Monday, December 28, 2009

Why "Healthcare Reform" Is Not Reform, Part I

"Healthcare reform" is a simulacrum reform; beneath the public relations, it does nothing to challenge the status quo "sickcare system" which is impoverishing the nation even as the health of the citizenry declines.

There are two fundamental reasons why the "healthcare reform" which passed the U.S. Senate on Christmas Eve is a simulacrum of reform: it does nothing to lower cost or limit the diversion of national wealth to a few cartels, nor does it address the food-diet-nutrition-lifestyle causal chains which are dooming the nation to an explosion of preventable chronic disease and diminishing lifespans.


Food, Inc. (film)

King Corn (film)

And two more which directly address the fast food industry:

Super Size Me (film)

Fast Food Nation (film)




The obesity epidemic can be viewed visually via this slideshow map of the U.S. I recommend you view this slideshow which depicts the obesity epidemic on a state-by-state basis:

Centers for Disease Control, U.S. Obesity Trends 1985-2007

Here's a chart of global obesity (BMI is not a perfect metric, but this certainly suggests some obvious conclusions)

Some question whether poor diet, excess weight and inactivity actually increase healthcare costs; this chart from the State of Minnesota shows that inactivity does have costs.

The terrible truth is that the "sickcare" industry, agribusiness, and the fast-food/ packaged food industries all profit immensely from poor diet/ nutrition, widespread ignorance of the principles of human nutrition and health, and a media-obsessed, couch-potato lifestyle which demands "quick fixes" for complex lifestyle diseases.

The incentives are all entirely perverse. As an academic notes in King Corn: "We subsidize happy meals (TM), not healthy meals."

How much profit is there in raw broccoli or carrots? Precious little. How "good" does packaged and fast food taste without high levels of salt, fat and sweeteners? Not very.

The quality of the nation's food has deteriorated without our being aware of it. One of the old farmers in King Corn flat-out states, "We're growing crap."

An academic in the film observes of corn-fed cattle fattened in massive feedlots and kept alive with monstrous amounts of antibiotics: The typical American hamburger is a fat burger (65% of total calories are from fat) held together by some meat.

This was not the case 40 years ago. Two generations ago cattle were routinely grass-fed (so-called free-range animals) and then fattened up with grain for 60 days or so prior to slaughter. They ate grass for up to two years. Now they are taken as calves and fed corn for 150 days in confined areas and then slaughtered.

Which animal do you reckon is healthier for you to eat?

As I describe in Survival+, a key way the status quo maintains power and control is by making history, even recent history, largely inaccessible.

Another subject of the film was a gentleman who drank a liter or two of soda every day which was sweetened with high-fructose corn syrup. Not too surprisingly (or perhaps it was a surprise to him?), he ballooned up to 300 pounds and became diabetic.

Let's ask of this "healthcare reform bill" which will direct 16%-20% of the entire nation's GDP to a handful of cartels: how many of the trillions of dollars will be directed to educate American kids over the course of not a semester, but over a decade of integrated curriculum, about diet, nutrition, fitness, cuisine and the responsibility they have for their own health?

Essentially none. An educated public is one which might shy away from fat-burgers, liters of soda and other extremely profitable products hawked by the food industries.

The sad truth is that there is essentially no profit in helping people stay healthy and immense profit in managing their chronic diseases. Yes, "defensive medicine" (ordering needless tests and medications by the boatload to fend off future lawsuits) is a factor, and so is the insanity of paperwork (by some estimates, 40% of the entire $2.4 trillion sickcare system is squandered on paperwork and fraud).

But we have to face the reality that the system incentivizes chronic illness (the fee-for-service model) and a growing multitude of questionable tests, drugs and procedures and offers radically perverse disincentives for helping people stay healthy. There is literally no way to charge a fat fee-for-service for helping people stay healthy.

A large number of healthcare professionals (RNs and physicians) read this blog (I am not sure why, but I am honored by their readership and insights). Thus I am aware of the "dirty little secret" known to healthcare professionals: the standard-issue American patient takes little to no responsibility for their own health. They demand a prescription for the medication they saw advertised every half-hour on TV, they want an antibiotic for their cold, even after being told viruses do not respond to antibiotics, they resist stopping smoking, entering AA to address their alcoholism, etc.

So what does this "healthcare reform" do to increase the level of knowledge and responsibility required of a free people? Nothing.

There is only one thing we know for sure about the U.S. sickcare system, "reformed" in this fashion: it will bankrupt the nation within the decade.

The truly sad thing is that it doesn't feel good to eat unhealthy food and sit around in unfit torpor; chronic diseases are terrible burdens, and people are needlessly losing years off their lives. The sad thing is that this "reform" by the Powers That Be is a mere simulacrum, an elaborate facsimile of the real reform we need to not just lower costs but improve the health of the nation's citizens. Shouldn't that be the goal?


Here are a few books of interest on these topics:



The Omnivore's Dilemma: A Natural History of Four Meals

Diet for a Small Planet


The Informant: A True Story

Fast Food Nation (book)

Permanent link: Why "Healthcare Reform" Is Not Reform, Part I


in HTML: Survival+ in PDF: Survival+



Thank you, Barney S. ($15), for yet another most generous contribution to this site. I am greatly honored by your support and readership.

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