At what point should an individual take responsibility for his health, and should there be a financial incentive/disincentive to influence that lifestyle?
I recently had the opportunity to travel to Annapolis, Md., for a weekend trip. Annapolis is an old historic town on the Chesapeake Bay. It is the home of the state capital, the U.S. Naval Academy, and, during the winter of 1783 to 1784, it served as the temporary capital of the United States. On my way back home, we decided to visit Fort McHenry in Baltimore, Md., which recently celebrated the 200 anniversary of the Battle of Baltimore, waged in 1814 on September 13 and September 14. That battle, part of the War of 1812 with Great Britain, is noted for the inspiration of our national anthem, Frances Scott Key’s “The Star Spangled Banner” - “Gave proof through the night that our flag was still there.” Yes, I like history.
In any event, on our way to Baltimore, we stopped at a typical strip mall diner for breakfast in the town of Pasadena, Md. While eating breakfast, my friend and I both observed and commented, that many of the patrons were - sorry to be frank - obese. I really do not know anything about the town or the area - the demographics, schools, workforce, average age, etc., but the patrons that were enjoying breakfast at the diner in Pasadena were not very healthy looking. The sad part was their children were eating the same food, and many were already obese.
A discussion regarding diet or lifestyle issues on a national level should also include a discussion on insurance, premiums, high deductibles, and also Obamacare. It is also appropriate and timely to discuss one’s individual responsibility when we all, (government, businesses, individuals), pay a lot of money for healthcare.
Last year, the former Mayor of New York City, Michael Bloomberg, attempted to “implement” dietary behavioral changes to the citizens by banning the sale of “big gulp” sodas at New York City movie theaters. A local judge decided Mayor Bloomberg “overreached” his legislative authority level and the law was never enacted. Bloomberg did ban cigarette smoking in bars earlier in his tenure.
On a national level, the FDA recently announced it will require restaurants with at least 20 locations, to display the calorie count of food items on their menus. “While no single action can fix the obesity problem, the step we’re taking today ... is a really important one for public health,” said FDA Commissioner Margaret Hamburg.
While one may argue that it is not the government’s responsibility to dictate lifestyle, the question stills remains, at what point should an individual take responsibility for his health, and should there be a financial incentive/disincentive to influence that lifestyle?
Numerous studies have linked poor diet, cigarette smoking, lack of exercise to diabetes, coronary heart disease, cancer, etc. Why should an individual who has a healthy lifestyle, with no visits to the doctor, hospital, clinic, pay the same insurance premium as someone who has a poor lifestyle, with multiple visits to the doctor, hospital, and clinic? When I purchased auto insurance for my daughter, her premium was greater than mine since “statistically” young adults have more accidents. When someone purchases life insurance, premiums are higher for someone who is a smoker.
I would suspect that if all those folks who were enjoying pancakes/syrup with sausage, danishes, and chocolate milk at the diner in Pasadena were asked to defend Baltimore against Great Britain in 1814, the Union Jack would be flying over Annapolis and not the Stars and Stripes.
Cognitive Biases in Healthcare
September 27th 2021Physicians Practice® spoke with Dr. Nada Elbuluk, practicing dermatologist and director of clinical impact at VisualDx, about how cognitive biases present themselves in care strategies and how the industry can begin to work to overcome these biases.