“The problem with socialism is that eventually you run out of other people’s money.”

Margaret Thatcher

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photo: ThomasThomas

I’ve had a little bit of time now to mull over the moral outrage directed at John Mackey (and, by association, Whole Foods), over Mackey’s recent Wall Street Journal Op Ed piece.   From what I can tell, the nexus of the piss-storm from the left has come about from the following two statements:

“…Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?”

and

“…Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.”

And I can’t say that I necessarily disagree with Mr. Mackey on these points, or with the whole of his Op Ed piece, for that matter. I think most of us here can pretty much full-on agree with the second statement.  How much could be saved in the health care system as a whole, if we were able to eradicate metabolic syndrome alone?  And this “syndrome”, in the vast majority of instances, is totally, totally, preventable.  Remove metabolic syndrome from the table, and I dare say that this debate would not even be happening.  The general public, however, has not yet been forced to face the fact that they are a huge (dare I say the largest?) part of the health care problem — not government, not business — but the masses who choose not to take serious interest in the maintenance of their own health.

As to Mackey’s first statement, well…I’m an odd political mix, and I hold true to no particular political party or ideology; that said, I am for what works in any given situation, regardless of the origin of that idea’s ideology.  I do, however, find myself siding mostly with the libertarian point of view on most issues.  Not always, though — health care being one example.  Putting a man on the moon, the interstate highway system, the creation of the National Parks system — these would have never come to fruition without significant government involvement.  It is my opinion that health care reform is the same kind of animal.  There is no perfect answer, of course, but I feel that a good first step starting point — a platform from which to proceed further — would be something akin to the Swiss/Dutch system.

This does not mean, however, that I believe the government to be competent (or uncorrupted) enough to handle such an undertaking.  Far from it.  Unfortunately, the health care issue comes tethered with vast amounts of money, and, with that, a phenomenal amount of greed and power mongering.  If anyone believes that at the highest levels of government and corporate America, if this discussion is centered around anything other than profit and potential profits, you’ve already ingested you’re fair share of “blue pills”.  Go now, turn on a Three’s Company rerun, and rest peacefully until your number’s up.

*Seriously, that’s my last red pill/blue pill analogy for quite some time.  I think I’ve sufficiently worn that one thin.*

My personal gut feeling about how healthcare reform will shape up is summed-up beautifully here, in a post by Hunter, at the Daily Kos.  In a nutshell, you’ll get mandatory universal coverage — coverage supplied by private insurers, and something similar to the previously-mentioned Swiss/Dutch system.  Insurers will make up for the have-to-cover, “pre-existing condition” groups and/or expensive customers with the positive of adding additional millions of paying customers to the bottom line.  Both the left and the right will, after sufficient “spinning”, claim ideological “victory”, politicians will mostly be re=elected in their districts, and the system will continue to eat itself alive because the underlying problems of corporate greed, political power-mongering, and an inattention to basic personal health (diet/fitness) remain.  The Swiss/Dutch system works, not because it is a clever mix of government and open-market interaction, but because the Swiss and Dutch are culturally of a different mindset.  No system can be created that will not ultimately implode under the weight of a diseased citizenry.  In the US, attitudes must change.  Priorities must be re-arranged.  I know I’m speaking to the choir here when I say this, but if you want true healthcare reform, you must first reform that person in the mirror.  Everything else, then, will take care of itself.

Tonight’s speech will be interesting…and telling.

In health,

Keith

25 COMMENTS

  1. Keith, this is so on point and well written…good work, my friend…the truth is that the majority of this country’s medical ailments are due to their own negligence, consumption of processed foods, overeating, smoking, excessive alcohol consumption, lack of exercise, failure to retrain themselves even after medical problems have been diagnosed, and sheer and utter lack of will power…and they blame the government.

    OK, your point of corporate greed is also extremely valid, look at what the food industry has done to this country…just making this crap (high sugar, hfcs, feed lot beef) available to people is cruel. There is no other country in the world that eats as poorly as the USA. Fruits and veggies are not what people buy in the store…they buy processed, boxed crap. No wonder they’re sick.

    It’s too early for the soapbox this morning, but thanks so much for bringing this important subject to light.

  2. Imagine how interesting it would be if in his speech tonight the President took the same tack he took with his education speech to schoolkids. He essentially said: It’s your personal responsibility to make the most of your educational opportunities, and it’s your responsibility to your country as well.

    Now replace education with health-choices and the same underlying principles become pretty radical. The President is without a doubt a great example of the value of education and also a pretty good example of the importance of diet and exercise. However, he can’t ask Americans to take look hard at what they put in their mouths every day. Pissing off 60-70% of the electorate does you no favors!

  3. I find it so perfectly ironic that in our decades long quest for cheaper food, we’ve come up with a food supply that probably causes hundreds of billions a year in unnecessary medical expenses.

    Take the easy way out, and you’ll receive your “just desserts.” (misspelled intentionally to facilitate devastating witicism)

  4. Keith, it may well be true that most people are responsible for their own poor health … EXCEPT… to some degree they’re NOT responsible.

    One large factor in their arrival at that state is the fact that they’ve been following the advice of their doctor and the government for the last 30 years. The “conventional wisdom” has been telling them to cut fats, eat more carbs, sugar isn’t evil (it’s just another carb), etc. The vast majority of people will accept what they’re told by the “authorities”. Say what you will about the culpability of the masses, one thing we all know for sure is that the masses don’t think for themselves. They just aren’t wired that way, and *that’s* not their fault.

    GCBC was a great book for me to read, because it ameliorated my lifelong disdain for the obese. Most of them are the victim of their diet, which was recommended to them by all of the “diet authority figures” for the last 30 years.

    • As with any contentious issue, there is plenty of legitimate fault to be laid at the feet of all parties involved. All sides, IMHO, need to seriously “step up their game”. I’d like to see the President, for instance, in tonight’s address, vow to quit smoking; his way of “taking a needle for the team”, so to speak. That would be quite the powerful gesture.

    • This reminds me of a discussion I was in recently and it’s really arguing two separate points:

      1. Individuals are obese because of social circumstances: parents eating habits, doctor’s orders, television diet guru suggestion, perhaps a somewhat vogue idea of “don’t give a shit” (typical of younger males). This would be an Interior, Collective argument in Integral Theory.

      2. Individuals are obese because of personal actions: they chose to eat the bad food, they chose to listen to authority outright and not pay attention to how their bodies felt after they ate, they chose to keep eating when they were satisfied, or to have that second dessert. This is an Exterior, Individual argument.

      They’re both right, actually. But they’re both parts of a larger problem. Eating habits and caloric intake are to blame; it would be much easier for an obese person to lean up if they reduced insulin, without question. But they’re eating more than they’re letting on, no matter the macro content (as is shown in doubly-labeled water studies).

      Also to blame is that we’re the product of a senate committee hearing deciding how the government is going to create policy regarding eating for health. It’s clearly a failed experiment and the information was sewn out of whole cloth.

      The truth is fluid no question about it.

      Best,
      Skyler

  5. As usual, very well put, my dear.

    Mike, while I agree in part that people have been given their “diet instructions” by the authorities it doesn’t take a genius to figure out that eating fried chicken & stuffing ho-hos in your mouth while 150 poundss overweight & not exercising is not “the authorities” diet suggestions. If it ain’t working you gotta take personal responsibility to change it & find what does work. But that is too much “work.”

    It was my understanding that Obama did quit smoking in order to run for President as an agreement with Michelle Obama for her support. I didn’t realize he had reneged. Thanks for the heads up.

  6. “but because the Swiss and Dutch are culturally of a different mindset. No system can be created that will not ultimately implode under the weight of a diseased citizenry. In the US, attitudes must change. Priorities must be re-arranged.”

    Hence the importance of cultural revolution through mechanisms like this wonderful Web site.

    Culture and mythology trump everything: we live by fiction.

      • Excellent, Skyler.

        Thanks.

        We need (healthier) better stories to live by. Our personal finance and business stories need to have debt edited out (or reduced significantly), for instance, so that we de-leverage in that regard.

        De-leveraging our health system stress requires better fiction to live by in regards to lifestyle. I like Ancestral Fitness; it edits out the debt — calories without nutrition.

        To good health,

        Brent

  7. First and foremost I want to say that I love your blog and I appreciate you putting the time and effort to share your insights and knowledge with a completely anonymous, invisible audience.

    Now I want to comment on your post.

    It’s easy to say individuals need to be responsible for their own health because that is how we want things to be. However, like you said, you believe in things that work. Could I interpret that you believe the inverse to be true; you don’t believe in things that don’t work? The fact is people are not taking responsibility for their health and as a nation we are experiencing the ramifications. The health system isn’t working, at least not up to our expectations. It no longer “fits” our unhealthy society. What is the cause of our societal ill? Are the powerful food corporations responsible by suckling us on their sugary teets? Is it our lack of temperance and inability to delay gratification and instead acquiesce to convenience? Or are we, as imperfect creatures, with all of our wonderful ideas and concepts of conventional wisdom simply incapable of knowing how to manage such a complex system like health care the same way we are incapable yet try to understand and operate other complex systems (the economy anyone?). So what is it? It’s probably all of these and an endless amount of other contributing factors. It is a very big systemic problem. However wonderful the concept of individual responsibility is (and I really do agree that it is likely the most important factor), the truth of it is that the individual responsibility model does not include the myriad of other social factors that play a huge role in influencing the issue of health care on a national level. Individual responsibilty is incredible important, likely essential, but believing that alone will solve our health care problems is choosing to look at the issue with blinders on.

    Thank you for your blog, keep up the good work.

  8. I have to agree with Mike Gruber that people are certainly not solely responsible. I would say mostly not even mainly responsible. I used to believe it was just a lack of will power. The Puritan blaming myself. I ate low-fat according to my doctor for the cholesterol, weight and blood pressure problems since I was 18. I was already in the 300s. My mom’s big and been dieting a long time following the next after the last one didn’t work. When I was young I wasn’t overly big and was into sports. We I started doing the “healthy” eating thing, I started getting bigger. You’re still growing I heard, don’t worry you’re eating right. Two decades of family meals being bulked up by tons of pasta, white potatoes, rice laden with chemical butter substitutes and low fat snacks like pretzels, popcorn and twizzlers (that was at least shorter lived). That certainly didn’t do my body any favors and I hope most of the damage is reversible. Of course, I’m probably genetically leaning that way as my grandparents both died of diabetes and my mom is overweight.

    After a fluke with a new doctor when I moved who told me to cut out some rice and beans (on my low cal/low fat diet) and replace it with some veggies to lower triglycerides, I started doing research. First Atkins who I had been told for years was a quack and that you’ll have a heart attack since I’d been on cholesterol drugs for at least 10 years then. Then research on the internet which certainly wasn’t available. I just couldn’t stop eating carbs, I realize now. Hormones, hunger, insulin. Blaming myself for lack of willpower and being lazy. In fact I still have problems when I eat pasta or pizza now on those rare occasions. You would think I would be able to control myself after losing 100 pounds. Not all the time. Hell I can fast 24 twice a a week no problem. Now, though, it is my fault I know what those foods are going to do to me and that I will have trouble stopping. When I was 353 at least I was 6’4″ (so I didn’t look as bad), active and my mother obese (though she didn’t seem to eat much), I would think about other obese people how did they let that happen. Now I wonder if they will get upset/ignore my advice if I tell them they could lose weight especially when I see their carts loaded with low fat products. These people generally do reject advice because they are trying what their doctor told them or they’ve read from experts. The people who take my advice are generally healthier but have something creep up on them or they get sick, etc. and I point them to research resources.

    Now I need to another 40 pounds or so, but not sure how much the extra skin, etc would account for. I’m transitioning into higher fat and we’ll see how it works.

    Regardless of the blame. The quite from epistemocrat is right on “No system can be created that will not ultimately implode under the weight of a diseased citizenry.” The main problem with this and its getting somewhat better because of people like y’all is the we’re in the minority and will have to lead through example hope people will want to emulate till mainstream health wakes up. I’m just not necessarily convinced the system is broken just overwhelmed and trying to solve problems it should not have to/was not designed to. Medical advances make this more costly.

    Babies and the elderly that would have died years ago are being saved today at enormous costs. Would this be a problem if people ate correctly? I don’t know for sure. I think it would certainly be lessened, but that’s just my guess. Imagine (as I’m sure you have) the reductions in costs that would come from reducing diabetes, heart disease and cancer alone. Prevention not the cure, that I’m sure the drug companies will produce any day so we won’t have to worry about it.

    That certainly went longer than I intended.

      • From the NYT Op Ed piece (Michael Pollan, 9/9/09), cited by epistemocrat:
        “…We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care…”
        and,
        “…To put it more bluntly, the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup…”
        Both of these snippets, and Pollan’s Op Ed in general, support my notion that “No system can be created that will not ultimately implode under the weight of a diseased citizenry.”

  9. Keith,

    Wonderful post and insights! Metabolic syndrome in children and adults has exploded 5 to 10x in the last 10 yrs. How will this burden be shouldered by society in 10 years from now? Or even 5yrs?

    No matter what kind of healthcare system is determined in the next couple of years, I am starting to have a problem knowing that ultimately we as product consumers and taxpayers will be subsidizing someone’s 4-vessel coronary bypass or cancer treatment because they are eating in extremely inflammatory, non-ancestral ways (healthy whole grains and gallons of high fructose corn syrup). Should business owners and the govt, who are the current largest health insurance purchasers, be footing these kind of preventable expenses?

    -G

    • My worry (aside from the overall health of our nation’s citizenry) is that healthcare will slip into the same fiduciary morass as the banking industry (different variables, to be sure; same outcome, however), where, in the words of Nassim Taleb, “profits are capitalized, while losses are socialized”.

  10. Yes, the ‘diseased citizenry’ will suffer for a while even after the ‘losses are socialized…’ I just came back from Costco (our local food warehouse) and though people think the bulk food is ‘cheap’ (eg, ARM mortgages)… they will pay the price later! (what was I there for?? you don’t want to know! ok… books and cheap coffee… Peet’s is just my TREAT *haa*)

  11. Question: what is the protein comparison between protein powder and whey powder? I thought the difference was that the whey contained a lot more but I may be wrong and am not home to check. However, with lots of lean meats that’s not so much of an issue as a protein deficiency in the US is virtually unheard of. You can get your daily requirement just eating cabbage and bread, oddly enough. There is protein in most of what we eat now.

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