The Health Care Pipe Dream

We occasionally hear and read about the efforts of people in the health care field, mostly academics and bureaucrats, to encourage people to engage in healthier personal practices that will both improve their health and reduce the amount of health care they consume. This, they tell us, is one of the keys to reducing our ridiculously out-of-control health care costs. They want us to watch our weight, exercise more, cut our sodium intake, stop smoking, drink less, eat more vegetables, sit less in the sun, and many other things, some of them reasonable and some of them…reasonable but not reasonable to expect of people.

Heartburn on a bun

Heartburn on a bun

The Curmudgeon thinks a lot of this talk is unrealistic, that even when people know certain practices are better for them they’re not necessarily going to stop doing things they like or start doing things they don’t. The Curmudgeon recalls a time, probably in the 1990s, when the experts were telling us that hot dogs are really, really bad for us and that we really shouldn’t eat them. It just so happens that The Curmudgeon doesn’t eat hot dogs, and when he attended cook-outs and declined offers of poison on a bun, he just told the simple truth: that he doesn’t care at all that hot dogs might cause him health problems 10 or 20 or 30 years in the future but that he cares very much that if he eats one he’ll probably spend a meaningful part of the next two hours… indisposed.

Want more fiber in your diet?  Suck one of these

Want more fiber in your diet? Suck one of these

And he thinks that’s how it is for most people. Once upon a time, for example, his attitude toward getting more fiber in his diet, which he expressed to more than one person, was “If I need more fiber I’ll suck a sock.” Now, though, he’s eating his own words – as well as more fiber: as someone who has diverticulosis that used to morph periodically into diverticulitis and had a foot of colon removed because of it, he keeps a mental count of how many grams of fiber he eats every day and doesn’t stop counting until he reaches 20 grams – and he never fails to reach those 20 grams.

So getting a young person to stop smoking because it may lead to cancer or emphysema 30 years from now is always going to be hard but getting someone to stop smoking because he or she is sick and tired of constantly coughing is much easier.

cold-turkeyThinking about that smoking analogy called to mind the 1971 movie Cold Turkey, which The Curmudgeon is certain he saw in a movie theater with his family when he was a kid. The premise is simple, and amusing: responding to the outcry that smoking is bad, a tobacco company offers $25 million to any town in which everyone – everyone – who smokes will quit smoking for 30 days. Eager not to spend that kind of money – remember when $25 million was a lot of money to a large corporation? – the tobacco company sends an employee incognito to sabotage the town’s efforts and tempt people with cigarettes. Written by Norman Lear and starring Dick Van Dyke, Tom Poston, Bob and Ray, Vincent Gardenia, Jean Stapleton, Paul Benedict, Bob Newhart, and a lot of other pretty funny people, it was a pretty entertaining movie. When you think about it, though, the premise is not unlike this current effort to get us to focus on wellness or what they’re increasingly (and obnoxiously) starting to call “community health:” that we’re all about instant gratification and it’s going to be awfully hard to motivate large numbers of people to give up things they like now because they will benefit from their sacrifices at some unspecified point in the distant future.

And The Curmudgeon says “Good luck with that.”




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