Putting “health” back in “health care”

Two weeks ago (geez, has it really been that long?!), Obama signed off on the health care bill. Meaning a whole lot of different things. At the time it passed, I asked my tweeps to give me their two cents on the health care bill.

Some opinions

“It isn’t about you (or me), mostly. Well, not at least until you turn 26, and/or get a job, or are determined to have a pre-existing condition. It’s about people our parents always taught us to help, those less fortunate, those we serve on Christmas Eve morning, at kitchens during the week. People we feel for, and want job training to help. Now, it also helps millions more without work, with cancer, diabetes. It opens a market with a serious competitor, not unlike Sams Club or Wal-Mart, it opens States to competition, it makes insurance companies less greedy.” – Dave

“We were the only rich country that didn’t ensure that its citizens have health insurance; now we’re not.” – John

Katharine at From A to Pink, who suffers with Cystic Fibrosis, directed me to the provisions in the bill that can help those with chronic disorder, like CF. The bill help people like her across the country who previously were denied coverage due to their pre-existing conditions.

“I don’t think insurance companies nor the government need to be involved in health care. Consumers pay doctors directly, costs decrease.” – John

“I do think health reform is needed- costs for doctors, patients and insurance companies are outrageous, but I don’t think this current bill is tackling the main problems like malpractice, the food system and preventative care. Also what scares me more, not just about the bill, but our government system in general, is how the bill got passed. I felt it got pushed too quickly and not thought out for the public, but for the politicians to get re-elected or liked by Obama. If it was written well, with a democratic majority, it should have been passed easily months ago, but even now, it barely passed and that scares me when it’s so expensive and might not comprehensive or helpful to us.” – Jacquie

“We have no money left. One day, someone will have to pay for this. Oh, and Obama’s a socialist.” – Charlie

“Health care bill…meh. It’s passed, so I’m going to have to get over my disagreement and hope it works out for the best!” – Gabrielle, at Une Vie Siene

Photo credit: adrianclarkmbbs

My opinion

At first glance, it appears that Obama’s health care bill has divided Americans into two separate camps: those opposed to it, who are focused on the economic toll it will have on the country—and those for it, who are focused on the obligation we have to make sure everyone has health care, regardless of  inability to pay or pre-existing conditions.

I feel like there are bits and pieces of all of these arguments I can agree with. The moralist in me sees that health care reform is needed while the pragmatist in me sees that it will be expensive and will not get at the heart of the problem. Maybe it’s pointless to talk in hypotheticals. I don’t think it is, though. And I finally have an opinion of my own about this whole thing (and sorry it has taken me so long to get around to posting it!)…

As is customary in this country, the government has focused on dealing with the problem (unaffordable health care and too many uninsured), which always creates more problems, instead of using tactics to prevent health problems in the first place. I know not all health care is treatment care, a lot of it is preventative care or care for illness that could not have been prevented—care such as annual check-ups, vaccinations, insulin injections for people born with Type 1 diabetes, treatment for cancers, autoimmune or other chronic disorders and a slew of other problems, not to mention treatment for accident-related injuries.

However, there are still too many health care dollars that are spent cleaning up messes that should have never been made in the first place. I found this article in Grist recently. Dr. Matthew Nisbet, who actually teaches at AU, was interviewed in a piece called, “Why aren’t climate scientists talking about health care reform?” I found it to be an interesting piece, and it is true. The climate change advocates aren’t really putting as much effort into drawing the connection between our human health and global warming. But I think this issue very similarly mirrors the gap that I see in the health care debate between “health/fitness/wellness” and “health care.” And why is there such a gap? Why is “health” sitting in one corner of the room while “health care” sits in another? It’s almost like when we, as individuals, think of “health” we think of all the personal actions we make to improve our health, while “health care” is the bureaucratic (and therefore often flawed) process we go through for the stuff we can’t take care of on our own. Why isn’t this relationship more interconnected?

My recommendations

  • Gym memberships Apparently, there are some health insurance companies that give rebates, discounts, or even free gym memberships. I doubt mine does. (But I guess I should check before I speak…no matter anyhow, as I have a couple free gym options at my finger tips as it is.) I think this is an excellent idea. How fundamentally smart. I was slightly appalled to read this on Insurance News Net: “…under the new law the government does plan to begin cutting payments to Medicare Advantage, a privatized, managed-care version of Medicare, in 2011. Such plans, in which members often enjoy little or no premium and free gym memberships, may be forced to reduce some benefits or increase premiums for the 10 million people enrolled in them.” Why not require health insurance companies to offer some sort of incentive for people to get active—in the form of free or reduced price gym memberships? Ten percent of the health care dollars we spend per year in this country are spent on obesity-related problems, mostly type 2 diabetes and heart disease. The food people are eating is much to blame, but so is a lack of activity.
  • Healthy eating and cooking workshops Jamie Oliver is making an effort to change the quality and nutrition of food in public schools (as is being documented on Food Revolution—and yes, I will be posting about this show soon. I am waiting to form my opinion after more episodes have aired)—however, children only consume about 16% of their total food from the cafeteria (more if they eat breakfast at school.) As Jamie Oliver’s program has so far revealed, many parents aren’t feeding their children properly at home. Sometimes it is because they don’t know how to cook healthy meals, sometimes it is about lack of time or money. Whatever it is, there is advice for them and that kind of  help should be something the government is interested in providing. Obama’s Let’s Move campaign will hopefully tackle this issue. But why not find a way to weave it into health care? Why not offer people an incentive to attend these workshops through their health care costs? If I was a parent, you better believe I would take my kids to a cooking class once a week if it meant I would get a rebate on my health insurance.
  • Smoking cessation In the U.S., smoking is still the leading cause of preventable death. Oh. My. Goodness. WHY. Honestly, this topic makes my blood boil more than the food system. The cost of medical care and lost productivity related to smoking is (conservatively) estimated to be $150 billion per year. I have a lot of friends and two parents that won’t love that I say this, but I will say it anyway, because I love them: tobacco should be outlawed. Call me a prohibitionist, but that is my opinion and I am sticking to it. Health insurance companies should be required to cover all expenses related to smoking cessation, whether it be in the form of the patch or hypnotism or whatever. If a method has been proven to work, it should be covered. It is an outrage that people are still dying from lung disease and cancer in this country (many from SECOND hand smoke!)
  • Rewarding people for rewarding themselves OK, here is a new-agey little idea. But whatever, I’m a new-agey gal. What if health insurance companies offered a “bonus” to their members if they could prove that they actually took their alloted vacation time? Stress is one of the top causes of heart-related problems, as well as a contributing factor of most other health problems. Taking care of oneself means taking time for yourself. Not enough people are doing this. And their health is paying the toll.

Pick apart my ideas as much as you like. I encourage a healthy debate. But keep in mind that sometimes it is the most radical and different ideas that become innovative solutions for complex problems. Does anyone have any other ideas for ways to incorporate more health into our health care?

The way I see it, health care reform doesn’t come down to health–it comes down to money. It comes down to the have’s and the have-not’s and the question of how we can provide health care to more people, but it doesn’t address how we can make people healthier. If we can implement ways to keep Americans from getting sick in the first place, we can save billions on health care, which will lower premiums for everyone.

Because we all need health care. But some of us aren’t doing our job of taking care of ourselves the way we should in the ways that we can. That is where the government should be focusing its efforts—helping people help themselves so costs for all can go down. That way, the people who need doctors’ help more than others can get the coverage they deserve.

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10 responses to this post.

  1. This post really hit the nail on the head and I really appreciate your insight. Recently, one episode of The Biggest Loser pulled one of their shock tactics by visually showing contestants how much extra money they have spent on health care as a result of obesity-related diseases. There really isn’t enough information on disease prevention out there, and it’s shocking how many educated people are misinformed about fitness and nutrition. If the emphasis on these issues was increased, the cost of health care would naturally go down.

    Reply

  2. “The way I see it, health care reform doesn’t come down to health–it comes down to money. It comes down to the have’s and the have-not’s and the question of how we can provide health care to more people, but it doesn’t address how we can make people healthier. If we can implement ways to keep Americans from getting sick in the first place, we can save billions on health care, which will lower premiums for everyone.”

    SUCH a great statement. I’ll be frank, I absolutely disagree with the current health care plan, and a huge factor in that is the fact that it offers no bonus for leading a healthy lifestyle. Certain things are unavoidable, but if a person smokes or is morbidly obese, it’s not fair that the burden of their healthcare is thrust upon the country as a whole. It sounds harsh, but if you’re not going to take care of yourself, why should anyone else want to pay to keep you healthy?

    Great post!! Hope you’re having a good day 🙂

    Reply

  3. I think you’ve made a lot of important points. I’ve heard it said that health care in the U.S. isn’t really health care at all – it’s disease care. Without a stronger focus on health and disease prevention, we’re really just spinning our wheels.

    Reply

  4. Food is so far from peoples thoughts that they do not realize how critical it is for health. It’s so easy to stop at the nearest C store and fill your belly with junk. Education begins at home, but many parents don’t even understand about good food. It’s too easy to sit in front of the tube and snack our way to the grave.

    Reply

    • unfortunately all very true. I don’t think it has to stay that way though. I think over time, especially if what they say is going to happen, with parents outliving their children, actually happens–people will know they HAVE to change.

      Reply

  5. I loved reading your opinion on the health care bill.
    I’m pretty happy it passed although still not entirely pleased.
    I think another aspect of preventative health care is looking at ways to change out sedentary culture. I think the idea of gym memberships covered/subsidized by health insurance is great, but hopping on the elliptical shouldn’t be the only form of exercise. We live in a car centered society, we walk from our house to our car, then from our car to work and back again, with little activity in between. A good thing to do would be to subsidize dense urban developments that promote walking and biking as alternative modes of transportation, if not at least promoting construction of sidewalks in suburban and rural areas to promote leisure walking, instead of pouring tons of money into perpetuating our dependence on motor vehicles. I’m in the Urban Planning field so this is something I feel strongly about, just thought I’d throw it out there.

    Reply

    • Thank you for this!! I had actually thought of that when writing up the blog, because it occurred to me that lots of people in this country don’t have access to gyms–but they still have two legs to walk around! Excellent point. One my sister is studying lately, she is getting her masters in Architecture and doing her thesis on architecture as preventative health care. http://holisticarchitecture.wordpress.com/

      Thanks!

      Reply

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