First, I have to answer a question Dr. Oz recently posed: Do you agree with Denmark’s move to tax fat food – at about 15 cents more for a hamburger and 40 cents more for a pat of butter? And could a similar tax help us get healthier here in America?
Simply put, no, I do not agree with the new Danish fat tax. I do not think a fatty food tax is right. And even if it were right, I don’t think it works. There is a much easier and fairer way to get people financially invested in their own health.
First, the data: Our medical care is twice as expensive as that in Europe and three to four times as expensive as care available in Mexico, India, Japan and China. Why? Because we have two to four times the amount of chronic disease as do Europe and Asia respectively. Why do we have so much chronic disease? Well, around 70% of chronic disease is due to your choices: tobacco use, food choices and portion sizes, physical inactivity and unmanaged stress. Obesity has started to overtake tobacco as one of the most expensive causes of chronic disease, resulting in well over $20 a pound per year in medical costs for the plethora of obesity-related conditions, including diabetes, joint damage, heart disease and cancer. It may even be as much as $60 a pound per year. Each obese American – there are 122 million of us – is an average of 53.5 pounds overweight. That costs the nation between $120 billion and $600 billion in extra expenses. We all share these expenses by way of pooled insurance costs, and those costs kill our job competitiveness by driving up both the costs to our companies and the Medicare debt.
If you have the five normals – that’s normal blood pressure, normal lipids, normal glucose, a normal weight for your height and you do not smoke – your Medicare costs for your whole life are between 33% and 50% of the costs of someone without those five normals. And virtually everyone can have these indicators of good health through lifestyle choices or medications.
At the Cleveland Clinic, where I work, our solution to this financial inequity is to make medical insurance like auto insurance: If you get more tickets (i.e., if you don’t get your blood pressure at an appropriate level), you pay more. Forty cents of fat tax: Who cares? It’s just an inconvenience. But if you’re being asked to pay a few thousand dollars more for insurance? Heck, you’d lean on your doc to make sure you knew how to get your health under control. And that’s what has been happening. Could you do that for Medicare? Sure.
Without the five normals, your cost is, on average, $18,000 - $12,000 more than that of a person with their health under control. But let’s say you lost the weight, lowered your levels and quit smoking. Then, as a reward, I say: Share 25% of the money saved with you, 25% with your doc (Those payments to you and your doc? They only start coming after you’ve achieved the five normals for five years, so the US budget benefits first) and put 50% toward reducing our debt. If you did that, you’d save the government over $1.5 trillion in 10 years and over $3 trillion in the 10 years after that. The results? Budget deficit solved; doctor shortage solved (fewer specialists needed); and the only side effects are extra energy, job offers, and a widespread positive outlook on the country’s future.
Write to those super committee members today and lobby for a new, better system.
Now, moving onto the fascinating Michael Jackson trial.
Dr. Conrad Murray, Jackson’s allegedly negligent physician, has breached common sense and standards of care many times – not having infusion pump, not monitoring appropriately, not having resuscitation equipment. And my take is that if he gave Jackson even 25 mg on the fatal night, he should have been monitoring him intently (but of course, I am a biased anesthesiologist who knows precisely how dangerous these drugs are). So I do think Murray’s actions contributed to MJ’s death. But I cannot wait for Dr. Paul White’s testimony. If they let White talk about standard of care, I would be surprised if Murray is not found to be guilty. It will be interesting if the prosecution gets to ask those questions.
This week's top piece of health news: A Mayo Clinic study published in the journal Pediatrics found that multiple surgeries on children under the age of two can lead to learning disabilities years later – and it may be due to the use of anesthesia. To learn what a parent can do if her child needs surgery, visit www.smarttots.org.