Wednesday, October 26, 2016 “Unhealthy Habits Are What’s Killing Us”

December 29, 2009 by  
Filed under Obesity

I discovered this opinion piece on yesterday (“Unhealthy Habits Are What’s Killing Us”), and found myself nodding time and time again at the key points the author, David Frum (a conservative — and I never agree with conservatives!), was making with respect to health care reform, which is likely to be written into law in 2010.

Political leanings aside, I really recommend reading the whole piece (it’s brief).

But if you’re short on time, the crux of his argument is this: “If you eat too much, exercise too little, drink too much, smoke, take drugs, fail to wear a seat belt or ignore gun safety, there is only so much a doctor or hospital can do for you.”

In other words, personal responsibility is critical at a time like this, when health care costs are soaring and so many Americans are under-insured or uninsured.

And, perhaps most importantly, he doesn’t think any legislation in the works will do anything to improve America’s health.

As Frum notes, “One-third of Americans are overweight. That one single fact accounts for almost 10 percent of all health care spending. At any given moment, one out of six motorists is unbelted. American children are nine times more likely to be injured in a gun accident than children in other developed countries.”

He goes on to say, “If all Americans quit smoking, if everybody wore a seat belt, if gun owners consistently secured their weapons, if we all drank in moderation and abjured illegal drugs and if the one-third of the country that is overweight would drop the extra pounds, those individual actions would do more to improve health and extend lives than any contemplated by Congress or the president.

Some companies, like mine, are trying to help their employees get healthy, acknowledging that a (voluntary) wellness program is an upfront investment in their employees now that will pay dividends later when their employees are taking less sick days and are healthier and less susceptible to illness/disease.

But even the very existence of a program like this lends itself to accepting personal responsibility, something not all Americans are willing to do … or think they even need to do.

As Frum concludes, “As you consider your new year’s resolutions, remember: better habits will benefit not only your family and yourself — but all your neighbors and countrymen as well.”

I’m one of those people who professes healthy living and really tries to live it. But I know not all our readers will necessarily agree that health and wellness are as important as I make them out to be, and so we welcome your thoughts.

How about you? What are your thoughts on voluntary wellness programs? Do you think personal responsibility should be a bigger factor in how we look at health care reform? Where do you stand on these issues?


49 Responses to “ “Unhealthy Habits Are What’s Killing Us””
  1. Joy Manning says:

    The government could do a lot to help improve the health of the American people.

    Did you know that all of those corn and corn-syrup based snack/convenience foods and beverages are essentially subsidized by federal programs? There is a dramatic financial disincentive for farmers to grow things that promote well being, like vegetables. If you haven’t already done so, I highly recommend watching Food Inc. to learn how this happens in detail. This is a core reason why obesity disproportionally effects lower income groups.

    Other government factors include the fact that drug companies are among the most powerful groups in the country. What if insurance were required to cover nutrition counseling and gym memberships the way it covers statin drugs? What if there were greater federal funding for education, enough so that kids could have gym five days a week and that nutrition could be taught in school?

    Personal responsibility is important, something that everyone–even poor, obese people–would like to have. But as a society we have a community responsibility to make a healthy diet and lifestyle a viable option for everyone.

    • mamaV says:

      Oh Joy — don’t even get me going on the high fructose corn syrup (HFC) issue! As a mother of two kids who just recently got educated on the topic, I was HORRIFIED to learn what products contained it;

      Whole wheat bread? Yep, better check the label.
      Fiber bars? Loaded.
      Yogurt? Ditto

      Basically, if our family of four attempted to “get healthy” and buy pure, organic foods –our grocery bill would double if not triple. Trust me, I have tried it.

      On exercise, it would be awesome to have FREE gym memberships. Our gym membership expired in Nov, my husband and I were really concerned that we could not afford to renew — but we did since we have a pact that anything related to health comes first (we have a stack of medical bills to prove it).


      • Joy Manning says:

        I feel compelled to say that I buy nothing that contains high fructose corn syrup and that my grocery bills for my husband and I range from $50 to $75 a week. That does not include the 2 to 3 dinners we eat out a week, but all other meals, including both our lunches, are home prepared. I shop Whole Foods, farmers markets, and buying clubs, and 75 percent of what we bring into the house is organic. The thing is we don’t buy whole wheat bread, we make it. We don’t buy anything prepackaged, like a fiber bar. And when we get yogurt, it’s the plain stuff bought in a large container–we can mix in sweetener and fruit ourselves. (We never have out of season fruit.) We also eat very little meat at home (when we do it is the astronomically expensive pastured variety), but we eat tons of beans and whole grains (very cheap!). Anyway, most people can not eat and shop the way they currently eat and shop, meaning buying the organic analogue for everything on their current shopping list, but you can eat well, organic, and without HFCS, if you rethink your grocery store/meal staples.

    • Meems says:

      I agree with this – I made a lot of changes to my grocery list after reading Linda Bacon’s “Health at Every Size” (she has a section on how preservatives and additives influence our weight and health), but I’m also lucky that my parents are willing to help their grad-student daughter with an increased grocery bill.

    • FreeEternally says:

      I have an ED (borderline anorexic) and my insurance company is refusing to cover seeing a nutritionist because it is not medically necessary or helpful. But, they do cover any drug that I would like to take really well and it is really easy to get medication. If the nutritionist was just prescribing a pill than it would be an approved appointment. Logical? Nope, not so much.

  2. lissa10279 says:

    I actually have wanted to see Food Inc for a while but it never came out here! I will have to wait til it’s on DVD, thanks for the reminder though!

    I do wish for all those things you mentioned, Joy. There really is a disconnect between big pharma and food lobbying groups and what the American public really needs. As you noted so well here, “But as a society we have a community responsibility to make a healthy diet and lifestyle a viable option for everyone.” I couldn’t agree more.

  3. julie says:

    I think most of us have aspects of our lifestyle that are just not healthy (not just food/exercise/smoking), but risky sports, tattoos, etc. However, I really agree with Joy re subsidies and pandering to pharma, Big business has too much invested to allow real changes, both in selling us unhealthy crap, and the drugs that help the symptoms of said crap. I don’t trust the government to ever really get it right, and am not looking forward to lifestyle legislation. I see potential for effects such as SF trying to deal with drug addiction (or not dealing, as the case were): lock them up, punish, but certainly don’t make treatment or rehab widely available, cheap and without outrageous waiting lists.

    OK, very early here, but while I agree healthy diet and lifestyle absolutely should be an VIABLE OPTION, I don’t think it should be mandatory, legislated by our government, who’s doing such a bang-up, (likely more harm than good, boon for insurers but screw the people), job with insurance reform.

  4. greenbunny78 says:

    see, I am a HUGE believer in personal responsibility. But having grown up in the US and now living somewhere with socialized medicine, I have to say, I like this system better. I like that should something happen to one of my kids (*knocks on wood*)- my ONLY concern will be getting them better. Not getting them better and “how the hell am I going to pay for this?”

    And I definitely recommend watching Food Inc. Though I have to say- between that and having read Fast Food Nation- I am not really sure what the heck I am going to eat the next time I visit the states.

  5. I totally agree with accepting personal responsibility for your health. This cocmment in paticular “If you eat too much, exercise too little, drink too much, smoke, take drugs, fail to wear a seat belt or ignore gun safety, there is only so much a doctor or hospital can do for you.”

    However, I still think we need a legitimate public option for insurance. It’s impossible for the average person to afford healthcare, much poorer countries manage their healthcare better than ours and that’s a shame.

    • lissa10279 says:

      I agree. When I lived in El Salvador, I went to the doctor for free. Granted, the facility wasn’t as nice as a doctor’s office here, but the care and treatment were the same and the medicines were a FRACTION of the cost. I’d buy all kinds of medicines when I visited my then-boyfriend (now-husband).

  6. Forestroad says:

    I pretty much agree with the discussion here. I think a lot of times the personal responsibility vs. society/community debate gets mistaken for an either/or proposition. Too little personal responsibility drains the system, but personal responsibility alone is not enough to get people to quit smoking and lose weight in statistically significant numbers, when we are up against pharma, ag subsidies, industrialized food, genetics, big tobacco, etc.

    I think voluntary wellness programs are a good idea, but I don’t think the emphasis should be on weight loss. People get discouraged from doing healthy things bc long term weight loss is so hard to achieve, when I believe the health benefits derive mainly from the behaviors, not the fat itself. I also agree with Julie that we all have our vices, it’s human nature, and trying to make fat people thin might not be a very productive strategy for controlling health care costs.

  7. Meems says:

    I don’t think there’s much I can add. I do believe that health is an individual responsibility, but that doesn’t negate my belief that we need a public healthcare option. Frankly, I believe that we should have socialized heathcare in the United States.

    Even back when I did believe in diets, it always bothered me that my insurance covered only a fraction of the cost, if anything, but would have covered bariatric surgery had I been heavier. I’m very lucky that I now have student healthcare that includes nutrition counseling with someone who seems very weight-loss-neutral, and (as I previously mentioned) that I have parents who are able to help me with the increase in cost that buying natural/organic/cruelty free products costs.

    “Wellness programs” should, in my opinion, include the information presented in “Health at Every Size” and maybe some of Brian Wansink’s research (he wrote “Mindless Eating” – which is fascinating, but focuses far too much on weight in my opinion) about the influence of packaging, presentation, and context in how much we eat. Penalizing people for things that are only marginally within their control (i.e. weight) simply doesn’t make sense to me.

    • lissa10279 says:

      I personally support socialized medicine, but we don’t have it here. But even if we HAD it, I still see a need for some degree of personal responsibility…and that would include promoting access for everyone to fitness centers/nutritionists … not just handing out meds. I don’t think someone who isn’t “healthy” should be given any less care — not at all. I think everyone deserves quality healthcare. But I do think many Americans feel entitled to it without being willing to make changes in their lifestyle. And if it’s for socio-economic reasons (as it often is) we have a big problem on our hands that needs tending.

      • Meems says:

        I agree that wellness programs should involve access to nutrition counseling, subsidized gym/fitness class memberships, etc. People should have access to methods of increasing fitness and health that don’t involve drugs, but I also don’t think we can force “personal responsibility” on others. I mean, how would we even do it?

  8. G says:

    I have a headcold so I’m going to jump in with three issues that spring to mind for me.
    First, I’m fine with it depending on how voluntary wellness is defined and measured. Is this self reported evaluations on overall subjective wellbeing, including mental health, or just all about the numbers – weight, blood pressure, number of mile ran in a week etc?
    And how voluntary such programs be? Some of these workplace initiatives can get competitive and turn what should be a personal endeavour into a public one.
    And then there’s the issue of “personal responsibility” … to whom? Ideally to oneself, but health is not a moral issue. It is my responsibility to myself care for my body with the TLC it deserves, but is it my responsibility to meet health/wellness targets defined by the govt?

    Great post BTW, given me a lot to think about, thank you 🙂

    • lissa10279 says:

      Thanks G!! Mine at work isn’t competitive and isn’t judged; to participate all you had to do was agree to a full wellness assessment and then you were able to use $X for a ton of things related to wellness (physical and mental).

  9. living400lbs says:

    I would feel a lot better about these “voluntary” wellness programs if they didn’t push diets (which fail long-term for most users). Exactly how does making people yo-yo their weight help their health?

  10. I’m probably going to get reamed for saying what I’m about to say, but this is an important argument.

    *How would you feel if someone called you a burden? Or trivialized your rights by equating them with what you cost?

    As a fat person, this is what I think about the argument for “personal responsibility.” That particular phrase comes off as blaming and accusing about a supposed “choice” I make.

    *When did health-care become a luxury? Something for the wealthy, who can afford to be fat.

    *Or something we have to earn? By becoming thin.

    *Or something only the moral deserve? Only if you are willing to become thin.

    *When did it become okay to single out a group and say society shouldn’t have to take care of them? Fatties don’t deserve it because they don’t take “personal responsibility.”

    *When did it become okay to police our behaviors? You either participate in a wellness program (ie loose the fat) or pay more for insurance.

    My fat is not contagious. If I walk into a crowded theater, no one is going to get fat and then die in the next week. I’m not even going to die of my fat in the next week.

    My fat is not illegal. There is no law that says I have to be thin. And all the arguments that say my fat is a burden on society are about cost-benefit ratios. They’re not about me hurting anyone directly.

    Health insurance, to date, is NOT SOCIALIZED. So, the argument about how much of a burden I am, is about a future possibility. Even if it becomes socialized, I pay taxes. I pay into the system for services like health-care.

    And the argument about costing society could be used about ANYONE that requires regular health care. Any disability. Any disease. Any person.

    At this very moment, I’m too fat to get insurance. They would outright deny me, based solely on my weight. Therefore, I DO NOT HAVE EQUAL ACCESS TO MEDICAL CARE. And I consider that denial a discriminatory practice.

    Sure, if I’m dying, I can get emergency services and then expect to have my wages garnished when I can’t pay the huge bill.

    I am fat. I am poor. I am disabled. And I have had my wages garnished because of medical costs I couldn’t pay.

    I believe in socialized medicine because I want EVERYONE to have equal access to medical care. And I don’t want that access to be dependent on my behaviors.

    Even if I was a murdering, alcoholic, drug addict, pedophile, fattie…I still believe I deserve equal access to health care.

    • lissa10279 says:

      No one should feel like a burden; I don’t think that was the tone or intent of the article or my post. You SHOULD have access to healthcare, regardless of your weight, sex, gender, pre-existing conditions, etc. All I (and the author) are saying is that prevention — and teaching healthy habits/changing some habits — could pay dividends for the future. Like you, I do believe in socialized medicine — everyone should be entitled to access. But I also think we do need to step up our own personal responsibilities, too — not all, but many diseases and illnesses could be avoided with better preventative measures being taken.

      • Thanks for your reply.

        You and I come from very different perspectives on this matter.

        I think your line “many diseases and illnesses could be avoided with better preventative measures being taken” pretty well sums up how we disagree.

        I don’t come from the perspective that you can stop yourself from getting diabetes or heart disease or cancer simply by eating right and exercising.

        I buy into the genetic argument. And I have a problem with the idea of prescribing a treatment for the many that is really only effective in the few.

        But, really, my concern is that you don’t see how this kind of rhetoric about cost and personal responsibility is being used as a rationalization for taking away my rights.

        I know that wasn’t your intent. You seem like a nice and rational person.

        But, when you take “personal responsibility” and present it as a “we” statement, then your including ME in that statement.

        That somehow I’m not taking personal responsibility. And that I’m uneducated about healthy habits. And that I fragrantly choose not to change my habits in order to be healthy.

        Maybe I just have as bit more faith in people. I tend to assume that people take “personal responsibility.” And I want others to assume the same of me.

        But, I also come from the perspective that the messages we hear about health are conflicting and confusing. The only reason I have a clearly defined opinion is because I’ve gone out and read scientific articles and research papers.

        To me, it seems like the article you are agreeing with comes from a very pessimistic and judgmental place. The guy is building an argument and it just happens to be one I really disagree with.

        I respect your right to disagree with me. And I think it’s okay if we come from different perspectives. I’m just trying to explain my viewpoint.

        • Darn. I caught that fragrantly typo in my first draft. It’s supposed to be flagrantly.

        • julie says:

          Doesn’t attributing all your health problems to genetics a classic case of not taking responsibility? I have diabetes/obesity in my family, it takes effort for me not to be obese. Alcoholism is genetic, yet nobody tells alcoholics that there’s no point trying to stop drinking.

  11. Bek says:

    I think I have to disagree with the sentiment of this article and this post.
    In Australia we are lucky enough to have a health care system which offers health care to all, it has its faults but when you are sick you can get cared for.

    This reeks of propoganda to keep the health bill coming from consumers pockets.

    There are MANY MANY awful illnesses that are totally random, completely outside of the control of an individual that can devastate families. I see them everyday, and next week will attend a funeral of my 30 year old school friend who had a heart condition and died on Christmas eve of a heart attack, she leaves behind a 2 year old son, there was nothing she could have done to prevent this. I see people with cancer, with autoimmune disease, with mental illness…none of which they have ’caused’

    ‘Lifestyle’ illnesses are on the rise but that is not solely the result of individual actions, there are societal changes that affect it too, more working hours, easy access to ‘convenience’ foods, gadgets that mean we move less. Its not as simple as saying people need to take responsibility.

    A society needs to ensure its own survival and in my opinion that society would be wise to care for ALL of its members! Black, white, thin, fat, gun owners, extreme sports participants, drug users, people with genetic diseases….its a slippery slippery slope to start excluding certain groups from health care.

    Under a conservatie government Australia saw more and more privatisation of the health care system with the politicians sprouting the answer to waiting lists was private insurance. As a doctor in the public health care system I saw the damage this was doing. I am hoping that our new government can rebuild a more socialist health system and also work to close the gap between the life expectancy of Indigenous and non Indigenous Australians.

    Every day I counsel people about what they can do to improve their own health but I think you cannot underestimate the difference that national policy and the health care system can make to the health of a population.

    Healthcare should not be a luxury.

    • lissa10279 says:

      Thank you for your insight, especially coming from a different country’s perspective. It’s greatly appreciated. I absolutely agree, healthcare should not be a luxury.

      “‘Lifestyle’ illnesses are on the rise but that is not solely the result of individual actions, there are societal changes that affect it too, more working hours, easy access to ‘convenience’ foods, gadgets that mean we move less. Its not as simple as saying people need to take responsibility.” — Excellent points.

  12. wriggles says:

    Take it from another outsider for what it’s worth, this article doesn’t support it’s premise very well at all.

    Those AOA statistics don’t fully comply with it either.

    Why for instance are there such weight disparities between black men and women?

    Black men’s rate of increase of overweight starts off 10 percentage points behind black women’s in 1994 and by 2000 ends up nearly 20 percentage points behind.

    In obesity, the increase amongst black women is double that of black men’s, start and finish.

    Are we to believe that black men’s life expectancy-allowing for the difference there tends to be between the life expectancy between men and women- has increased comensurately among black men because they are gaining at a slower rate?

    I’m guessing at a no.

    (In the category of overweight, they’ve gained at a slower rate than any other group mentioned, in the other categories, their gains are similar to others).

    The article claims;

    And Americans do all those things, more than other people. (eat too much, exercise too little, drink too much, smoke, take drugs, fail to wear a seat belt or ignore gun safety,).

    Leaving aside ‘gun safety’ (and you say we in the UK are masters of understatement) and seat belt wearing-how much do they contribute to causes of death overall?

    Do Americans really smoke more than other nations? I’d be very surprised, they can’t smoke more than the Japanese, surely?

    Ditto exercise, isn’t your rate of gym membership higher than a lot of countries?

    As for eating, people eat according to their hunger are Americans hungrier than others? Surely you aren’t less capable of knowing how hungry you are than others.

    As for drugs, he cheekily says ‘take drugs’ then switches to ‘illegal drugs’.

    Now Americans do seem to be more medicated than any other nation, with legal drugs especially, recent cases in the media show they are not harmless.

    As for illegal ones, they are unhealthy as much because of prohibition than anything else, just like everywhere else they are prohibited. If people want to reduce harm, you might have to legalise them.

    I have no idea why you Americans might take more drugs, but I do suspect you are ahead in the kinds of stress brought on by our modern day ways of living, than other countries.

    I also think you are more prone to be ‘proactive’ in terms of health and therefore more likely to go for what is available.

    Which picks up on living400’s point, those things don’t always yield the results they are supposed to from iatrongenic to ineffectual, unexpected consequences are often not allowed for.

    For example, less smoking seems to equal more fatness. Now I’m not saying that’s bad, but clearly Mr. Frum is.

    Sorry, that’s a lot of questions, I’m not expecting you to answer them, but they are worth thinking about before taking the bait.

    Modern healthcare merits closer examination, undoubtedly. Part of that should reflect the fact that there are issues of status regarding healthcare professionals themselves and empowered patients, some of them have a big problem with that as it tends to change the relationship between the two.

    I don’t say this to put them down, but they are sometimes quite antipathetic towards lay people’s attempts at ‘taking responsibility’- a phrase that cannot be taken literally in this context.

    • julie says:

      I don’t think most Americans eat due to hunger. Due to dieting, nutritional misunderstandings, desire to be thin no matter what, etc., people eat to calm cravings, emotional reasons, taste reasons, availability, boredom, etc. Have you seen the portions in most American restaurants? Easily 2-3 meals. I think most other countries diet less, don’t mess with non-fat foods, and eat more intuivitely, (when they’re hungry, what they’re hungry for), but we don’t, not so much.

      I also don’t think we smoke less than many Asians and European countries. Though our rate of gym membership may be higher, that doesn’t mean people go, and we’ve designed our cities to not be friendly to active transport.

      • wriggles says:

        If you click one of the arrows, it tells you about smoking rates from 2007.

        The original article is subscription only, and it says, European countries make up 18 out of the top 20 countries in the survey.

        Japan is no.3, the US no. 41 the UK no 66. Greece is numero uno.

        As for gym membership, as with everywhere else, more join than go, unless that discrepancy is greater in the US, then it’s still possible more American use the gym more.

        You are right that a lot of mal eating is caused by dieting, none of which was mentioned by the article of course and I’d love to know whether they mention this in wellness programs.

        Emotions cannot be seperated from eating, however I think you’re talking about when emotions trigger your appetite and/or hunger. That tends mainly to be a sign or product of duress.

        If that’s the case and it’s occuring in a lot of Americans then it is a societal problem. It’s showing that the forces acting in your society are producing duress in it’s citizens.

  13. Sue says:

    Great blog Lis. Very thought provoking. Since our government is playing partisan games with all of our lives, and health care costs are escalating, I agree we do have to be pro-active in taking charge of what we can. Certainly we can’t predict or have control over every illness or trauma to our bodies, but we do need to take responsibilities for the things we can. A comment to Elizebeth: isn’t it ironic that if indeed you were a “murdering alcoholic…pedophile” incarcerated, you’d have all of the health care you’d need. We take better care of our prisoners.

  14. vitty10 says:

    I live in Canada and I find it appalling that gun violence claims so many lives in the US. And in this day and age I can’t for the life of me understand why people don’t take 2 seconds to put on a seatbelt. These are preventable tragedies.

    As for everything else . . . Well I really wish they would use statistics about how healthy people actually are in reality rather than using statements like “One-third of Americans are overweight.” So? What does that mean? Are they healthy or not? Are there unhealthy thin people? Given that long term sustained weight loss doesn’t work for the majority of people what is the solution? And would that weight loss make them healthier anyways? Would weight gain make others healthier? If the goal really is to make people healthy I think that answering these questions, with actual facts, would be important. Given how much stress people are under these days maybe it would be wise to deal with they myriad of health issues that can cause rather than pointing the finger at teh fatties.

    As for optional wellness programs, I think they are great depending on how they are implemented. I recently cancelled my gym membership for financial reasons, and I would appreciate a program at work to help pay for one. But not if they gauge success by weight loss. I am fat. I had a trainer for 3 years and I’m still fat. That doesn’t mean that I didn’t improve my strength and cardiovascular health. So yes, I did take personal responsibility for my health, but to some people it doesn’t count because I didn’t succeed by their standards.

    I really hope your senators and congress people get their act together on health care and stop pandering to the insurance companies and the right-wing. It’s a crime that in a country as rich as yours that people don’t have equal access. The Canadian health care system isn’t perfect, but at least people don’t go bankrupt because they can’t afford to pay.

    • Meems says:

      The seatbelt and gun safety things have always bothered me, too – my mom is actually a survivor of gun violence, and I really wish the United States would regulate them better and with fewer loopholes.

      It seems to me that using the terms overweight and obese as shorthand for diabetes, heart disease, etc. is part of the whole pathologizing of individual body types. I was reading an article yesterday about how obesity is now considered an illness by several U.S. based health insurance companies. It ignores the fact that 1/3 of people classified as medically obese are metabolically healthy and normal (myself included).

      • Meems –

        I loved that you used the phrase “pathologizing of individual body types.” Great wording.

        Also, you may already know this, but the medical community has a special term for healthy fat people. “Metabolically healthy but obese.” And they have a special term for thin people that have diseases associated with fat. “Metabolically obese but thin.” I stumbled across these terms while reading through medical articles.

        Its just interesting to me that no matter how you look at the use of the term “obese” in the medical community, it is used to mean a medical disorder, such that you might even be able to argue that the medical term “obese” is less about adipose tissue (fat) and more about the whole “Metabolic X syndrome” thing.

        (Wiki says : Metabolic syndrome is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes.)

    • Emily S. says:

      I feel like, right now, articles use the 1/3 overweight, 1/3 obese statistic as shorthand for “and we have diabetes, and we have heart disease, and their knees hurt, and they snore, and they’re smelly too!”. The associations are so strong that you don’t even have to spell it out, “everyone knows” that when you talk about overweight and obese people, that comes with health problems.

      It’s similar to the repulsive statement from SC Senator a few weeks ago about how his state will be hit so hard by health reform, because they have so many black people. He was using black people as shorthand for poor people, and the association was so strong in his mind that he didn’t even think it needed explaining.

      Obviously there are a lot of problems with these assumptions.

  15. living400lbs says:

    Readers of this post may find this piece from the New England Journal of Medicine interesting: Carrots, Sticks, and Health Care Reform — Problems with Wellness Incentives.

  16. Janice says:

    I agree in personal responsibility. I am the first one to go to the vending machine and get those chips that I do not need. That is on me, noone else. However, I also believe that something needs done about healthcare for everyone but I won’t get into that debate. Wellness programs are great if they work and are encouraged. Ours started about a year and a half ago and has not changed. It no longer works to motivate competition. I think as long as they are offered, as long as they provide different opportunities for those involved that they are valuable to both employees and employers. Thank you for sharing the article.

    • lissa10279 says:

      No problem, Janice. I’m sorry your company’s wellness program didn’t work … but I do think it needs to be encouraged. Ours has been.

    • snore belt says:

      The general therapy. Snoring

      The patient treatment to snore according to different reasons for different treatments, the selection of treatment is to determine treatment effect is the most important factor. We four points to present the main method for snoring. First, the general treatment. Weight: obesity is one of the factors caused pharyngeal stenosis. Reduces weight loss of airway obstruction. Smoking cigarettes can stimulate the wine, cause inflammation of the pharyngeal pharyngeal swelling narrow, wine can make muscle relaxation, solitary, thus aggravate obstruction after falling. In addition, the side before sleeping refuses to calm sleep all have to snore.

  17. FatNSassy says:

    Nothing but propaganda. This is an attempt to blame the individual for all their health problems and deflect away for the corporations. Pollution, overwork, stress, medical mistakes, chemicals in food (including that garbage that is passed off as “diet” and “health” food) all take tremendous tolls on our health. Yet MSM never gives nearly as much attention to those issues. We know for a fact that stress, lack of sleep, and overwork cause weight gain, metabolic disorders and diabetes. Where in MSM do you hear harping that Americans are among the most overworked people in the Western world? No, it harps on portion size and sedentary lifestyles so the average t.v. fewer will never look beyond their own guilt to see the big picture.

    This is not a slam, but my honest opinion as a sociologist. I would naturally distrust anyone who wrote this article, or agreed with it uncritically. It is either someone who is paid propagandist, or someone who has so internalized the guilt they have become their own worst enemy. And we know how disastrous manipulation of guilty can be; it is how clergy got away abusing children for centuries. The parishioners were so blindsided by their own sins, they never questioned their leaders.

    p.s. I happen to weight 220lbs and not ONE OUNCE is extra weight. My body fits in to the natural range of diversity Mother Nature intended, and it the author is not bright enough to realize the weight standards were influenced by Pharma to sell more pills, he loses all credibility with me!

  18. Sue says:

    “The lady doth protest too much, methinks”. Lots of defensive comments to this article and very few that acknowledge that we all make choices, and need to take responsibility for them. I am overweight, I know that and I know that I need to do something about it. That’s it in black and white. The article said : “If you eat too much, exercise too little, drink too much, smoke, take drugs, fail to wear a seat belt or ignore gun safety, there is only so much a doctor or hospital can do for you.” What is it about this view that is so offensive to so many? I don’t get it. I am very angry at the state of health care in this country. For the past year, I have been unemployed and using COBRA to keep my husband and I insured. The price of this coverage per month is MORE than one of two unemployment check each month and we are struggling. To top it off, my husband now has diabetes and was told he needed to see a nutritionist which is NOT covered by our insurance. Does that tick me off? Absolutely. Can we afford to pay out of pocket? Absolutely not. So I go on-line and find out what I need to change our way of eating. It is what it is. The bottom line though is that we both need to lose weight and I don’t care what any of you say….added weight in adults can screw things up internally and IS one of several possible causes of type 2 diabetes. According tho the NDIC (National Diabetes Information Clearinghouse)
    “This form of diabetes usually begins with insulin resistance, a condition in which fat, muscle, and liver cells do not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. Being overweight and inactive increases the chances of developing type 2 diabetes.” Ya’ll need to take your heads out of the sand and admit that although our health care system is failing us, there are SOME things we can take control of and need to because waiting for the system to chanhe isn’t going to help any one of us.

  19. Sue says:

    Correction – I meant to say “waiting for the system to change”.

  20. electronics says:

    You’r completely right on this blog!!

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