Burning Down Our House

Rip Esselstyn, a former professional triathlete and currently a fireman, writes in his fine book The Engine 2 Diet:

Americans seem to feel it is their birthright to eat rich, fatty, meaty, and obesity-promoting foods. This mindset begs for a paradigm shift. Obesity is not caused by a fat gene passed down the family lines; its roots lie in bad eating habits and poor nutrition. These habits are colossal tragedy being passed from one generation to the next.

Rip’s dad, the famed cardiologist Dr. Caldwell Esselstyn, in clinical trials at the Cleveland Clinic, has shown that in almost all cases, heart-disease can be prevented and reversed through eating a plant-based diet of vegetables, whole grains, and beans. Esselstyn’s findings have been mirrored by other doctors such as Dr. Dean Ornish.

With that in mind, read this press release masquerading as a news story on MSNBC:  “KFC sandwich ditches the bread”:

KFC is thinking outside the bun.

The chicken chain rolls out its Double Down sandwich this weekend — although some might question whether it really is a sandwich. It consists of two white meat chicken breast fillets with a filling of bacon, Monterey Jack and pepper jack cheese with Colonel’s Sauce (a spicy mayonnaise).

Now read this story related by Dr. Dean Ornish in his book Love & Survival: 8 Pathways to Intimacy and Health:

Dr. Mimi Guarneri is an interventional cardiologist who directs a reversing-heart-disease program, based on my work, at the Scripps Clinic and Hospital in La Jolla, California. She spends part of her time performing angioplasties and part of her time teaching her patients how to change their lifestyle.

“I recently gave a lecture to a large group of cardiologists,” she told me. “At first, I talked with them about radioactive stents, a wire mesh designed to keep angioplastied arteries open by exposing them to high doses of localized radiation. Although it’s a new, totally unproven method with the possibility of highly toxic long-term side effects, the cardiologists just loved the idea of these radioactive stents. They couldn’t wait to try them. In the second half of my presentation I talked about our lifestyle program. Even though we have twenty years of randomized controlled trial data supporting your program, the cardiologists got so skeptical and even hostile to the ideas that patients could change their lifestyle and that emotions play a role in health and illness that many left the room.”

No wonder health care costs are unsustainable. This comedic, but tragic, situation in healthcare could not exist on a free market. In a free market, there would be few incentives for patients and doctors to unite in their desire to focus on curing symptoms through high-priced, dramatic interventions while ignoring both causes and lasting, low-cost solutions to health problems.

Homeowners insurance will not pay you to rebuild your house if it burns down after you bring your barbecue grill indoors and douse your briquettes with copious amounts of lighter fluid. Your insurance company would deny your claim on the grounds of gross negligence.

Most cases of type II diabetes and most cases of heart disease are preventable. Many cases of these diseases are caused by a steady consumption of high-fat animal foods and heavily processed foods laden with high-fructose corn syrup.

We are told that it is impractical to expect Americans to voluntarily make lifestyle changes. We are told that a largely plant-based diet is “draconian.”  Some patients might say, “I would rather die young than eat that way.” Of course, it is easy to make such flippant comments if others are paying the doctors’ bills. In his book Prevent and Reverse Heart Disease, Dr. Caldwell Esselstyn writes,

Some criticize this exclusively plant-based diet as extreme or draconian. Webster’s dictionary defines draconian as “inhumanly cruel.” A closer look reveals that “extreme” or “inhumanly cruel” describes not plant- based nutrition, but the consequences of our present Western diet. Having a sternum divided for bypass surgery or a stroke that renders one an aphasic invalid can be construed as extreme, and having a breast, prostate, colon, or rectum removed to treat cancer may seem inhumanly cruel. These diseases are rarely seen in populations consuming a plant-based diet.

We are told it will impact our basic freedoms if such lifestyle changes are required. This objection reflects a misunderstanding about how free markets work. On a free market, no one is entitled to anything that someone else is required to provide for them.  In a free society, we may voluntarily contribute to our neighbor who burns his house down after he barbecues indoors, but we are not required to help him rebuild his house.

Suppose health insurance companies could charge different premiums based on diet, exercise, and other habits that affect health risks. Now, some would object that this is impractical. Experts will be trotted out to tell us that the KFC Double Down sandwich can be enjoyed in moderation without adversely affecting our health. But the actuaries at the insurance companies are the single best of judges of risk, and they have every incentive to get it right.

Of course, there no guarantees; someone who eats a plant-based diet may well suffer a health crisis. Such is the nature of life. But insurance companies routinely discount automobile insurance to drivers who hold accident-free records and are free of speeding tickets. Such a driver may well have an accident next year, but the actuarial tables help health insurance companies profitably segregate by risk.

It is also true that a compassionate society may well seek the means to provide insurance for those with genetic conditions or those who do not engage in risky behavior but who do face what often seems to be inevitable health problems. Indeed, currently, because of wasteful spending in our healthcare system, those who through no fault of their own are truly in need go without care. But, as a sane society does not fund homeowners insurance for those who burn down their own house through their negligence, we shouldn’t subsidize health insurance for those who are negligent about their health and refuse to change. It is not compassionate to subsidize destructive behavior.

If health insurance premiums changed, behavior would change instantly. Voluntarily, fewer “double down” sandwiches would be sold, and more cookbooks on natural foods would be purchased. Parents would demand healthier choices in the school cafeteria. Patients would seek out doctors knowledgeable in preventive medicine.  The effects would cascade.

Now, I know that what I’m proposing is not going to happen in contemporary America. The issue would be endlessly litigated by a parade of lawyers and expert witnesses. It seems we are intent to go on spending billions of dollars for dubious, expensive, and often avoidable medical procedures—until we are bankrupt as a nation.


4 Responses to Burning Down Our House

  1. John A Wood says:

    Dr Brownstein has stated the ‘bleeding obvious’ and yet how many can see the obvious. What is missing in our consciousness that has so many agree with the proposition that ‘we are what we eat’ and then tuck into highly processed killer foods such as white flour, white sugar and white rice? Even the so called health conscious do that! I guess we have to get a lot, lot sicker and/or absolutely bankrupt before we wake up to the reality that we are murdering our health and our economies with our current nutrition and so called heath system. John A Wood Western Australia

  2. QN says:

    Professor B,

    As usual, your message is consistent and on point. That said there is a deeper issue at play and poor food choices is just one of the effects.

    The collective ego has highjacked society and is taking us on a binge unlike any we have ever experienced. The general self importance of the entitled believe I can, I will and I must…I do not have time, the patience nor interest in paying attention to such mundane tasks like shopping for fresh produce and whole grain products.

    Nor is there value taking time out of my busy schedule to prepare such organic materials for consumption, I am above preparing fresh produce like a low paid food prep assistant. I have more importants things to do that pay more by the hour.

    It is sad to see how home economic class programs have been tossed by the wayside because society does not value the traditional roles and responsibilities associated to that of a caregiver.

    It is seen over and over again the low wages paid to those that are providing care in homes and community centers for things like meal planning, food preparation and activities of daily living assistance to our most vulnerable and frail, the children of tomorrow and seniors of today.

    Until there is a shift this spiraling will continue and society will indeed look and behave like those on the spaceship seen in the movie Wall-E.

  3. John A Wood says:

    Professor B is of course spot on. Poor food choices, failing to save or invest for a rainy day, avoiding exercise as well as adequate rest along with other ways of nurturing our health, financial security and spirit are but symptoms of a more deadly condition… the cultural mind in chaos.

  4. Frankvv says:

    5/19/10 What is scary is that KFC’s new sandwich is a HUGE hit!!! http://www.msnbc.msn.com/id/37233140/from/ET?Gt1=43001

    As a side note I have been on an eating healthy kick for about 10 months. At any rate last Sunday for some strange reason I had an urge for McDonalds. I had a burger and fries, and afterwards I was incredibly thirsty! I must have drunk about a gallon of water. Seems my body no longer can handle the salt! The point is we as a society can ween ourselves of our love of salt by changing our diets. We also need to force restaurants and food processors to eliminate or greatly reduce salt: we will all be healthier for it!

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