Friday, February 26, 2010

Healthcare Cost Control 1

Ok, we seem to agree that health care is a big expense in the United States. Beyond that we have not gotten very far. Therefore I will post a few questions and comments during the next week or so. First:
  • Why are so many Americans OBESE and/or out of shape?
  • Why do people still drink excessive amounts of alcohol and/or smoke?
  • Why do people continue to participate in "risky" behaviors?
  • What can be done about it?
  • Should these actions be taken?
After decades of being told that a good diet and regular exercise are key to being healthy and happy, we don't seem to listen or change our behaviors. Some folks want to tax our twinkies, raise our insurance rates, sue fast food restaurants, nudge the farmers/food companies to grow/make healthier foods, etc. Of course the conservative folks see these changes as a violation of their rights and civil liberties. And no one wants "their" favorite junk food to become limited, expensive or unavailable.

By the way, I have linked a BMI calculator below. Remember, if your BMI is over 25 and/or you get winded climbing a few flights of stairs. You are or will be likely contributing to our healthcare cost problem. Using a treadmill, reducing portions sizes and/or cutting back on your processed sugars would be a very good thing for America. Being an Engineer, my simple math formula is:
Weight chg = Calories in - Calories out

And of course we all know that smoking, excessive drinking and being stupid increase America's health care bill. However, this does not seem to stop too many people.

Now if you are angry with me for unintentionally acusing you of being a burden on the American society and all your neighbors. Remember:

  • My BMI is ~26
  • I do minimal exercise and my diet is poor
  • I ride motorcycles, snowmobiles, jet skis, down hill ski, etc
  • And I love my beer and wine (rarely to excess. now a days...)

    Okay... Your turn...
BMI Site
OECD Health Site

7 comments:

  1. * Why are so many Americans OBESE and/or out of shape?

    They eat too much of the wrong kinds of food, and they don't exercise enough.

    * Why do people still drink excessive amounts of alcohol and/or smoke?

    Because those are things that they enjoy, or are in various degrees addicted to.

    * Why do people continue to participate in "risky" behaviors?

    Superficially, because they like to, and below the surface, because of a lot of messed up psychological reasons.

    * What can be done about it?

    People need to make decisions to live better, healthier, but that's an easy and even facile answer to what can be a very complex set of problems.

    * Should these actions be taken?

    Sure, but again, much, much easier said than done.

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  2. Why are Americans not healthier? It's very simple: because we are free to make our own choices. How do you fix it? Very simply, by allowing government to "give" us health care, and thus be in a position to take away every one of those choices because it "costs society money." Just imagine how much healthier you will be when your personal assigned bureaucrat tells you how much your new gym membership costs, what time you have to report, what exercises you have to do and for how long. I, of course, will be suffering from very high blood pressure about that point.

    J. Ewing

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  3. If government control is an unacceptable option. Any other thoughts on how to get American's to take responsibility for being healthier?

    Or should we just give up and take pride in being the largest humans on Earth??? I mean where else would "The Biggest Loser" be a popular show? Making celebrities of those who have really seriously let themselves go.

    I forgot to mention one of my simple comparisons. Imagine you are carrying a gallon of milk. Now imagine you have to carry it all day long no matter where you go. Now that would be exhausting.

    The bad news is a gallon of milk is only ~8 pounds. So, I personally am carrying ~2 unnecessary gallons of milk with me where ever I go. I can't imagine carrying 4, 8, 12 or 20 of them.

    Where does personal freedom start to unacceptably violate the public good? I don't have the answer, however it is worth asking...

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  4. Any other thoughts on how to get American's to take responsibility for being healthier?

    I think Americans are responsible for what they do. Maybe education is part of the answer, but I think most people understand in some broad sort of way, what's healthy and what isn't. In this area, I mostly agree with J. Ewing that government should not be coercive in this area, and I am generally skeptical about the effectiveness of the use of incentives in this area. The benefits of living healthy should be effective enough.

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  5. I think the whole problem we have with our health is that government has ENABLED us to be irresponsible. We have 3rd Party health insurance in this country. We get it from our employer (because of government incentives) or we get it through government, but when we get sick because of bad choices, the insurance pays. Imagine what would happen if the employer gave YOU the money, You got the tax break to buy health insurance, and you had to pay for the coverage you got. Or that government gave you a refundable credit instead of forcing you into the government system (as Medicare and Medicaid are now forced upon people). Then consider that the health insurance market gets deregulated so people can buy HSAs, young family policies, senior coverage, whatever, that makes them bear the cost of their decisions. I'm betting costs would drop 50%, health care quality would improve considerably, and people would take better care of themselves because they would see a direct financial benefit to doing so. In short, we not only have to avoid expanding government coercion, we have to eliminate the government coercion and interference that already exists.

    J. Ewing

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  6. This only works if we are willing as a culture to allow the unwise, unhealthy, irresponsible, etc to fail. By this I mean that they will need to pay the negative consequences of their short sighted and poorly disciplined decisions. How can there be true responsibility without consequences.

    In many cases this could mean discomfort, pain, financial ruin and even death of friends, family and neighbors. Are we ready to allow them to truly pay for their choices?

    Then how do we decide who made bad decisions? (unhealthy choices) And who was responsible, but was unlucky due to genetics, etc? (healthy choices) More on this in future posts.

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  7. "I think the whole problem we have with our health is that government has ENABLED us to be irresponsible."

    I don't think government enables McDonald's to any meaningful extent. And I don't think government should tell McDonald's what to serve.

    Insurance does have a certain enabling effect, but is that such a bad thing? Doesn't it allow us to do things which might otherwise be just too risky? Like driving to work in the morning on the freeway? The fact is a very vital and very successful industry, the insurance industry, exists and has existed for centuries, because consumers do not want to assume the full risk of their actions, whatever they might be, and so have sought financial products in the market place that lay off such risks, the products that insurance companies provide.

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