Thursday, September 10, 2009

Defending Myself

I really shouldn't have to do this. But with all the newsprint (and internet bandwidth) given over to the "Health Care Debate," I feel I should say something in my defense. "What!" you say? Well, it's obvious.... haven't you heard? Chronic illness is preventable. It's all chalked up to lifestyle choices. And I have three chronic illnesses, so I must be responsible - through my terrible choices - to the high cost of medical care and insurance. (/sarcasm)

It's true. I have three chronic illnesses. But none were related to "lifestyle choices." I don't drink. I don't smoke. I eat healthily and I exercise regularly. But if you read nearly any article about the health debate written recently, there's little differentiation between folks like me, and folks who really have lived a life of debauchery and decadent living (or at least didn't do a good job maintaining a healthy lifestyle.) I did a quick Google search, and found several prime examples.

“Unfortunately, largely avoidable chronic illness- things like diabetes, high blood pressure and heart disease- are a national epidemic. They account for 75 cents of every health care dollar spent. And they're driving up the cost of health care and insurance.” (Blue Cross, Blue Shield, North Dakota)

“These recession-related repercussions could not come at a worse time in the state’s battle against rising health care costs and preventable chronic disease,” said Valerie Fleishman, executive director of NEHI. “Through unhealthy behaviors, people are becoming unnecessarily ill at a time when we can least afford it.” (New England Healthcare Institute)

"Lifestyle choices contribute to chronic illness -- and ultimately higher health insurance costs,"…

“Today chronic illness accounts for two-thirds of a company's health care expenditure, yet 80 percent of all chronic disease is the result of three preventable health behaviors -- physical inactivity, poor nutrition and overeating, and smoking.” (Even During Financial Crisis, Investing in Wellness is Good Business Oct. 21, 2008)

“As a medical student and briefly as an intern physician, I've seen many patients with diabetes, high blood pressure, and high cholesterol. … What's more amazing is how these three conditions are fairly preventable with diet, exercise, and weight control.” (Dr. Anthony Lee, Jan 12, 2008 )

“Less than 1% of chronic illness is truly genetic in nature. Essentially, this means that chronic illness is preventable.” (How our lifestyle choices are causing us to sink into chronic illness, Colleen Trombley)

"On May 12, the Senate Finance Committee held a hearing on health care reform. …They gave the reasons that experts -- on right or left -- always give for supporting this idea [ending the tax exemption on employer-provided health benefits]. …It drives up health care costs by encouraging luxurious plans and by separating people from the consequences of their decisions." Brooks, David. "Something for nothing.(Editorial)." The New York Times 158.54715 (June 23, 2009)

“Most chronic illness is preventable through simple behavior changes, like avoiding smoking and excessive alcohol -- and engaging in healthy behaviors such as regular exercise, more sleep and a balanced diet.” If You Ask Me (column) by Don Riegle | Flint Journal Sunday March 22, 2009

“A core truth about chronic conditions is that most are preventable.” Preventing Chronic Illness Health Affairs, 28, no. 1 (2009): 36

Granted, I didn't vet these comments carefully. But I do quote a doctor, the New York Times, Health Affairs, and an insurance website, among others. It's not a kooky idea dreamed up in someone's basement. It's being said over and over and over again. Another thing these articles rarely do is make that distinction between preventable illness and those that are not. Or if they do make a distinction, it's something like "Less than 1% of chronic illness is genetic." (Which doesn't mean that the other 99% IS preventable, but I'm not going to argue that point here.)

Anyway, to you, my two faithful readers, I beg you... When someone tells you that chronic illnesses are preventable, rise to the defense of those of us who had no control over our diseases. We may share in the blame of higher costs, but it is not due to negligence on our part. And for me, that's a big distinction.


JAG said...

I have been following the health care reform debates a little, and had not heard anyone talking about the effect of the American lifestyle on health care costs. Actually, I think many of the people you quote are quite correct; much disease (chronic or acute) is preventable. Of course, you're also correct that not ALL chronic disease is preventable, and it's likely that far more than 1% is due to factors out of our control. There has actually been a good bit of research into this. According to the research, about 90% of type II diabetes in the US is preventable, about 80% of heart disease, and about 50% of cancer. Because these are all common diseases, and the same behaviors tend to prevent all of them, there is the potential to drastically reduce chronic disease with relatively minor lifestyle changes. But by drastically I mean somewhere in the neighborhood of 75%, not anywhere near 99%. As far as I know, your three are not particularly preventable, though. I can understand your frustration. But just think how much more research money could be spent on trying to cure diseases that CAN'T be prevented if we weren't spending so much on common but preventable ones.

Zana said...

I understand what you say completely, and I agree. What concerns me are when, say, companies like Blue Cross Blue Shield can issue statements like the one I quoted, and NEVER say anything about that 25% you mention. It worries me that some of the ideas I've seen floated call for a health surcharge on folks with diabetes, or whatever, unless they "change their lifestyle". But they never seem to consider/acknowledge those whose illness isn't a lifestyle problem.

Allen Lewis said...

Hi, Zana!

I am new to your blog - you can thank your colleague Chris Johnson of MCJ for this.

This post interests me because I am in somewhat the same situation you are. I do not know if you have any health insurance (I don't; long story), but I can certainly relate to the chronic illness is caused by bad lifestyle choices" debate.

I was born with a severe cleft pallete and hare lip. Fortunately most of those problems have been corrected through plastic surgery. But I still have problems with my hearing and sinuses which have nothing to do with lifestyle choices. I do try to avoid thing in my diet which exacerbate my sinus condition, but much of the problem is caused by things outside o my control - air pollution for one; institutional air conditioning for another.

So these self-righteous "it's all your damn fault that we can't have low-cost health care" statements just drive me up the wall. Especially when they are made by politicians and health insurance companies which are major parts of the problem.

Yeah, just blame the consumers. That is an easy out.


Allen Lewis said...

Oh! Forgot to mention, I love your avatar!!!

Zana said...


Welcome to my blog! 8-)

I'm blessed right now to have a job with insurance. But I also am considered a "state employee" and we in Alabama are always looking in dread to the next set of pink slips.

I've had folks look at me askance when I've revealed my diabetes, and one person even said "did you lose a lot of weight?" ARGH! So what the numbskulls in politics and the insurance companies have said in their "statements" is now being taken as truth by many Average Joes. And that's a scary thought.