The answer is individual accountability.
Those of us watching the healthcare reform debate closely have noted some topics that aren’t receiving much attention. Individual accountability – the question of how to deal with the very significant impact that consumers have on their health and well being due to personal behavior – has been noticeably absent.
Pollan argues that the so-called ‘Western diet’ is leading to obesity and a host of other health issues that cost the system billions of dollars each year. No argument there. He continues by bringing the premises from his books to the debate, placing the blame at the feet of the fast food industry and agribusiness interests.
His solution? Go after fast food and other sins of the American diet as part of healthcare reform while promoting fresh and local foods. Suggestions that most American’s are less than enthusiastic about (well, taxing fast food is unpopular at least). In addition, Pollan is throwing punches, stopping just short of suggesting less meat in our diets, a key component of his recommendations in In Defense of Food.
I’ve thought many times about how to draw parallels between modern food movement and healthcare. The connection I draw is a somewhat different from Pollan’s.
I wonder if there is a way to create a consumer movement for healthcare similar to the consumer movement that has come about for food. When I was growing up, meat simply appeared in Styrofoam packages at the grocery store, no one cared where food came from unless it was some exotic foreign land. And organic referred to anything that wasn’t plastic, metal or stone.
Somewhere along the way, people began caring. Movements begun years ago ,such as the California food movement started by Alice Waters, have now evolved to organic, local and slow food movements. Restaurants today are as likely to list the local farm which grew tonight’s greens as they are to list a country from which something was imported. Waiters can often explain how the catch of the day was harvested and why that’s sustainable.
In other words, this complex system by which food lands on our plate is now better understood by millions of consumers than it ever was before. Consumers are making reasonable value judgments between food choices that go beyond taste and price.
Healthcare, in contrast, is nowhere near that point. Consumers don’t know costs, have no meaningful way to judge quality, and often do not know or understand what their doctors are telling them.
In healthcare, we don’t even have taste as a way to judge.
So how do we get such a consumer movement going in healthcare?