Curious

Comment

Comment by Jason Hwang on November 14, 2011 at 8:42pm

My perspective is that the drivers underlying the obesity and diabetes trends are a little less insidious -- our health care system was built to take care of sickness and is just not equipped to encourage wellness. In my research since publication of TIP, I've had a chance to visit with a number of integrated health systems (organizations that are both payer and provider). In the book, we postulated that these systems (which we called integrated fixed-fee providers at the time) should carry the greatest incentive to keep people healthy and away from high-cost care. However, after talking to many of these health systems, I realized that they can do everything right and still have difficulty impacting disease trends like obesity because they don't have jurisdiction over where to build bicycle paths and parks, what nutritious foods are available in restaurants and grocery stores, etc. Ultimately, it takes a community-wide effort that is much greater than any individual silo of health care. Does that mean it's impossible? Certainly not. I've been very impressed by what Dan Buettner has done at Blue Zones: http://www.bluezones.com/programs/vitality-cities/

I would love to see this sort of comprehensive effort implemented nationwide.

Comment by Mary Beth Rosenstiel on November 14, 2011 at 4:15pm

Thanks, Jason.

So, here's my curiosity for today...global dibetes awareness. It simply amazes me that not only the US, but now the entire world is experiencing a chronic disease that is mostly man-made. That is the dramatic increase in DMII has been created by the processed food industry, and now supported by medicine and the pharmaceutical industry. Rather than eliminating the causes of this disease, medicine simply gives a diagnosis and treatment plan, then pharmaceutical companies sell numerous kinds of medicines and machines to  keep it under control. Neither ever addressing the 'cause' because there is big money in only treating the 'symptoms'. All in the name of $$$...because there would be major income losses for all these players if we really eliminated type II diabetes. But interventions that would lead to real change would eventually lead to less need for diabetes medical care and no need for drugs. Not likely to happen because it much too political.

We continue to feed our children some of the worst food in this country while they are in school...the feds provide subsidies for using this food. We continue to brainwash consumers with misleading information, which they believe is true. Overly processed food is the cheapest to buy, and with the economy in a slump, families are trying to make ends meet however they can. The government imposes restrictions on farmers with the kinds of natural and sustainable foods needed to provide truly 'nutritious' meals.

So, I can only see DMII as continuing to be the #1 chronic disease for children & adults, all  because of greed in far too many businesses/professions. That is unless we change how we educate everyone...grade school through university. Maybe if MDs and RNs were educated to help individuals/families make realistic life-style changes, to become true partners in their own healthcare, then maybe children will grow-up healthy and live longer than we will. One can dream.

Comment by Jason Hwang on November 11, 2011 at 2:57pm

Hi Mary Beth, I would love for this website to be a forum for discussing how to disrupt the health care system. Topics are wide open, and you should feel free to post your opinions and thoughts about what we ought to do to fix health care. I'll do my best to respond, and hopefully we can spark some conversation with others here.