Sustainability in health care - intentional choice
In my previous blog post on sustainable health care, I mentioned two fundamental aspects of sustainable health - intentional choice and transparency in health care. Let's talk about intentional choice.
When you think of health care, what kinds of choices come to mind? You can choose your doctor. You can choose the hospital that you may prefer. But beyond that, what else can you choose? Can you choose the type of insulin that you'll need for your diabetes? That seems a little absurd right? You wouldn't choose your insulin, that's your doctor's choice based on his or her training. Most of us would delegate that choice to someone who is more trained in the field.
But wait a minute, let's stop and take a closer look at why most people are diabetics. As we transitioned from a pre-WWII agrarian society to the consumer-based society we know today, we've seen a staggering growth in Type 2 diabetes. According to the American Diabetes Association, in 2012, 9.3 % of the US population had diabetes. The total cost of caring for diabetes in the US in 2012 was $245 billion dollars. (1)
Many peer-reviewed medical articles confirm that weight gain is a predisposing factor in Type 2 diabetes. And interestingly, many articles confirm this fact is a somewhat oblique way - diabetes, diabetic nephropathy, and hyperlipidemia can be reversed with surgery - bariatric surgery. (2) When you lose the weight, you no longer have diabetes.
Let's go back to talking about choice. For a great many Americans, obesity and the onset of Type 2 diabetes is a matter of choice. The choice comes down to the food that you eat and the physical activities that you participate in. You can even choose to defer the cost and responsibility of caring for your diabetes to a health care system that is simply - unsustainable.
So what are the deliberate choices, the intentional choices that can be made to create a sustainable health care system? In the case of type 2 diabetes, the choices are obvious. But for most of us, if a choice has no immediate benefit, why should we opt for the more difficult choice? Why choose to exercise when you could be watching television? Why choose to grow your own vegetables when you can pick-up prepared food that's quick and easy?
So what is an intentional choice? Intentional choices aren't always the easy choices. Deliberately choosing the more difficult pathway in your life may actually be more expensive or result in more work. But in the end, it's just about feeling good about yourself - your life, your health, and how you impact the world.
Jeffrey A. Oster, DPM