviewed Wendell Potter, formerly of the health insurance industry. Potter told of visiting a health care event not unlike one held in Cleveland recently. What he saw was starker. It was held at a rural fair grounds with the patients being examined in animal stalls. People came from miles around for the care. After more review of the health insurance industry he remembered Dante’s quote: “The hottest places in hell are reserved for those who in times of great moral crises maintain their neutrality,” and quit his high paid job to become a health care activist working against his former employer. Mr. Potter said that the Michael Moore film Sicko is accurate and on target. He went on to describe how the health insurance industry is doing everything in its power to discredit the movie and Mr. Moore.
The program is eye opening:
In the long run personal health care must become all important. Personal health and diet should be taught throughout K-12 along with personal finance. It probably will take the federal government, health care providers, advocacy organizations, numerous court cases, and much personal determination, to press upon all of us to pay attention to what we eat. This will be necessary because otherwise health care costs will bankrupt this nation and everyone in it. It will be tougher than a moon shot.
Can we do it? “Yes we can,” said President Barack H. Obama.
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