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Jun 6

John McClaughry: The Real Health Care Issue – Promoting Wellness – Caledonian Record

The news media are reporting the battle in Washington over the future of ObamaCare, and its proposed replacement American Health Care Act, as mainly a debate over coverage.

This is understandable, but the national debate over health care policy ought to be far more broad. We need to look more closely at why, aside from accidents, people need health care.

Paul Jarris MD was Vermonts exceptionally able Health Commissioner in 2004. At a Snelling Institute conference I attended, Paul told us that 51% of Vermonters suffered chronic illnesses, and 78% of our health care dollars were spent on them. Other estimates of the contribution to health problems of personal lifestyle choices tobacco, alcohol, drugs, obesity, inactivity etc. are in the 40-50% range.

If 40-50% of our health care spending results from poor patient choices, how can we find more effective ways to influence patients to make better choices, and so reduce the enormous expenditures that they are causing?

At a health policy conference in Texas last spring I listened to a persuasive talk by John Mackey, founder and CEO of Whole Food Market. Much of his talk is included in his new book The Whole Foods Diet, coauthored with two MDs.

In it Mackey describes the conference that Dr. David Katz of Yale organized, with 21 well-known advocates for various healthy diets. While differences in emphasis remained, all of the experts agreed that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or nonfat dairy, seafood, legumes and nuts; moderate in alcohol (among adults), lower in red and processed meats, and low in sugar-sweetened foods and drinks and refined grains.

Add to that regular physical activity, avoidance of tobacco, drugs, and liquor, and a positive and rewarding social environment, and you have a consensus path to lifelong health.

Mackey himself is a vegan (no meat, fish, eggs or dairy) but he stops short of promoting that plan. His recommendation is simple: eat whole foods instead of highly processed foods, and get 90% or more of your calories from plant foods.

Mackey tells how Whole Foods Market offers free weeklong wellness immersion programs to its employees. Often these men and women started out overweight or obese, diabetic, or suffering from high blood pressure, high cholesterol, heart disease, and other life threatening conditions. Many have seen dramatic results in even just one week, and have gone on to lose weight and in some cases have completely reversed their diseases.

Why does Whole Foods Market do this? Partly to illustrate the benefits of a whole foods diet along with other positive choices, and partly because Whole Foods Market wants to keep its employees healthy and control their companys health care costs.

The company is far from alone in doing this. In the 1990s Quad/Graphics in Wisconsin organized its own employee wellness subsidiary QuadMed that now manages programs in hundreds of locations. Marathon Health, headquartered in Winooski, provides onsite and near-site health centers and wellness programs for employers at over 130 locations in 40 States. Last month it won the Deane C. Davis Vermont Business of the Year Award.

Creative private sector programs like these can and do influence employees to make good health choices. For people who dont work for enlightened employers, civic and religious organizations like the Napa County (CA) Community Health Improvement Plan and the Blue Zones Project exist that work along the same lines.

Congress needs to make decisions about coverage, to be sure. Any next generation Federal health care policy ought to include income-tested support for catastrophic insurance that reduces the role of third party payments, tax equity for individual premium payers, expanded Health Savings Accounts to pay for ordinary medical expenses, preventive care and wellness programs, state-level innovation for Medicaid acute-care coverage, high risk pools to cover uninsurables, and improved price and outcome transparency to facilitate increased provider competition.

It should also recognize and support private sector health and wellness programs like Whole Foods, and effective motivational efforts that help people from grade school on to identify and avoid the poor choices that will cause them misery, and cost the taxpayers countless billions of dollars each year.

John McClaughry is vice president of the Ethan Allen Institute (www.ethanallen.org).

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John McClaughry: The Real Health Care Issue - Promoting Wellness - Caledonian Record

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