Low Tech Health Care Reform: Stop Smoking!

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Photo: sonofthesouth.net

I have a very simple way to save the government billions of dollars in health care costs, and make Americans healthier, almost immediately:

Outlaw tobacco.

Likely to happen? Not a chance.  The tobacco lobby is way too powerful, and the tobacco states will rally loudly and strongly against it, not to mention big pharma that will see a decrease in revenues as the use of patches, gums and pills goes down.

Okay, next option: tax the poo out of cigarettes.  Currently the average tax by state on a package of cigarettes is $1.19.  The state with the lowest?  Not surprising, South Carolina, where the tax is just $0.07.  The tobacco states  average is $0.33 per pack, while other states average is $1.30.  Pathetic, but it shows that there is a lot of room to increase the taxes, especially in the tobacco states.  There should be a HUGE federal tax on cigarettes.  Likely to happen?  See above r.e. tobacco lobby.

Next option: teach ’em young.  The feds need to mandate a  ‘smoking is bad’ curriculum YEARLY kindergarten through 12th grade.

Last option: We docs keep plugging at our patients.  I’m not so optimistic on this accord, but I’ll keep trying.  Here was my must recent attempt to convince a patient to stop smoking.  I report a conversation I had with a 70ish year old gentleman, on his way to the OR to have his foot whacked off secondary to peripheral vascular disease.

Me:  (earnestly) Mr. Marlboro, what can I do to help you stop smoking? Would it be helpful to have the nicotine patch while you are in the hospital?

Mr. Marlboro: (just as earnestly)  No, I don’t need the patch.

Me: You know, while you are in the hospital, it’s a great time to quit, because you can’t smoke here.  Besides, cigarettes are so expensive.

Mr. Marlboro: Well, I don’t care about the expense.  I’d just spend the money on something else.  Besides, I’ve smoked all my life, and it’s never hurt me.

At this moment, the transport team arrives to take him to the operating room.

Me: (defeated) Oh.

Good luck out there.  Sounds like I need to brush up on my motivational stop smoking speech, as I’m not envisioning President Obama or Mr. Daschle following my suggestions.

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Technology will not save health care, personal responsibility will.

 

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During  President Obama’s speech he stated

“We will restore science to its rightful place, and wield technology’s wonders to raise health care’s quality and lower its cost.”

I completely, totally disagree.  President Obama, health care doesn’t need high technology, health care needs personal responsibility.  America’s health care costs are excessive for several reasons, and most have nothing to do with technology.  America spends 15% of it’s gross domestic product on health care, or from a different perspective,  $5711 per capita.  Our closest big spender?  The wealthy country of Luxembourg,which spends $4611 per capita.  Japan spends $2249, and Italy, where they eat all that pasta, spends $2314 per capita.  Why are we spending so dang much?

Here are the reasons, and they have nothing to do with technology:

  1. We Americans are pigs.  30% of our population is obese.  Note I said obese, not over weight.  We eat in our cars, chow on super sized fat filled “fast food”, and consider opening the refrigerator a sport.
  2. Television watching has morphed into an art form.  The average American watches FOUR hours of T.V. daily! Who has time to watch that much?!  In addition the wii is now considered a way to exercise.  C’mon, gimme a break!  The only way a wii can help you get exercise is when you walk the cardboard box it came in out to the garbage.  (Yes, I have played!)
  3. The Marlboro Man still rides.  Nearly 20% of Americans still smoke.  (Sadly, including our president.)  Those most likely to smoke were those below the poverty level, with the least amount of education, (and the least access to health care).

Sloth is causing Americans to be unhealthy.  High technology will make us more efficient in the way we diagnose and treat illnesses, but it will not prevent them.  Obesity, tobacco and inactivity are the root cause to heart disease, diabetes mellitus, many cancers, and  COPD.  The fanciest technology in the world will not change this.  What will?  America will spend less when we have sweeping cultural changes such that Americans get off the couch, toss away the remote, and spend their money on healthy foods, rather than cigarettes and french fries.

President Obama, I’m glad you’re here, but please, focus on the root of the problem.  Pruning the tree will not change the roots!

Next post: HOW we can create a healthier America with out expensive high technology.

Visit change.gov and let Mr. Obama know YOUR views!

Hats off to a reader that encouraged me to visit Mr. Obama’s website called change. gov.  The reader encouraged me to leave my comments on e-prescribing.  I encourage all of you to visit the site, and let Mr. Obama know YOUR views on health care reform!