Health care reform starts with behavior, not medicine
August 9, 2009
To the Editor:
I am always amazed at the range of opinions people have regarding subjects that they do not have expertise in.
Bill Hamilton’s column on “Kevorkian care” extolls LBJ’s version of Medicare, despite the fact that it is scheduled to run out of money in 2017. Obama didn’t cause that. Overuse caused that.
He sensationalizes his story with images of Hitler and Stalin, saying this is where “Obamacare” will get us, implying that older people will be rationed out of care. What he doesn’t bring up is that we now have what former Colorado Gov. Dick Lamm called the most cruel form of rationing, which is excluding a large portion of our population from any health care other than very costly emergency room care.
He cites a book written in 1977 by John Holdren, the new White House Science Czar, and presents the writings as Holdren’s opinion on what we should be doing about population control, instead of being part of a series of ideas, sort of brainstorming session, taking his writings completely out of context to support Mr. Hamilton’s agenda.
Hamilton is correct in saying that health care is up to us. Leaving prevention out of modalities that health care monies are used for, however, is not the way to go about meaningful change in this country. Another way of putting that is that good health does not start with medicine. It is up to behavioral changes in individuals.
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That being said, we have an obesity epidemic that clearly is not being changed by individuals. If you add the costs of smoking and obesity in this country, we spend close to a third of $1 trillion to treat them annually, which makes the recent bail-out look cheap. Preventive programs that come out of health care funding and not paying for every medical procedure for people that clearly are not taking care of themselves are going to be the painful but necessary steps in order to bring health care costs under control.
Dick Morris, in his fear- and hate-mongering book “Fleeced” writes that health care utilization proposed might keep a 79-year-old diabetic with high blood pressure who smokes from qualifying for bypass surgery. He writes that like it’s a bad thing. Sometimes we have to choose between helping that individual and doing preventive care or programs for thousands for the same cost. Since Hamilton has never been excluded from the health care system, perhaps he doesn’t understand that.
At any rate, we all have to do more as individuals. Move more, eat less. Wear your seat belt (or helmet). Teach people from a young age what a calorie is, and how to get rid of them. Fight for legislation to publish calorie and fat information in menus. Our obesity epidemic comes from individuals from not knowing that their eating patterns increase their risk of stroke, heart disease, diabetes, cancer and score of other illnesses that we end up paying for later, or not caring. Studies show that when calorie and fat content is in menus, people order lower calorie items.
Fixing the health care system in our country is going to be part medicine, part individual behavior. Not understanding that influencing individual behavior is part of health care is not understanding why we teach people to brush properly and use floss.