Changes in Lifestyle Could Diminish Health Care Crisis

Craig Stoltz Health Guide
  • The American Cancer Society has determined that raising awareness about cancer isn't going to be fully effective unless people have insurance to detect and treat it. According to a report in the New York Times, the group will spend its whole $15 million annual advertising budget to convey the message that progress against cancer will be limited until coverage is universal.


    It's the sort of plan you want to argue against as soon as you hear it: If the group could spend that same $15 million this year and save even a dozen people's lives by getting them to get mammograms or colonoscopies, wouldn't that be a better way to spend money?

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    [Actually, according to the cold arithmetic of public health, no. To determine whether a prevention or treatment program is worth the cost to society, researchers usually price a saved life at $50,000.]



    A Thought Experiment: Personal Choices and Chronic Disease


    What if instead of arguing against the ACS action, we took it one step further?


    What if the big non-profits used their spending clout to push for movement in the other crisis in American public health, one so big and obvious that it's almost invisible?


    I refer, of course, to the daily personal choice crisis. You know, the tens of millions of unseen Americans--a majority, and far more people than the uninsured--who smoke, overeat, make bad food choices, drink to excess and/or don't get adequate exercise. The ones who don't visit their doctors regularly and, when they do, don't follow their recommendations.


    Over 70 percent of chronic disease--including heart disease, high blood pressure, diabetes and some cancers--is related to lifestyle, aka daily personal choices. Ninety percent of diabetics have Type 2, and 80 percent of Type 2 cases are related to diet and exercise.


    Ninety percent of lung cancer is related to smoking.



    The Power of the Purse


    So what if the American Cancer Society used its funding power to coerce lifestyle change? They could stop funding research into new genetic-based drug treatments until there's "universal adoption" of the 9-servings-a-day of fruit and vegetables program.


    The American Heart Association could quit funding research into new imaging technologies until we fix the "sedentary crisis"--the 70 percent of Americans who don't get sufficient exercise for adequate cardiovascular health.


    The American Diabetes Association can desist all support for islet transplantation research until the untenable level of white carbohydrate consumption dropped by half.


    Obviously this is a mere thought experiment. Medical research is vital, and coercion is usually a poor way to effect change (though it's worked pretty well to curb cigarette smoking).


    But the point is this: A vast amount of public health expenditures, and personal health suffering, are the result of choices people make every day. If someone--somehow--sometime--could figure out an effective way to make sure that the research we already have funded about diet, exercise, behavior change, and medical compliance is put into practice, one huge health care crisis would diminish.


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    This would result in huge savings. Which could then be used to fund universal health insurance coverage.

Published On: September 04, 2007