Eat less and you’ll pay less for health care
Short on time between appointments, I stopped recently at a Chinese buffet restaurant for a quick lunch.
With only 20 minutes to spare, I figured I could hit the steam tables, partake in the healthier options and get to my next interview on time.
It was the most depressing lunch I’ve had since eating gruel made from powdered soybeans in a Zairian refugee camp.
Almost every option was some kind of fried or sugar-coated meat, with only a hint of limp, steamed vegetables. But more dismaying was the client e le, made up almost entirely of overweight people piling their plates with food almost guaranteed to cause diabetes.
Noone was smiling, not even the staff. They appeared inured to the grim scene, shoveling out cheap calories to people who took no joy in consuming as much as
they could. The place felt almost like a drug den.
“Who is going to pay these people’s hospital bills when their health collapses?” I wondered. The answer is you and me through higher insurance premiums and taxes.
I’ve written many columns lambasting doctors, hospitals, drug makers and health insurers for their roles in jacking up health care costs. I’ve called for greater consumer price awareness, regulatory reform and an end to private health insurance as we know it.
As we prepare our holiday feasts, let me also call for individual responsibility. About 86 percent of U.S. health care spending today is on avoidable chronic diseases, according to the Centers for Disease Control and Prevention.
“Heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis are among the most common, costly, and preventable of all health problems,” the agency says. “About half of all adults — 117 million people — had one or more chronic health conditions. One of four adults had two or more chronic health conditions.”
Athird of Americans are obese. More than 15 million Americans are extremely obese, according to the National Institutes of Health. In 2012, diagnosed diabetes cost the country $245 billion, smoking cost $289 billion and obesity cost $190 billion.
These are the reasons why employee health care costs make up 7.6 percent of a company’s annual operating budget, according to the Society for Human Resource Management.
“The average cost per covered employee has increased by nearly $500 in the span of three years,” the group said in a recent study. “Employers spent an average of $8,171 per employee” in 2015.
The typical American family spends an additional $25,000 on health care, a 300 percent increase since 2001.
Research published in The Lancet medical journal attributes most of these health problems to physical inactivity. If people walked for just 30 minutes a day, the world would be a much healthier place. Choosing healthier foods and quitting smoking can bring about almost instant health improvements.
This argues for demanding greater personal responsibility. But how do you do it humanely?
Employers can help by offering health insurance and wellness programs that emphasize prevention over treatment. Humana’s Vitality program offers points for healthy behaviors similar to a frequent flyer program, which can be used to make purchases in the “Human a Vitality Mall .”
Most employer programs charge higher premiums to people who smoke, while offering free cessation programs. But companies are also making employees pay a larger share of the premiums along with higher co-pays and deductibles.
Unfortunately, most employees don’t make the connection between higher premiums and how they and their colleagues are running up ever higher expenses.
Then there are those with no health plan. Texas has the highest rate of uninsured in the country.
Hospital emergency departments are routinely filled with people suffering from chronic diseases, experiencing acute symptoms and seeking charity care that neither governments nor hospitals can afford. Turning people away is against the law, so doctors address the acute symptoms, the chronic disease goes untreated, and the patients become repeat customers.
I understand the desire to rail against the people in the buffet line. I’m certainly trying to lose weight after my experience. But science offers more effective solutions than lectures about self-discipline.
Just as some people are genetically prone to drug and alcohol addiction, some can become addicted to sugar and fat, according to research at Yale Medical School. Experts at Imperial College London have even found that a narcolepsy drug can help food addicts manage their eating.
Unfortunately, 57 percent of health plans don’t cover obesity treatments, 63 percent don’t cover obesity medications and very few cover surgery, according to the Obesity Action Coalition.
This holiday season, take a moment to examine how you can take more responsibility for your health and encourage healthy habits in others. But also feel compassion for those with chronic disease.
The best way to help them, and help them take responsibility, is to give them the tools for a healthier life.