Money, Politics, and Health Care: A Disease-Creation Economy - Part II

Last week, in Part I of Money Politics and Health Care: A Disease-Creation Economy, I outlined the issues that created this condition in our society. This week, in Part II, I will review a few strategies that could have the biggest impact on cost and outcomes.

Creating Health: Getting Money Out of Politics

Send letters and e-messages to your elected representatives encouraging them to support the following health initiatives:

Reclaim Food Policy

• Eliminate unhealthy foods from all schools, child-care and healthcare facilities, and all government institutions. The government must establish rigorous standards for school nutrition consistent with current science (through the USDA). Similarly, we need to create nutrition programs for other public and government-run institutions.
• Support lobby reform. We must change campaign finance laws so that corporate political donations from entities like big food, big farming, and big pharma can no longer control the political process. Reverse Citizen’s United.
• Subsidize the production of fruits and vegetables. Change the Farm Bill. Agricultural policies should support public health and encourage the production of fruits and vegetables, not commodity products like corn and soy. 80 percent of government subsidies presently go to soy and corn that are used to create much of the junk food we consume. We need to rethink subsidies and provide more for small farmers and for a broader array of fruits and vegetables.
• Incentivize supermarkets to open in poor communities. Poverty and obesity go hand in hand. One reason is the food deserts we see around the nation. Poor people have a right to high-quality food, too. We need to create ways to provide it to them.
• Build the real cost of industrial food into the price. Include its impact on health care costs and lost productivity.
• Tax sugar. We tax cigarettes and alcohol, which help pay for prevention and treatment programs. Sugar is at least as addictive, if not more. Scientists suggest a penny an ounce tax on sugar-sweetened beverages. This would reduce sugar consumption, obesity, health care costs, and provide revenue to support programs for the prevention and treatment of obesity.
• Create a public health advertising campaign. Make being healthy cool and sexy supported by celebrities and sports icons to expose the subversive practices of big food, big farming, and big pharma that propagate disease and suffering for millions. Focus on kids, teenagers, and adults using the best advertising techniques that speak to the emotional needs and feelings of the consumer. Use industry’s best weapons against them like the successful campaign against teen smoking, Rage Against the Haze.

Reclaim Public Airwaves

• Restrict all media marketing of fast food, junk food, and processed food to children. Food marketing directed at children should be banned (through the Federal Trade Commission). This has been done in over 50 countries around the globe including Australia, the United Kingdom, the Netherlands, and Sweden. We should follow suit.
• Regulate marketing of liquid calories, especially to children. Food-industry marketing practices brainwash children to believe that choosing their own products will provide instant happiness and fun. Do they know something we don’t or are they simply acting on sound evidence that having a 2 year old ask for brand name junk food before he or she can complete a full sentence might not be good for people or for society? One billion cans of Coca-Cola are consumed every day around the world; we have taken the bait. In communities without health care, education, running water, or enough food, there is Coke!
• The Food and Drug Administration should restrict unproven health claims on labels. Foods with health claims on their labels are often the least healthy. Adding a little fiber to a sugary cereal doesn’t make it healthy. Will Vitamin Water (made by Coca Cola) or Gatorade (made by Pepsi) and made cool by Kobe Bryant and Lebron James make our kids super athletes or just super fat? Is there a reason that over 50 countries ban processed food advertising to children?

Reclaim Our Schools

• Help reinvent school lunch programs. Starting with the Healthy, Hunger-Free Kids Act of 2010, which provides extra money for schools that comply with federal nutrition standards, remove junk food from schools by applying nutrition standards to all foods sold in schools (including vending machines in hallways where most kids get their breakfast of soda and chips) and support access to fresh produce through farm-to-school networks, the creation of school gardens, and the use of local foods. It doesn’t solve the void in education for self-care and nutrition, but is a beginning.
• Support schools as safe zones. Create access only to foods that support and create health and optimal brain functioning.
• Support changes in zoning laws. Prevent fast food and junk food outlets from being next to schools.
• Build school gardens. Teach children about the origins of food and experience the sensory delight of real, garden fresh fruits and vegetables.
• Support integration of self-care and nutrition curriculum. In schools from K through 12^th grades.
• Bring back basic cooking skills. In schools as part of a curriculum to include essential life tools.

Reclaim Health Care Reform

• Support real healthcare reform. To not only change insurance regulation, but also to change the type of medicine we do (lifestyle medicine), change how we deliver health care (in small groups in communities and in health care organizations), and pay for quality not quantity of care. During the health reform process in Washington, D.C., a group of three doctors (Dean Ornish, Michael Roizen, and myself) were asked what organization we represented. We simply replied that we didn’t represent anyone except the patients or anything but the science. They accepted it, but looked perplexed. No wonder. During health reform, the pharmaceutical industry had three lobbyists for every member of Congress and spent over $600,000 a day to make sure their needs were represented in the legislation.
• Support the creation of a health corps for America. Train one million community health workers and health champions in communities around the country by 2020. Through the act of “accompaniment” — getting healthy together — we can create a double revolution: change the medicine we do (focus on lifestyle medicine that addresses the causes of chronic illness) and change how we do medicine (in small groups that help people create positive social and behavioral change.) This new workforce of community health workers would “accompany” and support individuals in making better food and lifestyle choices and cleaning up their homes, workplaces, schools, faith-based organizations, and environment.
• Provide demonstration projects in community health centers. Provide inexpensive, nutritious meals (including take-out), recreational facilities, counseling/education (e.g., cooking classes), and healthcare based on systems/lifestyle/functional medicine at one location.
• Impose limits on pharmaceutical and unhealthful food advertising. More than $30 billion is spent on marketing junk and fast food to consumers, including $13 billion targeted at children and more than $30 billion is spent by pharma on marketing drugs to physicians (about $30,000 annually per physician). Direct-to-consumer drug advertising also drives prescribing practices based on induced preferences rather than science.
• Empower the National Prevention, Health Promotion and Public Health Council. As an ongoing vehicle for coordination of strategy and policy, focus specifically on developing policies and programs for lifestyle-based chronic disease prevention and management, integrative health care practices, and health promotion.

Reclaim Medical Education

• Mandate nutrition and lifestyle medicine training in medical schools and residency programs. Consider this: All of the major drivers of disease and health care costs are due to lifestyle—and therefore preventable—factors. If these factors were addressed, we could eliminate 90 percent of heart disease and diabetes, yet only one in four medical schools have a nutrition course, and only 28 percent of schools meet the minimum 25 hours of nutrition education recommended by the Institute of Medicine. And most of those nutrition hours are about nutritional deficiency diseases like scurvy and rickets. If we were successful in reducing heart disease by half or reducing diabetes (along with its complications) by 80 percent, hospitals would go bankrupt, pharma would see their profits plummet, and many physicians would be looking for another line of work.
• Support and develop a modular scalable nutrition curriculum. Address the lack of supply of adequate experts (scale existing programs such as the Institute for Functional Medicine.)
• Provide reimbursement for lifestyle treatment of chronic disease. Despite reviews of the science by major organizations and the support of nearly all the major medical societies who joined in publishing a review of the scientific evidence for lifestyle medicine both for the prevention and treatment of chronic disease, this approach is still not part of medical training or medical practice.
• Develop more funding for nutritional science. Congress should mandate greater funding of nutritional science and examine and test innovative treatment models that work. Guidance for dietary policy should be placed with an independent scientific group such as the Institute of Medicine, instead of the politically and corporately influenced U.S. Department of Agriculture who now tells us what to eat. They advised a low-fat diet food pyramid with at least 8-11 servings of bread, rice, pasta, and cereal a day in the 1980’s that coincided with the rapid increase in obesity and diabetes. It was lethal to mix politics and health recommendations.
• End irresponsible relationships between medicine and industry. Public health organizations like the American Heart Association and the American Dietetic Association should avoid partnerships, endorsements, or financial ties with industry that compromise their independence and credibility. Coca-Cola sponsoring events at the American Dietetic Association, or the American Heart Association promoting chocolate sugary cereals as heart-healthy because they have a few grains of whole wheat—is this credible?

It’s worth noting that these strategies span multiple industries, systems, and domains. We are currently experiencing a perfect storm where economic, scientific, and moral imperatives are all colliding and increasingly they are aligning around one very powerful, integrated solution. This provides an opportunity for us as a nation to do well by doing good — through fundamentally changing the way we think about health, money, and politics illuminating the often invisible forces that are putting our health and our nation at risk.

To solve this will require the collective imagination, intention, focus, and action by health care providers, consumers, and industry and policy makers. It will also require campaign finance reform and reversal of the Citizen’s United decision that puts too much money into politics, money whose first interest is not public welfare but profit. There is no place for that in our nation’s government.

In the words of the ancient Jewish sage, Rabbi Hillel, “If I am not for myself, then who will be for me? And if I am only for myself, then what am I? And if not now, when?”

Go to www.takebackourhealth.org to learn how to take back our health, take money out of politics, and join to see how we can and must get healthy together. Share your ideas and stories of how we can take back our health.

Please leave your thoughts by adding a comment below – but remember, we can’t offer personal medical advice online, so be sure to limit your comments to those about taking back our health!

To your good health,

Mark Hyman, MD