Today I watched the White House's town hall meeting on health care reform, broadcast right to my computer at work. I was encouraged by the participation and the feeling that so many people know that something must be done. What discouraged me is that seemingly we overlook the obvious in our complex searches for solutions. Healthcare costs, a lot. However, the people who cost the most are the sickest. One of the reasons many healthcare experts cite for them being so sick is the fact that they may go many many years without comprehensive health coverage before reaching 65 or becoming disabled and qualifying for Medicare. At that point, they then have access to as much healthcare as they wish. The problem is, by that time most of their illnesses are no longer simply treated by good primary and preventive care, they now require major surgery and procedures at a very high cost.
A good example is heart disease, which can be prevented, especially for those with high cholesterol by maintaining a healthy lifestyle and taking a statin drug. However, if you have no insurance you are likely unable to pay the $150-200 doctor's visit plus $50 a month for Lipitor. You probably also will not be able to afford visits to a registered dietitian who will advise you to increase healthy fats like nuts, olive oil, and avocado and keep away from the nasty deep fried kinds. Instead, you will slowly get sicker until you reach 65 at which time we will all be happy to pay for you to have a triple bypass, lengthy hospital stay and rehabilitation. To me it makes a lot more sense to make affordable coverage available to everyone somehow and pay primary care physicians a reasonable office visit fee for great preventive medicine. We also need to treat primary care physicians like the gatekeepers to our health that they are, instead of as the low rent physician you see to obtain a referral to a "real" specialist. This is not to say there are not issues which should be treated by specialists, I just believe that a greater role and emphasis on primary and preventive care for everyone will result in lower cost.
This brings me to my next subject, we are fat in this country and it is costing us, lives and a lot of money. Why are we not taxing fast food and soda? (Probably because Ronald McD got a lot of lobby money) If you want to drink it, eat it and cost us all money that's your choice, but we are going to use your purchases to pay for your healthcare and healthy food for others, thanks very much. I think every fast food purchase should be taxed at a pretty hefty rate with perhaps the exception of some items meeting a 6g fat and 600 calorie limit, those can be put on a healthy choice menu. Tax soda too, if I see one more two year old with soda in a sippy cup I might flip my lid.
Fresh fruits and vegetables should be subsidized. For a country whose children will, for the first time, not live longer than their parents, we are not motivated enough. It is disgusting that in inner city neighborhoods children and their parents can find a convenience store full of inexpensive junk food and soda but not one banana. It's absolutely shameful. We have farm subsidies for millionaire agrobusiness owners, how about subsidies for people who want to eat American grown produce? Let them eat fruit and veggies, cheap!
How about encouraging employers and insurance companies to offer rate discounts for healthy behaviors? Maintaining a healthy BMI, not smoking or quitting, or if overweight following a dietitians plan and making gains toward healthy weight loss, attending a gym regularly etc. Even better, employers should be encouraged to have on site fitness facilities and allow extended lunch hours to staff who wish to work out during that time. Ooooh, you say, that extra 15 minutes could lessen productivity. Oh yeah? You ever looked up how much extra unhealthy employees cost employers in workers comp claims, sick leave and health benefits? They should be begging people to work out on their lunch break.
No more soda and candy machines in schools, bring in the apple cart, the yogurt vendors and bring back daily PE. I want to start a revolution! You want to really save on healthcare, make it more expensive to be unhealthy and less expensive to be healthy. Provide low cost coverage so that everyone can have preventive health care. We all pay, because at 65, everyone gets health insurance and it's in our best interest if everyone has had access to a healthy lifestyle and health care up to that point.
