Monday, September 07, 2009

Does Health Care Reform Start At Home?

A recent editorial in the Wall Street Journal by the president of Whole Foods about the health care reform debate has kicked up controversy and inspired some to call for a boycott. One of the parts of the editorial that I found most thought provoking was the following:

Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his or her own health.

Unfortunately many of our health-care problems are self-inflicted: two-thirds of Americans are now overweight and one-third are obese. Most of the diseases that kill us and account for about 70% of all health-care spending—heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption and other healthy lifestyle choices.

Recent scientific and medical evidence shows that a diet consisting of foods that are plant-based, nutrient dense and low-fat will help prevent and often reverse most degenerative diseases that kill us and are expensive to treat. We should be able to live largely disease-free lives until we are well into our 90s and even past 100 years of age.

I have not had the opportunity to independently verify the truth of the claims made in these paragraphs but they seem worth pondering. In the past, I would have dismissed such assertions as the usual individualist ideological tactic of minimizing the social dimensions of a problem while emphasizing the role of personal choice. I'm beginning to think however, that any meaningful discussion of health care reform must include a discussion of self-care reform. If access to high quality and affordable health care is a right, then making good choices regarding my own health behavior is equally a responsibility. As my wife wisely and frequently reminds me, those aspects of my health I can control, I should control. In addition, I should care about my own health, but I should also care how my poor health can negatively impact my neighbor through potentially contributing to higher health care costs. Baha'u'llah said it this way, "Beseech ye the one true God to grant that ye may taste the savor of such deeds as are performed in His path, and partake of the sweetness of such humility and submissiveness as are shown for His sake. Forget your own selves, and turn your eyes towards your neighbor"(Baha'u'llah, Gleanings from the Writings of Baha'u'llah, p. 9).

Thinking seriously about self-care reform is not about absolving government of its responsibility to fix a broken system. It is about making a mental shift toward considering self-care as a contribution to the social good. It might even provide some added motivation to do the healthy thing when I'd rather not. Making such a mental shift is similar to thinking more about how my personal choices can negatively or positively impact the environment. It means adopting a world embracing vision of the spiritual and social implications of my health behavior. I cannot justly demand that society provide for my well-being without being willing to contribute to the well-being of society. Making efforts at self-care reform is a way for me to make such a contribution, however small it may be. As the late Michael Jackson would have put it, I have to start with the man in the mirror.

"the honor and distinction of the individual consist in this, that he among all the world's multitudes should become a source of social good. Is any larger bounty conceivable than this, that an individual, looking within himself, should find that by the confirming grace of God he has become the cause of peace and well-being, of happiness and advantage to his fellow men? No, by the one true God, there is no greater bliss, no more complete delight." (Abdu'l-Baha, The Secret of Divine Civilization, p. 2)


  1. I am trying to encourage mental health by recently writing a book, (The Cross and the Psychiatrist). This book tells my true story of recovery from severe mental illness and tells how you too can achieve self help and learn to help others. See at Terry Dorn

  2. Dear Phillipe,
    Great post! I think that some health related experiences help people realize that they have a responsibility for self-care. However, many other people tend to turn a blind eye to the social impact of their own unhealthy behavior.

  3. Hey Philippe!

    I met a fan of yours this past weekend: Ayesha from Nashville, who has recently rededicated herself to Baha'u'llah! She said that she has been using yer blog articles as devotional materials....

  4. Helen, it is always nice to hear about Ayesha. Do encourage her to share her thoughts on this topic as well.

    Maura, thanks for the comments. Now you know that I actually am listening to what you say.

    Constal, good luck with your book. Sounds interesting.

  5. I really liked this post! You may be interested to read the book "In Defense of Food" by Michael Pollan. It is all about how the American Diet contributes to our healthcare problems, much supporting that editorial, and he outlines how it evolved over time and what we can do to change now. All this talk gets me thinking about how Abdu'l Baha would talk of a time when we would all be vegetarians, and would be able to resolve health problems through modifications in diet. Anyway thanks for this great post!

  6. Marty6:16 PM

    Another aspect of individual responsibility for health care reform is to make the cost of health care part of any health care reform. Most of us have enough income to cover monthly health care costs. I would like to see the health care reform emphasize the insurance aspect of health care reform. If high deductible insurance were the standard form of health care coverage, people would weigh the necessity of a health care procedure the way they do any other expense (e.g. food, shelther and other such basic needs.) With low-deductible health care the real cost of health care is not factored into a person's choice of health care procedures. High deductible insurance would also dovetail with taking responsibility for our health in that we would have an economic incentive to be healthy. OF course there is still the problem of health care for the poor. But that is a much smaller problem than providing health insurance for everyone.

  7. Marty I appreciate your point about creating incentives for healthy behavior. I'm not sure though that a person having to pay more for medical procedures would actually change their behavior. By the time you go to the doctor, the damage is often already done. It would be an interesting thing to study though if that has not already been done. I have heard of rewarding good health in the way that good driving is rewarded such that healthier people pay less for their insurance. Coverage for the poor is a big issue which I will leave it to people smarter than myself to try and figure out.

  8. Phillipe,

    Bahai Thought has provided me with lots of material to reflect upon... like having my own personal cyberside or digital deepening just a click away!

    Thanks for the dedication and being instrumental in my redeclaration!


  9. Ayesha, always a pleasure.

  10. Anonymous3:54 PM

    There are fallacies in discussing "health care".
    The medical system largely gives us "sickness care".

    Where can we learn or be taught how to stay or become healthy, what foods to eat more of and what less? What to drink more of and what less? And what habits to cultivate and which to suppress?

    Self-indulgence is the easy way to get sick and a short life, self-discipline is the harder road but very satisfying.