Friday, September 18, 2009
Let Me Spend that Money, Secretary Sebelius, Thomas Frieden, Commissioner Farley, Kelly Brownell, and Dr.s Ludwig, Popkin and Willett
We should be doing this--spending money on prevention.
I know the Congressional Budget Office isn't convinced, but my gut tells me that a predominantly unhealthy nation is less secure than a healthy one. Whether or not the CBO numbers add up on the side of prevention, it'll cost us dearly to continue condemning Americans to a purgatory of chronic disease--preventible--debilitating, disfiguring, demoralizing chronic disease.
You've heard me say that many of today's illnesses should be reclassified as "elective," meaning that they're a result of our lifestyle choices and unwillingness to be compliant to health, and therefore, we should be paying out of pocket for the costs associated. 100% or a partial contribution? I dunno. But if you willingly eat yourself into type 2 diabetes, cancer or heart disease, it's your right but not your employer's, neighbor's or fellow policy-holder's responsibility to cover those costs--or to subsidize by having their costs skyrocket.
At the same time, we need to offer folks assistance in making better lifestyle choices. Most importantly, a shot at being healthy should be available to all Americans, and that includes easy and affordable access to real food--whole fruits, fresh vegetables, lean proteins and reliably safe water.
But eating issues aren't just about access, they're largely a result of warped conditioning to food-like substances--I call "ingestible entertainment"--which overrides an instinctive appreciation for natural foods.
Our gawdawful eating habits are a result of affluence, abundance and corporate greed mixed with nonstop neuro-chemical euphoria. If we're gonna help people get healthy, it'll take more than just having them pay out of pocket for poor choices; it'll take free and easy nutritional counseling, exercise instruction, and maybe most importantly, behavioral psychology strategies. Be honest, you're not eating to excess because you don't know better, you're eating to excess because it feels good, really really good. Sex-like good.
Hitting the bliss-point with food indulgences reads on an fMRI a lot like reaching sexual bliss. Our pleasure-reward system lights right up. When something so wrong feels so right, it takes a little help from our friends to make a rational decision. Our friends possibly being strangers on the other end of a self-help line, webinar or community support group. Friends who are experts in offering counsel and friends overcoming the same challenge. (Look to models like the 12-Steps-inspired Overeaters Anonymous.)
This investment in education, outreach and counseling will be money well-spent by the Obama administration and local governments to offset the financial cost and human cost of so many of us being so sick.
Whether it's today's big announcement from the HHS and CDC committing $650 Million to the "American Recovery and Reinvestment Act" and the "Communities Putting Prevention to Work," or it's the potential $150 Billion to be raised over the next decade in soda taxes, the cash needs to go to keeping people well. Without our health, we have nothing. No matter how the CBO adds it up, America needs to avoid zero.
And Prevention adds up to everything.