An Ounce of Prevention and a Pound of Letting Go

by Paul Deaton

“After
eight hours of lifting barrels, about the only thing I felt like doing
after work was hitting the tavern when it opened at 6:00 AM and then
heading home to crash and sleep.“


Something seems missing in the current discussion regarding the health care bills in congress, and it is significant.

I first understood the words “sick care” in 2007 at a public health conference in Columbus, Ohio. Dr. Julie Gerberding, then director of the Centers for Disease Control and Prevention, laid out the human lifecycle of dollars spent on health care in the United States, with its focus on treating diseases once they are diagnosed. Most of the current health care dollars are spent on people who are sick, thus “sick care.” According Dr. Gerberding, $300 million spent in disease prevention would represent a big step in reducing the overall cost of health care, if congress were willing to appropriate the funds. The cost of treatment of cardio-respiratory disease, diabetes and lung cancer would be less, if treated early. This makes sense and it appears that congress will do something to fund preventative health measures in their reform work.

Where the discussion of “health reform” and “prevention” has gotten off the track, is in the implied and stated discussion that “people need to have better control of their behavior” regarding health. John Mackey, CEO of Whole Foods, Inc. recently stated this argument succinctly, “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.” The argument asserts that people are lazy and if they applied themselves, we wouldn’t have this health care problem.

Baloney! When I was in college, I worked for two summers in a meat packing plant. It was a union job, paying $4.04 an hour, and I worked the graveyard shift cleaning up after the day’s production. One job involved cleaning 65 pound stainless steel barrels. After eight hours of lifting barrels, about the only thing I felt like doing after work was hitting the tavern when it opened at 6:00 AM and then heading home to crash and sleep. Going out to jog, bicycle or exercise was not in the cards because I was too tired and most of the rest of the day was spent getting ready for the next shift.

The idea that working people are too lazy to care for themselves is preposterous. When a person makes a commitment to work for a company for wages, on a regular schedule, there is a significant sacrifice in lifestyle and control of the work life. A culture of “jobs” and the work life it engenders may well be a significant part of the health cost problem. Politicians say they want to create jobs, and a majority of people want a job, but this aspect of work life can be problematic and is not being addressed in the current discussions about health reform.

Put this in context. Childhood obesity has become a significant issue regarding the health consequences and related health care costs it is expected to create in the United States. Children are not to blame for this epidemic. From an early age, they are barraged with messages about processed foods, sugary drinks and sweet and salted snacks. Combine this with less time “playing” outside and more time in sedentary activities and no wonder there is a problem.

Parents love their children and want to do right by them. In a life of “job culture,” their time outside the 10-12 hour workday commitment to their job is limited. Combine that with the extracurricular activities at school, family relationships and household chores and the idea of changing behavior seems near impossible. It is accomplishment enough to get through a busy day.

Processed foods are convenient and family gatherings are simple pleasures that are hard to deny. If there is a cooler of inexpensive drinks and a bowl of salted or sweetened snacks, then we feel we have earned the right to these things. Besides, the advertising dollars spent to promote processed foods tells us it’s alright to consume them, and frame up arguments that these food products are “all natural” or “healthy.” While the idea to “eat fresh, eat local,” or as Mackey says, “make healthy lifestyle choices” may help reduce the incidence and severity of childhood obesity, it is simply not in the cards for most families where both spouses work a “job.” Add on the misinformation about taxing foods that are bad for us, and it is no wonder people are frustrated with the legislative process related to health care.

At some point, we need to let go of the politicians and let them govern regarding health care, health insurance, health reform, health care reform, health insurance reform, or whatever we currently call the complicated and multi-faceted pieces of legislation that are driving the mainstream media frenzy around this story. As a people, we seem to be keeping politicians on a very tight leash, to the point that it may be counterproductive.

~Paul Deaton is a native Iowan living in rural Johnson County. Check out his blog, Big Grove Garden.