Archives for March 10, 2010

One obvious way to lower medical expenses is for people to exercise more, eat better, and give up harmful vices such as smoking and excessive drinking. While some medical expenses do arise from accidents, disease and other factors that cannot be easily avoided by a healthy lifestyle, a significant portion of costs arises from what can be best described as poor life choices.

From a rational standpoint, exercising, eating better and giving up harmful vices makes perfect sense both individually and collectively. For the individual, there is an overall increase in the quality of life as well as reduced costs in terms of health care and the price of vice (for example, vices like smoking tend to be rather costly). Collectively, this puts less burden on health care (public and private), increases work & school attendance, boost productivity and so on. On the downside, the more people who take this approach, the lower the income from “sin” taxes and the lower the income will be for people who work in health care and providing for the relevant vices.  However, the gains would seem to far outweigh the losses.

Unfortunately, most people are either not rational or lack the will to act upon their rationality (that is, they prefer laziness and vice to the better alternatives). While folks do turn to self help books (which do nothing), diet pills (which generally do not have a lasting effect), and other “quick fixes”, few folks do what it really takes to be healthy. This is because, as Aristotle would say, the temperate and hardy life does not appeal to most people. Aristotle’s solution was to use the compulsive power of the state to make people virtuous. This is not, of course, a viable option here in the United States. As such, appeals to reason and compulsion are out.

Perhaps the most realistic option is to make use of factors that do tend to sway people, such as emotional appeals, celebrity endorsements and so forth. If, for example, we could tap into the motivational power of Glenn Beck and Sarah Palin and use that to get people to exercise and eat better, then that would be a good start. While Beck looks like he could benefit from a fitness program, Palin is already and runner and in good shape. If she started adding a pitch for running as one of her talking points, I think that might get a person or two off the couch and onto the trails. I think that healthy living is something that could enjoy bipartisan support.

Of course, even if Palin was able to get some folks off the couch, the hard part is keeping them upright and away from the Cheese Puffs. I’ve been in running for decades and have lost count of the people I have seen start fitness programs only to end up unable to escape the couch.  I know what keeps me motivated, but I also know that most folks lack this quality (or fanaticism). To be honest, I do not know what would keep most people on the right track (aside from compulsion).

While this healthy lifestyle seems good, one possible concern is that healthy folks live longer. As such, rather than dropping dead, they will keep going on for quite some time. The problem is, of course, that at their advanced ages they will start eating up health care resources to keep them going.

While this is a reasonable worry, the fact seems to be that people who live longer because of good health tend to not be a burden even in old age. For example, I know many people from running who are, to blunt, damn old. Yet, they are very healthy and tend to have very modest medical needs (far less than folks who are younger, yet unhealthy).  Even if old healthy folks do consume more health resources than unhealthy dead folks (who would consume none), the overall savings would seem to be  a net gain. That is, the lower expenses in the younger years would offset any extra costs accrued because of the longer life.

Naturally, folks will probably point out that older people can be expensive to keep alive. However, these costs generally are for people who did not lead healthy lifestyles.  Keeping someone going who did not take very good care of himself can be rather costly, but someone who has been very active in her own health will probably be far cheaper to maintain.

So, I say to my fellow Americans: put down the Cheese Puffs, put out those cigarettes, and get out there and run like your life depends on it. Because it does.

To quote a great philosopher: “Dying like a fatty is no way to die, people.”