Posts Tagged ‘land use’

Health Farce: Why Places that Don’t Suck Are Necessary for Health

Wednesday, September 23rd, 2009

So why would a blog dedicated to Places for People concern itself with health care? Well, let’s start from the beginning with a few basic questions:

Q1: What is the # 1 cause of  death for all people ages four to forty-four?

A: Das Deathmobile

Q2: How many people are permanently maimed each year due to car crashes?

A) 10,000

B) 50,000

C) 120,000

D) 400,000

(Hint: If you chose D, you would be correct! DING! DING! DING! DING!)

Q3: What are the # 1 and #2 causes of chronic disease for all people of all ages in the United States?

A: Sedentary lifestyle (enabled by–you guessed it!–das deathmobile, and enforced by poor land use & transportation policies),

and,

B: Poor food choices (again, enforced by bad federal agriculture/food policies)

(In no particular order, btw, since the two seem to mutually reinforce one another.)

Unfortunately, our decisionmakers have yet to make these connections. For instance, I’m represented by a congresswoman who has made health care the top issue of her tenure as a politician. Over the years (going back to when she was my county supervisor in the early 90s) I have tried to communicate to her that the priority should be health. That access to health care is a component of health, but it should not be the overriding goal. That it is a means to an end: the goal being health. Unfortunately, she confuses means with ends and continues to equate health care with health. Frankly, I’d rather not have to go see a doctor. Routine check ups are fine, but in the end, the best way toward a healthful life is access to good food, safe public spaces & places for those of us who get around under our own power (i.e., exercise as part of our daily lives), clean air and clean water. But she continues to deny the link between these environmental factors and health.  She continually votes for more pavement (paving under prime farmland, trashing our air & water, creating unsafe conditions for pedestrians & bicyclists, etc.) and does nothing to re-orient our current government health care programs (Medi-care/aid) & subsidies (tax-free employer health benefits) away from fee-for-service; i.e., fee-for-service resulting in force feeding more procedures to the detriment of good health. (A good discussion of the problem of this over-doctored approach can be found here).

Fortunately, there are some synapses firing elsewhere.

Indeed, there has been some great thinking to come out of all of the Sturm und Drang regarding Obama’s health care push. Yes, finally, we have some insightful thinkers who have written eloquently, thoughtfully, logically and systematically about the difference between health and health care.

The best I’ve found appeared in September’s Atlantic Monthly

This eminently just & logical solution is the only way out of our current bind of crushing health care costs–costs imposed on all of us by poor food policies (Q3 Answer B) and militantly car-oriented transportation policies, both of which are forced upon us by the federal government (with plenty of local collaborators, to be sure!) (Q3 Answer A).

Re: Q3 Answer B (above), Michael Pollan does a fantastic job of exposing how, if a universal health coverage mandate is imposed, we’ll likely see a positive domino effect on our nation’s food policies.* Why? Because the health insurance companies, being forced to take all comers, and no longer able to deny coverage, will have an extreme profit motive to get people to eat better foods for lifetime health. Health! It will be in the insurance companies’ best interest to see us living healthy lives–throughout our lives–rather than simply not caring about long term health under the current system because, hey, right now, if you get sick, you’re kicked off the plan! Under the current system, why should they care? With universal coverage, they will have no choice but to care. Maybe we can finally use the profit motive to the good. Better access to better foods, and major changes in our nation’s agricultural/food policies, what’s not to like? But first, as Pollan points out, there is likely to be an epic battle between the insurers and the food producers. I’ll be at the 50 yard line to watch this one!

Re: Q3 Answer A, I’ll add a prognostication that complements and follows along the lines of Pollan’s argument: We’ll also likely see insurance companies showing up to city council meetings and militating against car-oriented development policies. They’ll also turn their lobbyists loose in DC (and state capitals across the country) to reform  transportation funding away from highways-only and toward creating really cool places that draw people out to walk, bike or use public transit–in a safe environment. A place that doesn’t suck. Health care for all might turn out to be a boon for really cool places! The insurance companies might even see it in their best interest to offer rebates for living in walkable neighborhoods!

And now you see why a blog that is all about places for people is concerned with getting health care for all.

*Pollan is speaking this weekend (starting Thursday at the Kohl Center at 7 PM) at several venues around town.