Sunday, March 28, 2010

Moving on Down the Road

As Al Sharpton declared victory alongside President Obama this past week, he didn’t hesitate to openly declare and applaud the President as one step closer to “socializing America.” Access to healthcare services will expand and our Nation’s most vulnerable will be healthier for it. If Al said it, it must be correct.


We also read the story this week by Brian Wansink. Brian is the John Dyson Professor of Consumer Behavior at Cornell University, where he directs the Cornell Food and Brand Lab. He is author of over 100 academic articles and books, including the best-selling Mindless Eating: Why We Eat More Than We Think (2006). This week, he published research of how pictures of the Lord’s Supper have changed over the last 1000 years, with more recent pictures showing bigger plates, more food, and heavier apostles. The punch line seems to be that humans, without even trying, reflect life based on their own perceptions and biases. Even effort to replicate artwork done before us is jaded by our mindless sense of perspective bias.

So when we look at the CDC website on the obesity epidemic in the United States from 1988 to 2008, http://www.cdc.gov/obesity/downloads/obesity_trends_2008.ppt, I’m guessing President Obama will conclude our Nation of fat people is just a perspective bias and the increasing costs of healthcare are all related to bad quality and poor access to care.

I saw a well educated 51 year old lady in the free clinic this week. In 2007 her husband lost his job and, with both in poor health, they decided to move from Chicago to downstate Illinois, closer to two of their children. Her husband died earlier this year and only now was this woman “getting around” to her own health needs. Her medication needs were what prompted the visit to see me. Since 2007, she has not been taking her prescribed insulin, hypertensive medications, asthma drugs, or other diabetes drugs. She was not without financial resources, she just didn’t have insurance or the inclination to take responsibility for her health, given other priorities and the attendent costs. Because the neighborhood federally qualified health center does a means test and charges accordingly, this lady chose the neighborhood free clinic that didn’t ask about your financial status. I was aghast someone so apparently well educated, with some financial resources, with such significant health problems, would simply go without medication for almost three years.


Once our perspective shifts from repetitive external cueing, most of us simply develop a new reality and keep on moving down the road as changed people. I guess change comes quicker now than in the past, partly because of mass media and rapid deployment cycles for new goods and services. So what is the repetitive cueing needed to increase individual responsibility for our choices? More importantly, what are the opportunities for us to help lead the way? Thoughts?

2 comments:

Anonymous said...

My father was an RN in the ER at the local hospital for many years. As he and I engaged in debate about Health Care Reform, one of the more striking things he told me was of an overweight young woman who had come into the ER with stomach pains. She had no insurance (other than Medicaid), she did however have several gold fillings in her teeth, a cellphone with at least two ringtones, eight rings on her fingers, gold chains around her neck, drove a Mercedes and bragged about her celebrity endorsed perfume. She balked at the notion of using an inhaler or taking daily meds as her chest pains were due to a bad asthma attack. After a near 24 hour observation stay she was released and billed through Medicaid.

Turns out she had been in the ER a month prior for the exact same problem. The culture of America is where the health crisis is. These are the people who only increase the costs of you and I and gladly take the handouts from the government as a "right". Those are the people who demand "free" healthcare at the expense of another's health.

You mentioned Rev. Sharpton's comment, I think Max Baucus' comments regarding the newly passed healthcare bill are just as telling:

BAUCUS: This is also an income shift. It's a shift, it's a leveling to help lower income Americans. Too often in the last couple of three years, the maldistribution of income in America has gone up way too much. The wealthier are getting way, way too wealthy.

I'm all for for healthcare reform, I am not however for income redistribution so the sloths of society need not be forced to get up and be productive. When your main work skill is to extend your arm for the handout, we're all punished for it.

Unknown said...

Elinor Ostrom, recipient of the 2009 Nobel Prize in Economics, disputes the validity of tragedy of the commons. If everyone added just one more cow, the commons would be overwhelmed, except that all of these dumb farmers are actually cow resource experts and they won't allow that to happen.

Groups naturally assemble to preserve their common interests and resources and they can be successful at it. Isn't this what insurance is all about?

One could argue that a national epidemic of obesity proves that gluttony is the basis of human existance, and therefore, we need to do away with the public troughs, or at least not build more of them.

But, some would argue that obesity is an achievement. Poor children used to starve to death. For the most part, national policy has eliminated that problem by putting really cheap calories on retail shelves.

Some say that we are an obese nation not as a result of our carnal and base human nature, but as a consequence of the subsidies to a few corn, pork, beef, and poultry production system managers. The result is an abundance of really inexpensive calories being consumed by a species which evolved so that a few would survive by fattening up during good times. As a result of a tremendous pooling of subsidies, talent, equipment, and biotechnology, we have spurred on tremendous advances in both food production, its distribution. We have also created many unintended consequences.

In an election between starvation and diabetes, that vote has been cast. Having decided that, let's master the next level of refinement.