Two seemingly unrelated newspaper articles caught my eye recently. One was written by Walecia Konrad for the New York Times (11/13/10), titled “Protecting Yourself from the Cost of Type 2 Diabetes,” the other was by Dov Seidman, the author of “HOW: Why HOW We Do Anything Means Everything… in Business (and in Life).”
The piece about the cost of treating diabetes is based on the real-life story of Karen Christian, a 74-year old former Red Cross worker who was forced to sell her home in Monterey Bay, California, to pay for her out of pocket medical expenses. Karen lives now with her daughter in a small town near Tucson, Arizona. The move was necessary not only because she ran out of funds, but also because she qualified for Medicaid in Arizona, which she did not in California.
Although she dearly misses her home and especially her garden by the Pacific Coast, Karen considers herself lucky to get the medical treatment she needs and to have most of her expenses covered. “The trade-off is good health, and that’s worth it,” she is quoted saying in the article.
Karen’s diabetes was diagnosed almost by accident when she volunteered for a test at a local health fair sponsored by the Red Cross. But Karen should have known. She is considerably overweight (the article included a photo), which makes her a prime candidate not only for diabetes but also for hypertension and heart disease, to name just three of the most common illnesses connected with obesity.
Karen may now be receiving the necessary care for her diabetes, however, she is far from being in “good health.” Having lost her home of many years in one of the most beautiful places on earth, together with all her social circles and familiar surroundings, and having been forced to move to a small town in the Arizona desert where she presumably doesn’t know a soul except for her own daughter, must be a daunting experience. The daughter may be welcoming and generous, the living conditions may be nice, she may make new friends quickly, but in any case, this is a major change in Karen’s life. How is she going to cope?
I don’t know what caused Karen to become overweight. But I do know that stress is one of the main contributing factors for obesity. In order to deal with her diabetes successfully, she will have to lose weight – the sooner, the better. But will she be able to eat healthy in her new place? Will she find outlets of wholesome foods in the little desert town? Will these foods be affordable on her tight budget? Will she be able to cook? Will her daughter be conscious of her needs and be supportive? Can she join a gym or go on walks outdoors? (Probably not in that kind of heat.) If these issues are not addressed, Karen will not get better and the move may turn out as a bad idea.
You may say that folks like Karen have no choice. And, unfortunately, that is true in many cases. But let’s keep in mind that Karen and millions of others like her have developed lifestyle-related illnesses that could have been avoided – but bankrupt them now.
This brings me to the second article I mentioned. Dov Seidman does not explicitly write about health issues. He’s an economist. But his reasoning about the many roots of the current economic crises around the world sheds also a light on the subject I’m addressing here. Seidman has coined two very useful terms when he speaks of the two types of crises we can face in or lifetime: One he calls “End of Life” crisis, the other “Way of Life” crisis. The first crisis type threatens us with destruction and annihilation (nuclear war, massive asteroids hitting earth, etc.). These (hopefully) don’t happen all too frequently. The second kind, however, can occur quite often. A “Way of Life” crisis can be devastating, but it is not necessarily deadly. While there is not much we can do if we are about to be pulverized by some act of God or by some crazy deed of man, we can manage limited crisis events. “Unfortunately,” Seidman writes, “we… respond to Way of Life crises as if they were End of Life crises, and that’s why we need to rethink our response.”
Karen and millions of her fellow-patients are dealing with real Way of Life crises. Lifestyle-related diseases don’t occur suddenly and without warning. They develop incrementally, depending on our actions. Our health care system is not set up to deal effectively with Way of Life crises. It confronts illness like a sudden catastrophic event and treats it accordingly. Our whole apparatus of medical technology is geared toward crisis intervention. We are flooded with expensive medications for every imaginable ailment. If that doesn’t do the trick, we have every high tech gadget in the world at our disposal to find a quick fix. In the long run, this cannot be the answer. It is not sustainable and it is ruinous for too many of us.
Prevention would be a better way. But for now, a pro-active approach does not even come into focus. Insurance companies are willing to pay for bariatric surgery but not for weight management counseling. The kind of care many sick people would really benefit from is neither available nor deemed affordable. So we continue on the same path despite of better knowledge.
Seidman calls this a kind of “pragmatism that exploits short-term opportunities.” Being solely focused on “situational values” (another one of his useful terms) limits us to short-term solutions. By contrast, he says, we need to act more in accordance with what he calls “sustainable values” for long-term success.
Success, of course, can mean many different things, as does failure. What would it mean for people like Karen? Only she can say, at least in hindsight. Without diabetes, she would probably still live in her own home near Monterey Bay, tending her garden. What a shame.
If you enjoyed this article, you may also be interested in reading “Obesity Rate in America Keeps Rising With No End in Sight” and “Staying Healthy in Tough Economic Times.”