HEALTH CARE/Joan Retsinas

A Perverse Incentive to Get Healthy

Those New Year resolutions to “get healthy” are generally moribund by February. But this year conservatives can marry their loathing of Uncle Sam to their resolution for better health.

Certainly a large swathe of the electorate loathes Uncle Sam. At least that is the message from the midterm elections. “Less” is the new mantra. Instead of giving Uncle Sam more leeway, a lot of voters want to shrink him, to rein him in.

On the healthcare front, those voters can shrink Uncle Sam and stanch the flow of money pouring out of government’s spigots (and out of taxpayers’ pockets) — while getting healthier. Loathing offers a perverse incentive to keep those New Year resolutions.

Here are a few surefire ways.

• Get a flu shot. The media screams “Ebola Ebola Ebola” on the 24/7 outlets, with coverage of the few hapless souls who contracted Ebola, and the few exposed to it. In one poll, 40% of young adult-respondents thought that Ebola was a greater threat than the flu. But, prosaically, the flu is the prime killer. The Centers for Disease Control and Prevention predicts that this season, more than 200,000 Americans will be hospitalized with the flu; as many as 49,000 may die. ( Yet we can easily protect ourselves. Pharmacies, schools, hospitals, clinics – all dispense free vaccines. The more people who remain unvaccinated, the more people who will end up seriously ill, if not dead – and the higher the healthcare tab. So, to save taxpayer money, get yourself vaccinated. Ditto for whooping cough, tetanus, diphtheria, typhoid, polio. We don’t have epidemics of these diseases because enough of us get vaccinated.

• Get all the preventive tests your insurance will pay for. Cervical cancer, breast cancer, prostate cancer, high cholesterol, high blood pressure – these diseases kill a lot of us; but preventive testing can help identify those at risk. In 2012, 8 million women reported to the Centers for Disease Control and Prevention that they had not been screened for cervical cancer in the past five years. That screening, coupled with vaccination against the HPV virus, can cut the number of cases of cervical cancer. The South reported the highest incidence of the disease. You can test blood pressure and cholesterol at pharmacies. Again, the more of us who get seriously ill, the higher the healthcare tab.

• To shrink the nation’s healthcare tab decisively, shrink yourself. Lose weight. “Overweight” and “obese” citizens run higher risks for a host of diseases, especially diabetes and heart disease. You don’t need wondrous drugs to slim down, just the willpower to change your diet. Eat more fruits and vegetables. Eat fewer “empty calories,” fewer carbohydrates. Recognize that calories count. At the same time, walk, jog, bicycle, dance, and/or swim more. We not only overeat, we under-move. And we pay for the subsequent care, either through premiums or taxes. The healthcare tab for an adult diagnosed with diabetes comes to roughly $13,700 per year, with $7,900 spent directly on diabetes treatment, about 2.3 times higher than would be spent for a patient without diabetes. (That patient, whose physician had urged him/her to lose weight pre-diagnosis, will be urged to lose weight, post-diagnosis).

• Drive safely. Wear seat belts. Don’t drive under the influence of your drug of choice. Don’t talk on the phone or text. Even if your state permits it, don’t do it. Automobile accidents add to the hospital tab.

Last year the nation spent 17.9% of GDP on healthcare, a major chunk of it through government. While we may not be able to change reimbursement incentives, surely we – the electorate that this past election voted to shake off the shackles of government – can take charge of our own health. Ironically, hating government – wanting to shrink a bloated Uncle Sam – might propel us to get healthier. A perverse incentive that might work.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, December 15, 2014

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