Carole Carson

Political Promises, Healthcare and Our Big Fat American Deficit

On September 11, 2008, the U.S. budget deficit reached an all-time high of $9,682,116,996,293.84. Servicing this debt requires around $500 billion annually, give or take a few billion. And like the addict who needs another fix, we continue to spend. This year, experts estimate that an additional $410 billion will be added to the big fat American deficit. Moreover, because of the rocky economy, less revenue from taxes may cause these numbers to rise.

The United States is currently spending 16 percent of its gross domestic product on healthcare. This figure will probably expand in tandem with the expanding waistlines of overweight and obese Americans, whose numbers now total two-thirds of adults and one-third of our offspring. Surplus weight results in health problems that translate into additional medical costs. Consequently, the direct and indirect economic costs of the rising numbers on the bathroom scale are sobering. Individuals, insurers, employers, government programs (including Medicaid and Medicare) and county, state and federal governments pay for direct costs. And as most individuals and employers know too well, insurance premiums are rising. The average annual premium for a family of four is over $12,000.

Indirect costs are harder to measure yet just as real. They reflect the loss of income resulting from absenteeism, sick days, restricted activity and premature death.

I wrote about this issue in an article titled "Political Promises, Healthcare And Our Big Fat American Diet" that appeared September 3, 2008 on basilandspice.com and included a summary of the solutions to the healthcare dilemma proposed by the two presidential candidates. Go here for the full article.

McCain proposes a $5,000 tax credit to help uninsured families afford coverage. He also proposes taxing employer-subsidized medical insurance. McCain believes that improved management of the healthcare system will trim costs.

In contrast, Obama’s priority is obtaining coverage for the 45 million uninsured Americans at an estimated annual cost of $65 billion. Like McCain, Obama assures voters that better management of the healthcare system and cost controls can lower the annual insurance premiums to an affordable level of $2,500 for a family of four.

Both of these candidates agree that the healthcare system needs attention. Although they disagree on the means, both want citizens to have access to affordable healthcare. Without being drawn into the merits of either candidate’s proposals, we can focus on three fixes that can help us become more fiscally and physically fit (FIT):

F: Fix the medical model. Instead of reimbursing physicians and hospitals $250,000 for a single heart surgery, fund wellness and prevention programs for 1,000 people at $250 each. That’s the perspective of Dr. Nick Yphantides, author of My Big Fat Greek Diet and the poster child for what an individual can achieve when lifestyle changes occur. Once a big man (he weighed nearly 500 pounds) with an even bigger heart, Dr. Yphantides now weighs 237 pounds. He uses his personal example with his patients and members of the community to promote healthy lifestyles even though it would be more lucrative to focus on the treatment of medical problems arising from lifestyle choices.

I: Intervene in the lives of individuals to cut through denial. Alabama is experimenting with a stick rather than a carrot. State employees will be fined $25 if they fail to make lifestyle changes that address health and weight issues. Although most of us prefer a carrot to a stick, some of us may need the sting of a stick to wake us up.

T: Tackle the issue of fitness as a community. We need to change the environmental cues that encourage us to overeat and underexercise into ones that encourage us to eat more healthfully and exercise regularly.

Communities can adopt successful group weight-loss programs such as the Nevada County Meltdown, where over 1,000 people lost nearly four tons in eight weeks. Or communities can introduce Dr. David Sabgir’s model, the Walk with a Doc program in Lewis Center, Ohio. Each Saturday at 8:30 a.m., Dr. Sabgir and other physicians and medical-care providers walk with about 175 to 200 patients, family and friends.

How I cast my ballot once inside the voting booth this November is a private matter. Publicly, however, I have no problem sharing my ideas on how we can enhance the health and well-being of friends, family and neighbors. As a by-product, we can reduce the cost of healthcare and help lower the national debt.

My own medical cost-containment program is to lead a healthful lifestyle to render expensive medical care and prescription drugs unnecessary. And my tongue-in-cheek goal is to die a natural death without the help of a doctor.

Healthy Aging—for Kids?

One potato, two potato, three potato, four.

Kids won’t live as long as their parents did before.

This lighthearted chant conveys a serious message: today’s children may be the first generation to suffer more health problems and live shorter lives than their parents will.

September is national Healthy Aging Month, and the traditional focus of this health promotion has been on adults 50 years or older. But in light of the downward trend in longevity, the concept of healthy aging needs to be applied to everyone—even children.

I wrote about this issue in an article titled “Healthy Aging—for Kids?” that appeared on Gabby Reece’s Web site

on August 24, 2008. Go here for the full article.

Whether we’re teachers, friends, parents or relatives, we can help children get FIT and preserve their option to age healthfully. Here are three FIT tips:

F: Feed your children home-cooked meals that include vegetables and fruit. Fix family favorites but reduce calories—for example, replace oil or butter in baked goods with applesauce. Fill your cupboard and refrigerator with healthy “fast foods” (for example, bananas, apples, hard-boiled eggs, whole-wheat bread, raisins and carrots) that kids can grab and eat on the run. Find games to play either indoors (Wii Fit or another exergame) or outdoors that will get your family moving.

I: Inquire about the calories and content of restaurant and processed foods and check specifically for fat, trans fat and sodium. Involve yourself in parents’ groups promoting healthy school lunch programs. Initiate family rituals that include a nightly family dinner. Introduce concepts about portion size and caloric content. Invite your children to help you cook.

T: Teach children about nutrition. For example, discuss the importance of drinking milk to build strong bones and eating fresh fruits and vegetables to provide needed vitamins, fiber and nutrients. Track your family’s screen time (video, television and computer) and set a limit on use. Take time to participate in fun physical activities with your kids and show them by example that exercise is important.

Raising children is a daunting yet fun-filled challenge. Whether we’re a parent, relative, teacher or physician, we have one goal: to develop children into fit, productive adults. To assure this happy outcome, all of us must adopt a healthy lifestyle. We’re never too old—or too young—to focus on fitness.

Five potato, six potato, seven potato, eight.

We need to help kids change before it is too late.

How to Age Disgracefully

The phone rang shortly after 8 a.m. on a Saturday morning, and the news was brief. Kay Cossette, a 94-year-old friend, had died in her sleep during the night.

Kay had suffered a stroke four years earlier, so the news was not unexpected. Yet I was surprisingly unsettled by the finality of her death. I spent the next few hours recalling hilarious times we had spent together and the enormous impact Kay had on my life.

I met Kay shortly after I moved to Alameda, California in the early ‘80s. She and I attended Twin Towers United Methodist Church, and when the pastor called for volunteers to host Sunday’s coffee hour, Kay and I responded. We teamed up for what would be the first of many delightful activities.

At the time, Kay was in her late seventies and was 30 or more years my senior. But in terms of outlook, Kay was easily 30 years my junior. Her first unsolicited observation about my life was that it was all work and no play. As a single parent of two, I had neglected my own needs and forgotten how to play.

When Kay learned that my closest relatives were 2,000 miles away, she adopted me. Making me over became her personal rehab project. Kay invited me to join a monthly bridge group, attend Oakland A’s baseball games (where, to our delight, we were regularly carded when we bought hot dogs and beers), experiment with golf and play tennis, my current passion. When I was bedridden following surgery, Kay brought me chicken soup. To while away the hours during my recovery, she climbed onto my bed, where we played her favorite card games, cribbage and Skip-bo.

I thanked Kay for bringing me back to life by taking her to dinner at the fanciest restaurant I could find—one in Ghirardelli Square in San Francisco overlooking the Bay on her 75^th birthday. Her birthday present was a 4-foot white stuffed gorilla that I crammed into an oversized black garbage bag topped off with a big yellow bow.

Surrounded by gleaming chandeliers, white linen, muted music, an impressive assortment of wine glasses and silverware and an attentive waiter, Kay opened her present. Kay immediately named the gorilla Alice, tied the yellow bow around Alice’s neck and seated her at our table. When the waiter took our order, Kay insisted Alice order first.

We shared conversation, food and drink with Alice that night, much to the amusement of neighboring patrons and the staff. We had too much fun with Alice to care about the odd looks we received. From that point on, Alice occupied a prominent seat in the middle of the sofa in Kay’s living room.

Until her stroke at age 90, Kay swam for an hour each day in her backyard pool, whatever the weather. She also captained her bowling team and loved to hike. Kay was active in community affairs and constantly took people, like me, under her wing. I’m certain that many of her adoptees attended her memorial service because they loved her as I did. But no matter how many people Kay befriended, she made each of us feel special.

I’m grateful for teachers, mentors and role models like Kay who make a powerful difference in the lives of everyone they meet. Kay helped me recover my sense of play, and her unconventional style confirmed my suspicion that we can be dynamic, involved, engaged and constructively influential, whatever our age. Our bodies may get older, but we can stay forever young at heart.

I miss Kay’s raucous laughter and treasure the memories of times we spent together. Most of all, though, I feel honored by Kay’s presence in my life. Kay taught me a great deal and presciently prepared me for a role I had no idea I would play in the future—fitness advocate. Standing on her shoulders, I’ll seek to repay Kay by making a difference in the lives of those around me. And like Kay, I intend to age disgracefully by having one heck of a good time.

"Teachers open the door. You enter by yourself."              Chinese Proverb