don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

Doctors can be frustrating. You wait a month-and-a-half for an appointment with one and, when you finally get in, the doctor says, "I wish you'd come to me sooner." (An anonymous lament seen on the Internet.)

Happy Labor Day. I hope you are well today and stay that way forever or as long as possible, whichever comes first. I wish you good health for two reasons: 1) It's a richer and more enjoyable way to be alive and 2) you probably can't afford to get sick. I know I can't, and neither can at least 40 million other Americans without health insurance.

Maybe it's time for someone to lead a grass roots movement to eliminate the entire business of health insurance. I don't want to lead such a movement -- I have my hands full running for mayor of Tampa while trying to remain competitive in triathlons, writing these daily "Don's Reports" and looking after my busy social life! Yet, it may be time for a grass roots leader to step forward and lead an important movement. If enough employees decided it was no longer in their interest to pay exorbitant health insurance (actually, sickness care) charges and other purchasers of this failed program came to the same conclusion, health insurance as we know it could end --- and maybe we could move to universal coverage, like most of the rest of the more or less civilized world.

Take a look at the trend line for health insurance:

What's wrong with health insurance, other than the fact that it costs too much? Well, for starters, it subsidizes all the wrong things. For those who live a healthy lifestyle and have pretty good genetics, it is not as good an investment as other ways you could find to utilize the same amount of money to improve your life situation. Ending such insurance would lower medical costs dramatically and thus moderate a significant threat to the viability of the U.S. economy.

Why would the U.S. health system be less expensive without health insurance? Quite simply, because if people had to pay out-of-pocket for the medical care they use, they would use, and eventually need, much less of it. Furthermore, they would raise a ruckus when costs increased or were added inappropriately.

Dick Marlowe, a columnist for the Orlando Sentinel, once proposed eliminating health insurance, which he termed a "something-for-nothing idea that hurts health care." Marlowe compared the use of medical insurance with an all-you-can-eat restaurant deal, where the incentive, of course, is to overeat. Ditto the inducement with health insurance. The insured go for too many tests, submit to questionable procedures, endure too much doctoring and otherwise equate more with better, since the cost is more or less the same either way and, what's more, it's covered by insurance and "now's my chance to get my money's worth!" Unfortunately, more doctoring is not the same as, nor does it lead to, better health. More doctoring never will be the path to improved health status. In fact, it is more likely to lead to just the opposite! Why else would there be a term like "iatrogenic illness?"

Of course, Marlowe's proposal only went part way toward a system that would be less expensive and twice as effective. What is most needed is an alternative to the frayed safety net that health insurance represents. There is only one way to do this. A way must be found to provide a full-scale incentive program that will motivate citizens to stay healthier by choosing wiser lifestyles! By discouraging gross habits (smoking, alcohol abuse, sedentary lifestyles, living with unnecessary stress, eating too much fat) and encouraging people to add positive elements to their lives (more fun, more passion, more affection, a better balance between work and play), vast numbers of Americans might not get sick so often in the first place. Thus, they will not miss health insurance and have little use for doctors, save for special occasions (if hit by a bus or the usual problems associated with getting really old and beginning the active dying process, for examples.)

Such a plan must not rely solely on reason and excellent programming, however invaluable these qualities are. Persuasion-based educational approaches only work with those predisposed to sensible lifestyles. The reformers must include incentives for wellness that appeal to all elements, especially those with the sorriest lifestyles! Pay Americans to swim, bike, run or whatever they might be induced to do daily to improve their wellness vital signs -- that's the key. These wellness vital signs can be of a physical nature or have a psychological dimension. The former might include body composition and recovery heart rate; the latter might entail an individual's humor index, stress skills, sense of balance merit badges, and the like. The payoff incentives could take the form of tax breaks for those who voluntarily use designated wellness centers (where pre and post-testing for wellness values would be tracked and reported.)

Another incentive could be subsidies to defray, or substitute for, out-of-pocket costs for medical services. Regrettably, even with a conscious, wellness-oriented populace, people will still suffer injuries and illnesses, but at a minuscule level compared to the current levels wherein society is visited by a plague of worseness lifestyles.

What do you think of this idea? Think there might be something to it? I'd love to hear from you. Be well.

(Note: This essay will be filed in the archives in the MENTAL DOMAIN under the skill area of effective decisions. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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