Who Said Consumer Driven Healthcare Cannot Be A Market Force?

Stanley Feld M.D.,FACP,MACE

I love Costco. Its prices are great and its selection is abundant. Last week I was dazzled by the display of megavitamins as soon as I walked into the store.

Americans want to be healthy. Few have a death wish but many (60%) are obese. Megavitamins have been touted as the instant route to healthy living. The megavitamin business has grown into a $30 billion dollar a year business.

Megavitamins have been successfully oversold.

There is no evidence that megavitamins are the route to health and healthy living.

“A national survey by the US Food and Drug Administration found that 73% of US adults were found to use dietary supplements in 2002.”

At this point there is no good scientific evidence for the use of megavitamins. “People believe what they want to believe.”  The placebo phenomenon is extremely important.

The media is the message. Somehow the power of advertising has convinced the public that it is good to take megavitamins.

Costco is trying to take advantage of the hype. Consumers are driving this healthcare choice. The result is a $30 billion dollar a year business. The money is coming directly out of the consumer’s pocket. It is not included in healthcare costs.

Consumers are trying to be responsible for their health on the basis of hype. It is much easier in the mind of most to stay healthy taking a pill than do the heavy lifting required for healthy living.

Why can’t someone create an anti-obesity hype that works as well as the megavitamin hype?

Increases in obesity lead to increased Type 2 Diabetes, hypertension, hyperlipidemia and the resulting Diabetic complications of stroke, heart attack, blindness, amputations, chronic renal disease and cancer.

Many schemes have been devised to decrease the increasing obesity rate. None have worked except eating less and doing more.

With the increasing obesity in children there is an increased incidence of Type 2 Diabetes in kids, teenagers and young adults.

Gastric bypass has become the rage for these young super obese people. To my dismay more and more insurance plans are paying for gastric bypass procedures. Even Medicaid is paying for the procedures.

Is the world going nuts?  I guess Medicaid’s logic is if the people become thinner it will decrease the incidence of Diabetes, decrease the complications of Diabetes and therefore decrease the cost of healthcare for these people.

To me it is like painting over rust. The rust will bleed through and the money for the paint will be spent already.

Americans do not get any help from society norms. We are flooded by manufactured foods with tons of calories and tons of salt. Mayor Bloomberg passed an educational law that fast food stores must publish calorie counts on foods.

This is helpful is the calorie count is accurate and people pay attention. 

Home cooking served in small portions is essential. The fat, calories and salt can be controlled. There is no need to have a home cooked meal anymore.

All you have to do is go to Costco or Sam’s and buy any precooked meal you want. Dinner is a 3 to 10 minute microwave pop away. Why would any busy person bother to prepare a home cooked meal? The harmful consequences prepared meals are in the distant future.

If you have dinner at a restaurant an average meal contains more calories than the average person burns in a day. My wife and I have been sharing for years.

Consumers want to be responsible but it is very difficult in the cultural milieu of our society. 

Ken Cooper M.D. created an exercise craze in the 1970’s. It has lasted until the present. He did not figure out how to get people to sustain their exercise program. He also did not figure out how to get people to decrease their intake in our sea of manufactured food and pre-cooked food.

The incidence of obesity is growing.

Most consumers are not stupid. They seek to be responsible in the easiest way possible.

Someone will come along and initiate a legitimate health craze.

The Ideal medical savings account (by providing financial incentives along with intense public education through appropriate advertising) can be as successful as the Dietary Supplement industry.