Tuesday, February 1, 2011

A Whimsical and Illustrative, If Impractical, Approach To Solving Our Health Care Crisis

It has always been the view of this blog that Obama Care and the politicians that wrote the voluminous and unreadable 2000+ page legislation got it all wrong. They assumed that the problem was escalating health care costs and then wrote legislation to treat this symptom, not the underlying root causes. High costs are an outcome because of other factors.

It is as if the political class is treating a cough but do not understand whether the cough is caused by allergies, the flu, bronchitis, pneumonia, cancer, strep throat, etc. Unless you know what the underlying disease is, if you treat only the symptom, in this case high and escalating health care costs, the chances of success are quite low.

If you look at the literature on the health state of most Americans, you find a consistent pattern:
  • Americans smoke too much.
  • Americans eat too much.
  • Americans eat too much of the wrong kind of foods.
  • Americans do not get enough exercise.
  • Americans in general are getting older.
The first four items in this list are modifiable behaviors. They are the key to getting health care costs under control. Obama, Reid, Pelosi, et al never understood this. They raised taxes and implemented new taxes and fees, they created an untold number of new government agencies, they will criminalize millions of Americans for not bowing down to Obama Care and buying mandatory health insurance for themselves, etc. They treated the symptom of high health care costs as a tax, control, and bureaucracy problem, not a behavior and aging problem. Their chances of success are very small, assuming the legislation ever gets fully implemented and is not declared unconstitutional.

They also did not understand that forcing a human being to do something is never the best way to get something done. If you can make someone want to and like to do something from a behavior perspective, they are 1) more likely to do it, 2 ) do it with more conviction and 3) do it for a longer period of time. Forcing an American to do anything just gets their ire up and robs them of the freedom of choice, something a government should rarely, if ever, do in a democracy.

This is where some creativity and originality may have been a much better approach, in conjunction with modifying behavior relative to good health habits. We got none of this creative thinking from those in charge of Obama Care, it was the same old overbearing, freedom robbing, inefficient government control approach. Maybe they should have looked at the following YouTube video for some of that refreshing new thinking.

This video covers an interesting experiment that was done in Odenplan, Sweden. The video opens with a shot of what looks like a subway area with abutting stairs and an "Up" escalator. In the first part of the video, the overwhelming percentage of travelers take the escalator to get up to street level, very few take the 20-30 stairs up. It is then that a bunch of engineers and others get involved. They transform the stairs into a simulated piano keyboard, with both black and white keys. When someone steps on the stairs, a piano note is generated so that by walking up the stairs it is as if you are playing the piano.

After the installation of the musical steps are completed, the majority of travelers opt now for the keyboard stairs and not the easier escalator. According to the video, the usage of the steps increased 66%. Using the steps is obviously a better health option but a healthier option that people chose of their own free will, not one forced on them.

If Obama, Reid, and Pelosi were in charge of the situation, they would have shut down the escalator, forced people to use the stairs, written a 2,000 page manual on the proper way to use steps and charged citizens a fee to do so. The stairs would not make any sound since the government bureaucracy in charge of implementing the musical stairs would have been bogged down in red tape and never got around to the job.

http://www.youtube.com/watch?v=2lXh2n0aPyw

Now, is it feasible to convert every set of steps in the country to musical steps? Obviously not. However, in a whimsical sort of way it would be cool to do so. Americans would gladly use the musical steps even though it was healthier for them, they would still be free to chose but by using some creativity, the right behavior would occur without new government regulations, without a loss of freedom, without coercion, and without new taxes.

This would have been such a refreshingly new approach, guide, not force people to the right behavior to address and eliminate the underlying causes of high health care costs. If you reduce the demand for health care services because of musical steps or other innovative behavior modification, simple economics would drive down the costs, assuming the supply of medical services was constant.

That is why when you correctly view the issue of high health care costs as a behavior modification issue and not a government bureaucracy and tax issue you see that the solution should be executed from a public health viewpoint. How can you find a way to make good health behavior the right and freely chosen behavior to do? That would have been the creative, innovative, and liberty-wise right approach. It is not the type of behavior we can expect from our political class. We have not had our political class solve any issue from a creative, innovative, or freedom perspective for a very long time.

That is why Step 26 from "Love My Country, Loathe My Government" would have been the right approach. This Step would have put together a panel of very smart Americans, sans politicians and lobbyists, in the mode of the successful Manhattan Project, the Apollo space program, the Military Base Closing Commission, and the Grace Commission on reducing government costs. Let the experts go about defining the true underlying causes to the problem and let the smart members of the panel come up with piano steps-like public health initiatives that modify behavior, address the underlying root causes, allow us to not lose our freedom of choice, not create mega-new bureaucracies, and not waste our tax dollars.

Now, as mentioned above, even if you modify all of the bad American eating and exercising habits, you are still left with the simple fact that Americans are getting older and in all likelihood will need more health care. That is why Step 4 from "Love My Country, Loathe My Government" is also a vital step. This step would funnel resources into solving some of the biggest cancer killers of our time and vigorously attack the problem of dementia and Alzheimer's disease. These are the health care cost causers that will cripple the nation's financial viability unless we can find a way to solve these health issues.

Over time, better eating and exercise habits might mitigate the cancer and Alzheimer's impact but that would happen down the road. With thousands of Baby Boomers turning 65 every day, we must find a way to attack and conquer these diseases to mitigate the impact on health care costs. Obama Care does not make this approach a priority, which is a shame because if you do not solve this disease factor, it does not matter what you do from a taxation, government control, and bureaucracy perspective. The sheer number of Baby Boomers will overwhelm the system from a cancer and dementia perspective.

Thus, as you go through your day, think about using the stairs once in a while and imagine a piano playing every time you take a step. It will invigorate your body with the healthy stair option and maybe invigorate your mind, possibly staving off dementia, if you can imagine the piano steps playing a song as you go up. This will certainly make a bigger contribution to a healthy America than anything in the Obama Care legislation.

As the video says, "Fun can obviously change behavior for the better."



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http://www.cato.org/
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http://www.repealamendment

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