Stanley Feld M.D., FACP, MACE Menu


Why Bother?

Stanley Feld M.D.,FACP,MACE

MICHAEL POLLAN wrote an inspiring article about climate change in the April 20, 2008 issue of the New York Times Magazine section.

I have substituted the word healthcare system in my minds eye every time he mentioned climate change. Mr. Pollan is describing exactly what has to be done for the healthcare. His major point is every individual has to get involved. The individual has to be aware of the issues and then act in his self interest and do his small part. The parts will add up to the necessary change.

Why bother? That really is the big question facing us as individuals hoping to do something about climate change, (healthcare) and it’s not an easy one to answer.

Al Gore’s “Inconvenient Truth” is scary, if true. Let us assume global warming is true for this argument. Al Gore’s suggestion to me as an individual seemed bizarre. I am happy to say it was also depressing to Michael Pollan, a person I admire.

“ No, the really dark moment came during the closing credits of Inconvenient Truth, when we are asked to change our light bulbs. That’s when it got really depressing. The immense disproportion between the magnitude of the problem Gore had described and the puniness of what he was asking us to do about it was enough to sink your heart.”

In thinking about it in terms of healthcare and general behavior we as individuals can make a big difference. People are social beings. They need other people. If we can create a trend we can make a difference even if others choose not to follow.

“ But the drop-in-the-bucket issue is not the only problem lurking behind the “why bother” question. Let’s say I do bother, big time. I turn my life upside-down, start biking to work, plant a big garden, turn down the thermostat so low I need sweater, forsake the clothes dryer for a laundry line across the yard, trade in the station wagon for a hybrid, get off the beef, go completely local (with my food purchases).”

If no one else did the same the only impact you would have is for yourself and your self interest. You would save money and improve you wellness. I was terrified to read about tilapia fish farms in Indonesia. How can we allow our government to allow its import? We have no idea of the conditions in Chilean fish farm where “Chilean Sea Bass” comes from. Restaurants make Chilean Bass sound romantic, sexy and expensive. However the details of these fish harvests are chilling.

If we the people change and do little things to improve our health the payback is beyond personal virtue. If everyone does the same the change in society will be enormous.

“ A sense of personal virtue, you might suggest, somewhat sheepishly. But what good is that when virtue itself is quickly becoming a term of derision? There are so many stories we can tell ourselves to justify doing nothing, but perhaps the most insidious is that, whatever we do manage to do, it will be too little too late.”

This is nonsense as science is beginning to show us. Nonetheless, we tell ourselves all kinds of stories to justify our weight, our food intake and our lack of exercise. We can make a difference in our health and healthcare cost if we are determined to change our behavior. Small changes in society’s trend setting can help change behavior for the better.

“ So do you still want to talk about planting your own gardens? I do. Yet it is no less accurate or hardheaded to say that laws and money cannot do enough, either; that it will also take profound changes in the way we live.”

We have seen money and laws cater to vested interests and not societal interests as they should. Individual actions add up. The most profitable center in a hospital is the Bariatric Surgery Center. Hospitals are reformatting themselves to all have Bariatric Centers. They would go out of business if we conquered obesity. This victory can only happen on an individual basis.

“Whatever we can do as individuals to change the way we live at this suddenly very late date does seem utterly inadequate to the challenge.”

So why bother? We should bother because we have a responsibility to ourselves and our children and grandchildren. We have a responsibility to repair the healthcare system before the ability to deliver the greatest healthcare on the planet implodes. We, the people, have to drive the change and make the politicians respond. Politicians are responding to the secondary vested interests.

“ The Big Problem is nothing more or less than the sum total of countless little everyday choices, most of them made by us (consumer spending represents 70 percent of our economy), and most of the rest of them made in the name of our needs and desires and preferences.”

This is the reason we need to own our healthcare dollar. We have to be motivated to drive the change.

“For us to wait for legislation or technology to solve the problem of how we’re living our lives suggests we’re not really serious about changing — something our politicians cannot fail to notice. They will not move until we do. Indeed, to look to leaders and experts, to laws and money and grand schemes, to save us from our predicament represents precisely the sort of thinking — passive, delegated, and dependent for solutions on specialists — that helped get us into this mess in the first place. It’s hard to believe that the same sort of thinking could now get us out of it.”

Michael Pollan hit the nail on the head. Whether it is climate change or healthcare we need to be responsible to ourselves. The inspiration lies in his next example.

“Sometimes you have to act as if acting will make a difference, even when you can’t prove that it will. That, after all, was precisely what happened in Communist Czechoslovakia and Poland, when a handful of individuals like Vaclav Havel and Adam Michnik resolved that they would simply conduct their lives “as if” they lived in a free society. That improbable bet created a tiny space of liberty that, in time, expanded to take in, and then help take down, the whole of the Eastern bloc.”

We have a government for the people by the people. We have tremendous power to influence our government. Our health is our most important asset. It is our responsibility to demand the infrastructure to help us maintain our health.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

  • Dave Greenstein

    The Dalai Lama relayed a quote to me once that resonated and I’ve lived by ever since “be what you want the world to be”. I’m not even buddhist 😉

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