..."Let's focus on behaviours. You might think that it would be easy to formulate and implement a set of evidence-based policies to prevent disease. For example, we already know how to prevent or delay at least 80 per cent of heart disease, 91 per cent of Type 2 diabetes, 82 per cent of cancer, and so on.
So why don't we do it? The biggest problem is that there is no money to be made in preventing disease. In fact, anyone who tries to actually prevent disease will meet with strong opposition. Words are OK, just don't try to do it.
Here's an example from the United States. On July 31, 2009, Representative Kathy Dahlkemper introduced Bill H.R. 3472.
Its basic premise was to provide workers with discounts to their very expensive health-care premiums if they began to engage in healthy behaviours. Specifically, insurance premiums would be reduced by up to 20 per cent for workers who engaged in one of the following: quit smoking, lowered their blood pressure to the normal range, reduced their body mass index to the normal range, or reduced their cholesterol levels.
There were no stipulations on how the workers must accomplish these outcomes. They could choose to take medications, exercise, alter their diet or do something else. It was up to the individual. The only requirement to obtain the discount was a note from the patient's family doctor that the change actually had occurred. For example, the doctor would certify the patient's current weight compared to one year ago. To ensure integrity of the system, there would be a fine of up to $1,000 if a family doctor was convicted of knowingly falsifying his or her report.
All of this seems reasonable. In fact, this innovative bill had political support from both Republicans and Democrats. Republicans liked the fact that it reduced the tax burden of citizens, while Democrats liked the idea that it promoted prevention and reduced health-care costs.
It is not every day that legislation can be introduced with such bipartisan support that benefits both workers and employers. In short, everybody would win. So, did this common sense bill pass? Of course not. Who opposed it?
The American Heart Association, the American Diabetes Association and the American Cancer Society.
This incredible situation was recently parodied on The Daily Show, with the headline: Why Did the AHA Kill a Bill Encouraging Healthy Behaviour?
Forbes magazine reported on a Washington lobbyist who was interviewed as to why these organizations used their collective influence to prevent such a positive bill from becoming legislation. According to this insider, the problem was that, "As a general rule, giving everyone a taste of the business is a good idea." In other words, if less money became available for treatment and investigations due to disease prevention, these advocacy groups would require financial reimbursement.
After being mocked on The Daily Show, the heart association issued a statement to clarify its position. According to Forbes, the AHA disapproved of the bill because it "would restrict access to health care to those who need it most, and research has shown that this has a negative effect on health.
"We are working hard to assure access to affordable, quality health care for all".
After reviewing Bill H.R. 3472, no sensible person could conclude there's even a single word toward restricting access to health care, let alone restricting care to those who need it the most. In fact, the title of the bill is: "To provide for health insurance coverage premium discounts for healthy behaviour and improvements towards healthy behaviour."
Quite simply, practitioners and advocacy groups would lose money if there were less disease and, as such, the bill needed to be killed.
That is why we are unlikely to reduce disease incidence and prevalence rates. There is no money in it. In fact, Bill H.R. 3472 was so well conceived that Congresswoman Dahlkemper even suggested that, to ensure impartiality, the program be supervised by the U.S. Centres for Disease Control.
So what happened to Dahlkemper? Various groups worked together to ensure she was not re-elected in 2010. I guess that will teach her for trying to promote healthy behaviour and prevent disease. There simply is too much money involved."
As I've said in the past: without sickness (real or implied), a major part of what's left of our economy would go belly-up. These "disease lobbies" (including the AMA) need a reason to stay in business, so they need clientele. Without sick people to lobby for, and hopefully gain federal funding for, these groups would quickly lose influence power in politics, donations/bequests from dead people and surviving families, and media attention to influence doctors and patients alike. Big Pharma is closely tied to these people for a reason.
To combat this whole mess, all we can do is do for ourselves--nobody's got our backs. Find our own best way to prevent disease (here are my suggestions), and help others find their own way. Remember--three generations of disease avoidance is all it takes to eradicate chronic disease in your family tree, and we're certainly not going to get any help from the government, disease lobbies, Big Pharma, insurers, hospitals, doctors, or anyone else whose livelihood (no matter how remote) depends on you not being well.
In contrast, they WANT us to come in and make ourselves cozy in their little circle of money-making hell--this is why all the fuss about "access to health care." They, in turn, get access to our wallets!
Even politicians are involved--they make raw milk illegal, insist nearly every dairy product sold in this country must be pasteurized, entice farmers through subsidies to produce "faster, cheaper, better" foods that are anything but, make land unavailable through tedious zoning restrictions and ridiculous acquisitions, and worse--tie up land that could be going to grazing or growing in order to "create jobs" with projects such as the John Murtha airport-for-one. They even go so far as to allow for food stamp use in restaurants and fast-food outlets, when the rules clearly state users aren't allowed to buy ready-made foods or hot foods.
It's every man for himself out here. I hope you have a financial and/or health life raft stashed away somewhere...unless you're already in it and rowing for all you're worth, like I am.
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