With the presidential debates gearing up again we are sure
to hear more about health care. But we propose a slightly
different question. In addition to asking how we can get
more people healthcare coverage, we should also ask why so
many people are sick in the first place.
The words of John Kennedy might today be, "Ask not what the
health care system can do for you. Ask what you can do to
reduce the health care burden". But before delving into
what we can do, let's take a look at some realities that
our next president could face in their first 'State of the
Union' address.
On the downside -
* We are not healthy: 60% of adults and 20% of kids are
overweight; 30% of today's kids are anticipated to become
diabetic; 20% of high school kids have early stages of
heart disease. The estimated economic burden of depression
for the year 2000 (most recent estimate) was $83.1 billion,
and this is just one of many brain-related diseases
* We are aging: within the next couple of decades, about
20% of the population will be of retirement age; 4.5
million people already have Alzheimer's disease and by 2050
there will be 16 million cases.
* We are heavily medicated: anti-depressants are the
leading selling drugs in the United States; record numbers
of children are on these and anti-psychotics; for adults,
cholesterol and blood pressure medicines are becoming as
common as breakfast cereal.
On the upside -
* The US government estimates that healthier lifestyles
could save $71 billion per year in health care costs and
another $14 billion in lost productivity.
* 1 out of 7 deaths are premature and could be avoided with
better diets and active lifestyles.
Perhaps the next president should spend a little effort
promoting methods to improve these statistics. But how?
We typically think of heart disease, diabetes, depression,
and Alzheimer's dementia as very different problems. But
the more we learn about disease, the more we realize that
these seemingly different diseases often have a lot in
common at the cellular and molecular level. They also have
a lot in common when it comes to how they gained a foothold
in your brain and body to get started in the first place.
However, we have an arsenal of tools proven to help reduce
common cellular damage to maintain fit brains and bodies.
What are those tools? Some high tech drugs and medical
equipment that is out of reach for much of the population
lacking health care insurance? Actually, no. These tools
are very low tech and available to everyone. They are:
1. Eating a quality diet
2. Getting regular physical activity
3. Keeping your mind active and engaged
4. Getting enough sleep and rest
Sounds easy, right? So why don't we all do it, and why
didn't we have all of these problems 50 and 100 years ago?
First of all, in yesteryear a breakfast muffin contained
about 150 calories. Today that muffin is 400 calories. A
large drink at the soda fountain totaled 12 ounces. Today,
that drink is the smallest size on most menus. Yes, we are
suffering from proportion distortion. We love to eat, and
it ain't peas and carrots we are a cravin'.
Second, for many people going to work actually meant going
to work, physically. Today, the extent of our office
exercise is finger aerobics on our QWERTY keyboards.
Physical activity used to be a regular part of everyday
life, not a chore that you have to schedule into your day.
Third, as Alvaro pointed out on a recent Sharp Brains blog,
many of us 'outsource our brains' and no longer think for
ourselves. With mass media messages, GPS systems,
calculators, spell checkers and electronic organizers, we
must ask the question how well we could function without
them. I know I am guilty of this one, myself.
Finally, we are staying up later and getting up earlier to
meet those deadlines. On average, we get 1.5 hours less
zzzzzs than we did about 100 years ago. Not only that but
we spend far more time busy, busy, busy when we are awake
than we ever used to.
Now, change happens. We shouldn't expect to always do
things the way we used to, and we're not suggesting that.
Food, in all its irresistible varieties, is much more
available. Are we supposed to just not eat it. Well, uh, it
wouldn't hurt to pass on the second helping of triple
chocolate cheesecake now and then.
And no, we can't jog around our office but we can do simple
things to introduce more activity into our day. Walk
instead of drive those 1-mile errands. Park further from
the door, take the stairs . . . you've heard all this
before. So why don't we do it?
One reason is that no one likes to be told what to do and
subjected to some guilt trip, most people just don't
respond to that. Also, most people haven't really thought
about what they really want their health to look like or
developed a reasonable plan to reach their health-goals. As
the old adage says, "If you don't know where you are going,
you are sure to get there", plus it helps to have a map.
Finally, even with a plan many folks will give up after the
first sign of failure or fatigue. These changes don't
become easy until we make them an integral part of our
lives.
So how do you motivate people to take action to maintain
their health? Since everyone is different, many options
exist. The obvious answer, that will motivate the most
people, is money, money, money . . . money (did you hear
'The Apprentice' theme song).
At a policy level, it would be exceptionally helpful if the
next president worked to create incentives for healthy
lifestyles and behaviors. Now, I know this is easy to say,
probably not as easy to do (and keep everyone happy), but
you have to walk before you run.
What if the next presidential administration actually
incentivized (is that a word yet?) us to take better care
of ourselves? What if health insurance companies gave
discounts to people that tried to live a healthy lifestyle?
What if the government gave us tax breaks to eat healthier
food and exercise? What if each individual had one
government subsidized continuing education, or
self-enrichment class each year? Would this reduce the
overall health care burden for employers and make it more
affordable to cover more people? Help reduce sick days and
increase productivity and creativity? Hmmm....
We realize there are many caveats to implementing such a
plan but something has to be done and maybe some bright
politician can figure out how to do it. Who would lose if
the country were to improve their health?
Insurance companies wouldn't have to fork out as much.
Medical providers would be able to divert more of their
attention to preventing disease, instead of managing
chronic illness. The government wouldn't be in such a hot
seat for the health care crisis. Big Pharma might sell
fewer drugs, but there are several new health-related
industries that they have the expertise to tap into.
Basically, we would all win.
So back to our initial question: "Why are we so sick in the
first place?" If you step back and see the forest for the
trees, our world has changed drastically in the last 50 to
100 years. With technology, and the availability it brings,
we may have become a little complacent, a little too
trusting that the magic cure-all pill is there for us.
It is true that we are living longer. But I'm sure with
increased longevity, everyone would want at least a
reasonable quality of life and currently that isn't the
status quo. So the answer to our question seems to
be....lifestyle choices. Making the best lifestyle choices,
and maintaining them, isn't always easy but the best things
in life rarely are.
So Madam or Mister President, will you help us help
ourselves?
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