Is it better to spend more money on fewer people if we all benefit in the end?
Last week I heard a former healh-care executive now in the power business (a seemingly odd transition, but since we have a competitive power sector in Texas, both are essential services) say that two-thirds of health care costs in the U.S. are due to diet, lack of exercise and smoking, so "If people quit smoking, ate less fast food and went for a walk every day, we'd save billions." Then I read an article in a recent New Yorker about data-driven health care. Digging into billing records (becase actual patient records are not digital and are not available for this kind of analysis) the analysts discovered that a very small percentage of patients accounted for a very large percentage of costs. That reminded me of another New Yorker article by Malcolm Gladwell that did the same analysis for homelessness. The conclusion is that spending more on prevention especially for those who either are or are likely to become the highest-cost consumers of medial or social services reduces costs and delivers better care. However, the political cost will be high because it directs scarce resources - health care and social service dollars - to people who superficially 'undeserving.' While society gets a long-term benefit, some individuals get a greater immediate benefit seemingly at the expense of others. It is more acceptable to spend millions (read the article - it is millions) providing ineffective treatment to a person in crisis than to spend thousands preventing that same person from getting to that crisis. We'll pay for someone with chronic asthma to visit the emergency room, but not for a health care or social worker to check in on them to make sure they had and are taking the medications (or making the life changes) to keep them out of the ER.
I'm not sure how to translate this to policy, but at least I can work on my own stuff. So - I'm tracking what I weight and what I eat on livestrong.com. Today I'm at 205.5 lbs. Until Valentine's Day, it's no alcohol and cutting red meat drastically. I exercise with the Rummel Creek Men's Bootcamp and Social Club two or three times a week. Two friends and I are signed up to run a half-marathon in Upstate New York in September in honor of my 50th birthday. Yesterday I jogged 5 miles with Anthony - took about an hour and my right leg is just a little sore. I don't smoke and I take my cholesterol meds every day.
We'll see how it goes.
