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TMFBro (< 20)

Eating our way into pricier health care



September 11, 2009 – Comments (13)

Because I know you're dying to hear my opinion about health-care reform, here you go: Any changes that don't account for personal responsibility is a huge mistake. The fact of the matter is, one of the reasons that health care is so expensive is because, as a country, we're not healthy people. 

An article in the New York Times has some stats along these lines:

"No one disputes that the $2.3 trillion we devote to the health care industry is often spent unwisely, but the fact that the United States spends twice as much per person as most European countries on health care can be substantially explained, as a study released last month says, by our being fatter. Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet.

"According to the Centers for Disease Control and Prevention, three-quarters of health care spending now goes to treat “preventable chronic diseases.” Not all of these diseases are linked to diet — there’s smoking, for instance — but many, if not most, of them are.

"We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care."

In the interest of full disclosure, I read that article while eating a bowl of Frosted Flakes.

13 Comments – Post Your Own

#1) On September 11, 2009 at 11:29 AM, outoffocus (22.84) wrote:

Because I know you're dying to hear my opinion about health-care reform, here you go: Any changes that don't account for personal responsibility is a huge mistake.

Rec just for that statement right there.

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#2) On September 11, 2009 at 12:14 PM, Huayra (< 20) wrote:

I'm from the Netherlands and we of course are also following the whole american healthcare debate. Here in Holland and also our neighbours in germany have a very good system in place via private insurers, but with things like price for the basic care package with all essentials and mandatory insurance and acceptance all regulated by the government.

It works great, no person will ever go bankrupt over illness, as you have a maximum risk of a couple hunderd euro's per year and the emergency care does not have waiting lists as some non-urgent procedures. The total cost spends per person is much less then the US for example and it seems to me that our system is a good compromise in your whole discussions as it is more regulated and better set up then your current system, but not as extreme as the canadian or UK system for example. We don't have to have a public option for example, because the goverment tells the insurers what they can charge for basic care. Then it's up to the individual if he/she wants to have extra insurance for example for dental coverage for adults, children up to 18 are covered under their parents basic coverage. 

Obama seems to understand what needs to be done to get the US back on a sustainable path, but it will mean citizens will have to start paying the bill in the form of higher taxes at some point. There is no such thing as a free ride, although the free ride was extended by increased debt and leverage.. But the house of cards came down in the end..

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#3) On September 11, 2009 at 12:38 PM, Gemini846 (34.27) wrote:

The systems in mainland Europe are much better than the systems in Canada or the UK. Most of the ammo for the wait in line arguments comes from the UK.

I'm sure you've never seen how poorly Medicaid works to know why American's are so aprehensive to allowing the government to ration care or raise taxes. Allow me a few examples:

My dentist told me before she started her private practice she worked in a medicaid shop.  Any procedures other than extraction to a front tooth (non molar) were considered cosmetic including fillings. No basic care (exams, screenings) were covered.

Medicaid covers costs of delivery, birth et, but not many forms of contriception (or voluntary sterilization).

Medicaid covers dialisis, but you have to find a place that will take you, since most of the places know they get more money from private insurers and cash patients.

Lines are reported 40% longer in local area pediatricians (study not scientific - Florida Bay area only) who take Medicaid.

I'm not saying what Europeans have is bad, I'm not saying it can't work here, but I will tell you what I've seen so far is a lot of waste and very little care.

It is also disheartening that programs such as HSA's that are proven to empower people, doctors and reduce costs are not being strongly brought into this argument. Sure those plans might be availible on the "Heath Care Exchange" and I hope they are but I don't understand why we need Government Beurocracy to organize something that the internet could do for free.

Nobody on the left who wants massive coverage is looking at the costs. They are using funny math and statistics only a politician could love to call this program "budget neutral".

I'm so tired of people running around saying "we have to do soemthing, we have to do something". I agree. How about we figure out how to lower costs. Tort reform, pharmacutical advertizing, and most importantly deregulation of state based insurance contracts are a start. You'll know the system is working when you start seeing ads on TV asking people to switch thier health insurance.

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#4) On September 11, 2009 at 1:04 PM, blake303 (28.50) wrote:

+1 rec

Out of curiosity, how much of our health care costs can be attributed to gun violence and how does that compare to countries without well regulated militias? I tried to look it up myself, but google just returns articles about the nutjobs in AZ that brought guns to a health care rally.

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#5) On September 11, 2009 at 1:25 PM, TMFKris (91.12) wrote:

I have to point out that not all fat people are unhealthy to the point of requiring excess health care. (Whatever we consider excess to be, over $1,000 a year? I got no idea. If I don't have kids, can I do something else with the money that would have gone to pay for the birth and all the health-care costs that that new person would require? OK, that's just a pet peeve of mine.)

And not all skinny people are healthy. And not all fat is caused by food and exercise choices. And not all food choices are even choices (Whole Foods is great in theory, but then there's pocketbook reality, even not during a recession).

And the media (the sacred NYT and its writer) bring the same anti-obesity biases to their work as soceity as a whole. 

Basically, fat does not necessarily equal unhealthy.

Here's a link to Kate Harding's Shapely Prose blog titled "Don't You Realize Fat Is Unhealthy?" I think it makes many good points.

Kris (Motley Fool copyeditor); I'm eating a ham (OMG!) and provolone (OMG!) pita with (OMG!) real mayonaise

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#6) On September 11, 2009 at 1:50 PM, TMFKris (91.12) wrote:

I thought of a better way to say what my point was in writing my post: Just pointing out that pareceling out the effects of personal choices on health care costs is going to be fraught with personal feelings, incomplete science, competition for a limited good, and contemptuous, specious rhetoric.

Kris (TMF copyeditor)

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#7) On September 11, 2009 at 2:02 PM, russiangambit (28.67) wrote:

Build the sidewalks and the bikes routes. Europeans and Asians are not fat because they walk. Also, it would be nice to have some sort of portion guidlines. US portions are 3-4 times of the European. Have you seen a European muffin?  US variation is 4-6 times bigger.

As for not all fat people being unhelthy, I think such people think they are no unhealthy because they don't know what healthy is. None of the overweight people I know can run even a mile without stopping. It is hard for them to walk, let alone run.

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#8) On September 11, 2009 at 5:51 PM, Option1307 (30.65) wrote:

Any changes that don't account for personal responsibility is a huge mistake.

I completely agree here with you, personal responsibility is necessary for all aspects of life and it seems to be dwindling away.

I also agree with you that Americans in general are not "healthy". we have a lot of very abd habits and routines which undoubtedly add to our healthcare problems and costs. However, this also touches on another very difficult situation, who is to say/decide what is "healthy"? Obviously this word has many different meanings depending on who you talk to.

I agree we need more personal repsponsibility, I would just point out that this brings up an etirely different set of challanging questions.

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#9) On September 11, 2009 at 6:52 PM, devoish (65.42) wrote:


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#10) On September 11, 2009 at 7:05 PM, devoish (65.42) wrote:

Sign off from the above post.

Devoish: who just fed his kids dinner of homemade tomato soup and meatloaf and a cucumber salad all made from organically grown vegetables, organic eggs, and "naturally raised (whatever that means) grass fed, hormone and antibiotic free meats.

And knows that against flame retardents, bpa, endocrine disruptors, air pollution, water pollution, the above advertising, the cheaper costs and greater availability of junk food, friends and family that did not want to hear it, he has failed his kids and needs Governments and societys help.


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#11) On September 14, 2009 at 11:11 AM, TMFKris (91.12) wrote:

A Newsweek article on being fat and healthy. 8/27/09

I'm reading it now, so can't sum up what it says except that a person can be fat and healthy.

And I agree with Option1307. It would be a quagmire determining what "healthy" is.

 Kris (online copyeditor)


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#12) On September 17, 2009 at 12:45 PM, eldemonio (97.55) wrote:

The Whole Foods Alternative to ObamaCare

“The problem with socialism is that eventually you run out of other people’s money.”

—Margaret Thatcher

With a projected $1.8 trillion deficit for 2009, several trillions more in deficits projected over the next decade, and with both Medicare and Social Security entitlement spending about to ratchet up several notches over the next 15 years as Baby Boomers become eligible for both, we are rapidly running out of other people’s money. These deficits are simply not sustainable. They are either going to result in unprecedented new taxes and inflation, or they will bankrupt us.

While we clearly need health-care reform, the last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment. Here are eight reforms that would greatly lower the cost of health care for everyone:

• Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees’ Personal Wellness Accounts to spend as they choose on their own health and wellness.

Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan’s costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.

• Equalize the tax laws so that that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.

• Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.

• Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.

• Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.

• Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor’s visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?

• Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.

• Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.

Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals. While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?

Health care is a service that we all need, but just like food and shelter it is best provided through voluntary and mutually beneficial market exchanges. A careful reading of both the Declaration of Independence and the Constitution will not reveal any intrinsic right to health care, food or shelter. That’s because there isn’t any. This “right” has never existed in America.

Even in countries like Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce treatments.

Although Canada has a population smaller than California, 830,000 Canadians are currently waiting to be admitted to a hospital or to get treatment, according to a report last month in Investor’s Business Daily. In England, the waiting list is 1.8 million.

At Whole Foods we allow our team members to vote on what benefits they most want the company to fund. Our Canadian and British employees express their benefit preferences very clearly—they want supplemental health-care dollars that they can control and spend themselves without permission from their governments. Why would they want such additional health-care benefit dollars if they already have an “intrinsic right to health care”? The answer is clear—no such right truly exists in either Canada or the U.K.—or in any other country.

Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his or her own health.

Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.

Recent scientific and medical evidence shows that a diet consisting of foods that are plant-based, nutrient dense and low-fat will help prevent and often reverse most degenerative diseases that kill us and are expensive to treat. We should be able to live largely disease-free lives until we are well into our 90s and even past 100 years of age.

Health-care reform is very important. Whatever reforms are enacted it is essential that they be financially responsible, and that we have the freedom to choose doctors and the health-care services that best suit our own unique set of lifestyle choices. We are all responsible for our own lives and our own health. We should take that responsibility very seriously and use our freedom to make wise lifestyle choices that will protect our health. Doing so will enrich our lives and will help create a vibrant and sustainable American society.

—Mr. Mackey is co-founder and CEO of Whole Foods Market Inc.

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#13) On September 17, 2009 at 1:04 PM, outoffocus (22.84) wrote:

—Mr. Mackey is co-founder and CEO of Whole Foods Market Inc

OMG, the "mmmkay" guy on South Park is the co-founder of Whole Foods?  Thats awesome. 

In other news, I wholehearted agree with the reforms proposed above.  MMMkay?

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