Healthy Bytes

An open letter to Gov. Arnold Schwarzenegger regarding “Universal Health Care”

read time: 1,225 words, (yes, very wordy today) about 6 minutes

As a California citizen and tax payer, I appreciate your desire to improve the health and welfare of California residents.
And I even agree with the logic in your argument – basically, the people who pay for health insurance also pay for the uninsured.

But I completely disagree with your question – “how can we get everyone insured?”

Let’s take the top of the chart health “issues”…
-> Heart disease
-> Cancer
-> Diabetes
-> Obesity

Even the CDC publicly states these are all primarily diet and lifestyle diseases.

What are doctors trained to do?
They’re trained to TREAT NOT PREVENT.

In 2003 the Princeton Review surveyed every US accredited medical school (122) and accredited osteopathic school (19) about nutrition education in their curriculum.
40% of the schools had a nutrition requirement. The average amount of nutritional training at the schools that required any was 2.5 credit units – about 38 hours.

What that means is, if your doctor went to one of the 4 in 10 medical schools that actually had a nutritional requirement in the curriculum, she probably got a total of 38 hours of nutritional training. But if your doctor went to one of the 6 in 10 medical schools that had no nutritional requirement, he could have as little as zero hours of nutritional training.

In their book “The Real Age Diet”, Drs. Michael F. Roizen and John La Puma revealed, “The two of us combined received fewer than eight hours of education on nutrition in more than six thousand lecture hours in medical schools.”

Dr. Michael A. Klaper, Director of the Institute of Nutritional Education and Research:

“What’s really tragic about this is that we were so busy learning how to fix broken arms, deliver babies and do all of those ‘doctor’ things in medical school that we considered nutrition to be boring. But after we get into practice, we spend most of the day treating people with diseases that have huge nutritional components that have long been essentially ignored.”

It’s not my intention to bash doctors. If I was suffering from a trauma such as (ahem) breaking my leg on the ski slopes, I’d be immensely grateful for their training and skill… because I would need TREATMENT.

But if I were on the path to diabetes… or coronary heart disease… or obesity, I’m simply not likely to get steered off that path by a typical doctor… if I could get an appointment and more than an 8 minute visit.

Nope. Now once I’ve arrived and meet the “criteria” of the disease… they’ll treat me with drugs and medical procedures (read $$$). Again, they’re trained to treat, not to prevent. We should not put the responsibility of prevention entirely on their shoulders.

“Stitch in time, saves nine”…
Specifically, current data reveals that $1 spent on prevention = $3 of health care cost saved.¹

So if I spend a single dollar on “preventive” options, I’ll save $3 in medical costs.
That’s a pretty compelling ROI don’t you think?

Corporate America does. There are more than a few corporations that have moved past lamenting about the rising cost of health care; past “studying” how to lower the cost. They’re implementing “wellness” plans that focus on prevention through education, better eating and exercise. They’re spending money on not needing medical care.

CNN House Call ran a clip over the weekend about knee replacements. There’s about 400,000 of those a year at $31,000/knee. That’s projected to increase 8 fold to 3.5 million by 2030. ²

Why… weight. 1 pound of weight results in 4 pounds of pressure on the knee… with every step taken. Reduce the need for knee replacements by reducing weight. Prevention.

You want universal health insurance.
That solves the problem of not everyone having health insurance.
But how well does it solve the goal of improving health?

While it might be wonderful to have “some insurance company” pay for your diabetes testing strips and prescription drugs and doctor visits and hospital visits, wouldn’t it be so much more elegant,
so much more delightful,
so much more cost effective to prevent diabetes?

Oh, by the way, the annual costs of diabetes – per person – was estimated at $13,243 in 2002. This per the American Diabetes Association. ³ I’m sure it’s quite a bit higher now.

Here are just a couple things to look at:
When did we cut phys ed in schools… when did childhood obesity start rising.
When did we stop learning to cook … when did ‘take out fast food’ become “normal”.

Schools in this country that are doing something about BMI are seeing results.
I bet most, if not all the kids that have taken home “BMI Report cards” had health insurance. All the while their weight was climbing.
The schools that are measuring BMI, that have implemented more phys ed and exercise and that have improved the food available at school are seeing results. And mind you, these programs have only been introduced over the last 2 years.

Again, having health insurance has made little difference. Getting exercise and eating a healthy diet is what’s making a difference.
A much better ROI for whoever is paying the bill and for the individual kid.

And yes, there is controversy about BMI, and controversy about “BMI Report Cards”, but the results from these programs seem to be better than the results from having health insurance relative to obesity and all it portends.

The State coffers fetched somewhere in the vicinity of $400 million in capital gains tax just from Google employees cashing in some of their stock options last year. ⁴,⁵

Why not use that to fund preventive programs in schools?
I’ll bet Sergey Brin and Larry Paig would be delighted their tax dollars were invested so intelligently.

If you want a better answer, ask a better question.
How can we improve the health of Californians?

Because climbing, climbing, climbing to the top of a ladder really doesn’t matter much when….
you’ve leaned it up against the wrong building.

Health care costs are absurd.

The Federal government quants just released a report that states health care costs will nearly DOUBLE in the next 10 years. This well outpaces any projected rise in overall economic growth. It’s a fast moving target. ⁶

Finding a way to throw money at it today is just opening the gate to an escalating financial commitment. And how well will that improve the health of Californians?

Further, a report by private economic think tank, McKinsey Global Institute claims:
“Most components of the U.S. health-care system are economically distorted, no single factor is … the silver bullet for reform.”

So - health care is (and has been) outpacing the cost of inflation, and, it’s not reasonably “reformable”.

I don’t disagree that having health insurance is a good thing just in case you suffer a trauma.

But I don’t agree that having health insurance is the most cost effective way to improve the health of Californians… not by a long shot.

Further, I believe the best way to deal with out of control health care cost is not to need it, i.e., practice prevention.

I sure don’t feel like I get much for my health insurance dollars. The insurance company’s version of a birthday card is to increase my premium every year… and I’ve never even made a claim.

Could I please get more for my tax dollars???
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1. http://www.cbsnews.com/stories/2007/01/22/eveningnews/main2386130.shtml [↩]
2. http://CNN.com/HEALTH [↩]
3. http://www.diabetes.org/for-media/2003-press-releases/02-27-03.jsp [↩]
4. http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2006/05/09/MNGSVIO7NG1.DTL [↩]
5. http://www.latimes.com/business/taxes/la-fi-google12jan12,1,4854417.story?coll=la-headlines-business-taxes [↩]
6. http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.2.w242 [↩]

This entry was posted on Wed, 21.Feb.2007 at 3:30 pm and is filed under Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.