Sunday, November 18, 2012

Healthy Patriotism

Today I was shopping. I suffer from a syndrome that I call "Shopping Induced Low Blood Sugar," or SILBS. I headed for Boston Market, because I knew I could get a relatively healthy snack quickly and cheaply. I got a piece of chicken (dark meat) and two sides: green beans and mixed vegetables. A cup of coffee. I sat down to eat. It looked good!

There were lots of other people enjoying their food.   But, something was wrong! Danger was in the air... I could smell it! I looked around. Everyone else was calmly eating. I glanced surreptitiously at the plate belonging to the older gentleman sitting across from me. Everything on that plate was beige. Turkey. Mashed potatoes. Stuffing. Corn. No colorful vegetables in sight!  Over there, a woman, semi-hunched over her plateful of beige, accompanied by a huge cup of soda. Behind me, a mom with two young kids. One had mac and cheese and corn. The other had turkey, mashed potatoes, and gravy. No veggies. Next to me a young lady was complaining about Boston Market's policy of omitting salt shakers on the tables. (Instead of the shaker is a card that explains Boston Market's concern over their customers eating too much sodium. It further explains that if one wants salt, it's over there by the beverages.)

Now, if I had seen one of my fellow patrons catch on fire while they were dining, would I have run over and tried to help? Of course. If I had seen one of them later, getting ready to jump off a bridge, would I have tried to talk them out of it? Of course. Yet there I sat, helplessly watching a roller coaster ride with a broken track. Nobody else saw it, and nobody else would listen to me, or believe me, and the ride was about to end horribly for a whole train of people.

The roller coaster was filled with people heading for a health crisis. According to statistics, at least half of the people in this room were either already suffering from at least one chronic illness that could potentially kill them. Although the rate of obesity for adults in America is 30%, every single of of the people (including the children) in this room were at least overweight.

Should I have gone over to the gentleman next to me and quietly suggested that he might want to have a plate of vegetables to go with all that gray stuff on his plate? Should I have offered to get the kids some green beans? Should I have just stood in the middle of the room and screamed, "WHERE ARE YOUR VEGETABLES??" At best, I would've probably been called a busy body and told to shut up.  If I'd persisted, there would've probably been restraints involved, maybe even a police officer or two. 

Look. I am concerned about these people on a personal basis. And if I thought speaking to them would help, I would. But the fact is, they are contributing to problem bigger than themselves.  

Everyone is concerned about the price of healthcare in America and the topic makes for some pretty contentious debate about how it should be handled. But there seems to be a very big disconnect between "the price of healthcare" and personal responsibility. When people overeat, don't exercise, and otherwise neglect their health, they are going to get sick. Their  insurance is going to have to pay for them to go to the doctor regularly and often, get tests, and if things get really bad, have surgery or other invasive procedures. Of course these higher costs to the insurance companies are passed on to everyone in the form of higher premiums.  If they don't have insurance, and can't pay for their healthcare, the costs are  passed on to the taxpayers one way or another. 

More than half of Americans now have at least one chronic condition. These chronic conditions comprise 75% of all healthcare spending. And it doesn't stop there. When someone becomes chronic, the dominoes start to fall. People start missing work, leading to less productivity to the tune of $153 billion a year. More money lost.

 Getting people to stop smoking, eat good food (but not too much!), and exercise is a constant mantra of your primary care providers. But I wonder, if we told our patients that being responsible for their health is patriotic, that would make a difference?