Three recent articles caught my attention: one on healthcare costs, one on drug addiction treatment and one on transforming healthcare with a simple question. Let me see if I can weave them together.
Geoff Colvin in a recent FORTUNE magazine article, challenges us to ask a very different question about the costs of healthcare. Lifestyle diseases– coronary artery disease, hypertension, diabetes, some cancers –are the root cause of higher healthcare costs. Vast cost savings would result from changing our lifestyle habits. Why don’t we? He opines that:
- No economic incentive (in 1960 we paid for 56 percent of healthcare costs out of our own pocket and 2010, 14 percent).
- It is socially acceptable (being obese is OK), and
- Bad habits are addictive (smoking, alcohol, perhaps “hyperpalatable” foods). So, change the debate from healthcare resource allocation to lifestyle disease reduction.
In the Wall Street Journal Review section, authors Mark Kleiman, Jonathan Caulkins and Angela Howken speak to the failure of our approach to drug addiction, i.e. the War on Drugs. Their focus, supported by very interesting research and ongoing programs, is getting the addicts who have violent or dangerous behaviors off the street. Bring societal safety back to the forefront of the efforts– and not fill our prisons. Solutions, simply stated, are clear, unequivocal, uniformly enforced, with immediate consequences. An example: an individual who has committed alcohol-related crimes must be tested twice a day for alcohol. If the individual doesn’t show up or if a test is positive, immediate incarceration. Ninety-nine percent show up and are sober.
And finally, in WSJ online, Laura Landro makes the case that appealing to patient’s perception of quality of life and personal goals before talking about their blood sugar, blood pressure, or other metrics, opens the door for engagement around healthful behaviors. The key to making it happen are counselors (I would call them health educators) who follow the patients, sometimes multiple times a week. Well-being is more than absence of disease.
So, can we reduce the costs of healthcare by supporting life style changes, with economic incentives and personal goal enhancement and real immediate consequences? It would be hard to put the pieces in place, but it is a nice package.