Wednesday, October 5, 2011

An Idea: Health care for healthy people

This blog is centered upon a simple idea. Let healthy individuals have access to lower cost health insurance. If you eat healthy food, eat moderately, and exercise—but aren’t lucky enough to have Big Govt or Big Business (aka, have Rich Uncle Healthcare) pay for your insurance, you should not be punished for something you did not create: a health care system with costs spiraling out of control.

And why are they out of control? One huge reason is that many Americans are extremely unhealthy. A large segment of the population is sedentary, overeats and needs lots and lots of money to be kept alive. This is compounded by them getting a pass from the government and/or their place of work, so their unhealthy habits aren’t curbed.

Meanwhile the uninsured suffer.

We all would like to have a rich uncle. He pays for college and has a trust fund waiting for you. But Rich Uncle Healthcare puts the uninsured at risk while encouraging unhealthy and inactive over-eaters to live large.

Estimates put the uninsured at 50 million people in this country. Most of them are like me: they can’t afford it. I am an independent contractor, so the firms that give me jobs are not required to offer me medical insurance. They offer a higher wage, and expect that I buy my own.

Well, with the soaring costs of insurance, I can no longer afford it.

The apt reader will say: get a job that offers health insurance. That is a way out for me, but it ignores the larger question. Premiums are going up so quickly that it not only currently puts me out of the market, it cuts into the profits and budgets of companies and government agencies. It stifles our economy. We’re all paying for it somewhere. You might be okay today. But if Americans continue to get more and more obese, this will lead to higher and higher curative costs, and tomorrow maybe you or your employer will be priced out of the market.

Simply: Exorbitant health care costs eat into our collective wealth, because Americans eat too much unhealthy food. We’re all sicker and poorer from the food Americans eat—even if some of us don’t actually eat it.

What do you think? I welcome your comments.

Our cars are and houses are over-large and they contribute to our energy dependence and environmental pollution, among other things. The excess energy those objects can’t use is expelled into the atmosphere. But our inactive bodies can’t expel the gobs of energy we eat but can’t use, so the excess energy comes to rest on our midsections, hips, arms and legs. If you’re rich (or middle class with Rich Uncle Healthcare) and you eat too much you’ve got liposuction, stomach stapling and gastric bypass. If you’re poor you balloon up and begin to get diabetes at age 30. All groups need heart bypasses, angioplasties and stents in their 40’s and 50’s. All these procedures cost lots of money that could’ve been saved if we just ate a healthier diet.

In 1988 the Center’s for Disease Control and Prevention found that for every dollar we spend on health care, 97 cents went to treating the cure—the after effects. 3 cents went to prevention.

My cousin, God bless him, was 350 pounds 10 years ago and nearly died. Surgeons gave him a gastric bypass and stapled his stomach down to a fourth of what it had ballooned out to. He got down to a healthy weight. But he’s now pushing 350 again. I love him and wish he’d get his appetite under control, but you don’t know him. Why should you pay for his poor choices?

Two groups of people are living large in this untenable system:

1. Obese and inactive people who aren’t taxed or charged for their excesses. Let’s look at smokers—a similarly unhealthy way to live. Smokers get hit with excess taxes (sin taxes) to pay for the burden they put on the health care system. What about their equally unhealthy cousins?

2. Health insurance (and related) companies making tons of money off obese people.

For me personally, my wife will hopefully get a job soon with a firm that offers benefits. She’s just out of college, and looking for work. Like many recent grads, no luck yet.

I recently did a web search for individual health insurance plans. It was for my wife and me since we don’t have kids yet. They asked for age, sex and if we smoked. Nothing about diet. Nothing about exercise. Why not? (First I put in that I didn’t smoke. Then that I smoked. A difference of $10 a month, on average. That’s $120 a year, smoker vs. non smoker. ???  But I digress.) The lowest plan was $89 a month. Not bad, eh? It has a $10,000 deductible. No maternity. No prescription drug plan.

I narrowed it down to more sensible terms. A $500-$1000 deductible seemed reasonable. Got 11 plans. Prices ranged from between $350 and $807. Meh. A couple were $350 – $500-ish. Still high, but what choice do I have? A visit to the doctor’s office was $25-$40. Fair. All had a prescription drug plan. But whoa. Only 2 had maternity coverage. A plan costing $701 a month and the $807 plan.

$700 - $800 a month? Why should health insurance cost as much as a mortgage? Why should it even cost $500? I could cut back here or there. No entertainment expenses. No vacations. No cable. What kind of life is that? Would you want it? And even if I did bite down and pay $350 - $500 and sacrifice having kids, it’s only good for one year. What price will it be next year, when more of us are sicker and need more medical care? More heart bypasses? More angioplasties? More expensive surgeries trying to save ever expanding obese bodies that have been abused for decades?

For me, and many like me, it’s the car payment or the health insurance. And I need the car to be able to make money. So here we are, stuck. Praying that my wife finds a job.

But there is something we can do, and I’ve begun to do it. The idea to start this blog also came from my own decision to make myself healthy by changing my diet. I’m 40. I was in decent shape, but figured I’d better do what I can because I don’t have any alternative if my wife does not find a job with insurance. I’m a fictional writer, and I’ll always remain an independent contractor. Hopefully, I’ll sell something soon and that might help pay for my own insurance.

I used to drink a little too much. I ate as much diary and meat as veges and fruits. I ate and drank that way for years and always carried a little extra weight. Even with intense workout periods, (running 1000 steps a day, playing basketball 3 hours a day) I’d still keep a spare tire around my waist. I was a near constant 190 pounds. On a six foot frame.

I now eat a diet based very heavily on plants and whole grains. I don’t eat anything processed by the food industry. (I’m an artist and I’ve cut way down on my drinking—hard to do!) I prepare nearly all my own food. I have severely cut back on animal-based foods. I will hopefully live the rest of my days without the need to see the doctor for any diet-based disease.

I gave juicing a try after seeing two revealing documentaries. Fat, Sick and Nearly Dead and Forks over Knives (FOK) Both were compelling, but FOK was more scholarly, and it examined empirical evidence that proved to me that a Western-based diet (eating lots of meat and dairy and processed foods) severely abuses our bodies. It focused on the famed China/Oxford/Cornell Study that found that a plant-based diet is the key to long lasting health.

After the juice fast for 2 weeks—wow! A pound a day melted away. Now I’m at 175—which seems to be my ideal weight. (My spare tire is quickly disappearing.) I’m not a strict vegan, but I can see where they’re coming from. I feel amazing! So energetic. I will never again eat as much meat and dairy as I once did.

My favorite current dish: Heirloom tomatoes with cucumbers, basil and spinach. Pinch of salt and pepper. Drizzle on a little extra virgin olive oil and balsamic vinegar. POW! Fitness Superman Jack LaLane (God bless him) said “Exercise is King and Diet is Queen. Put them together and you’ve got a Kingdom.” All due respect to Jack—who was an absolutely amazing man—I think Diet is King and Exercise is Queen. Not all of us need to tow a chain of boats across the San Francisco Bay! He also said, “If man made it, don’t eat it.” I agree—assuming it came from the factory. And: “If it tastes good, spit it out.” But Jack never tasted my tomato, cuce and spinach salad. Ha!

In lock step with a healthier diet, I have upped my exercise routine. I’m lucky that my day job requires a lot of walking. But that isn’t enough, so I added a weight training regimen to my daily routine. 30-60 minutes a day. (50 push ups a day. I want to hit 100 in 6 months.)

To be an American is to be independent. Or at least to try. I’m relying upon me to improve my life. American as Apple Pie. But mine is without the butter, sugar, eggs and milk. I’ll bake mine with honey, soy milk and egg whites and I’ll bet mine tastes as good as yours. I haven’t actually made such a dish so that’s debatable, but still, I’ll hopefully live a long life eating mine.

So why can’t my health insurance rates be lower than an unhealthy person? While I control what I can with my diet and exercise, I’m constantly in fear of a fall or an injury. I can’t play basketball or soccer for fear that I’ll get hurt and go bankrupt.

Lower health insurance for healthier people. It seems logical. Better drivers pay less for auto insurance. Go get speeding tickets and cause a bunch of accidents. Then watch what your auto insurance company does. You own a home? Don’t fix your leaky roof and submit a claim, I’ll bet your insurance company dumps you. They should.

Why can’t we stamp individual assessments on health care insurance? And make it more equitable like home and auto insurance?

I don’t think obese people should shape up or to hell with them. I am a Christian. I believe that all life is precious, and every attempt should be made to keep anyone alive. If someone gets sick we should do all we can to save that person’s life. I wish that same sentiment were applied to me and 50 million others. Now, if I get deathly ill, my local hospital is required to treat me. But I can wave bye bye to my house and any assets, because I’m declaring bankruptcy.

I think that in America, a fair share of the burden should be put on the individual. Anyone and everyone can eat their way to proper health, just as we’ve eaten our way into dangerous health. If you’re eating poorly, it hurts me too. Most states have helmet laws for motorcyclists. Because if you don’t wear a helmet and wreck on your bike and get severe brain damage—we all pay to keep you alive. Not fair to us. So you get ticketed if you don’t wear a helmet. Well where are the tickets for eating fast food everyday?

Lot’s of us overeat, smoke and chew tobacco, drink to excess, (or some combo of these harmful activities) and if we’re lucky enough to work at a large corporation or for the government, or if we’re on welfare, we get away with paying little or nothing for health insurance. But this is what drives up costs! How is that equitable? And from my view on the outside, how is that just? There are 50 million of us out here. Don’t you think it’s time we fought back?

Americans are responsive to injustice. It’s a reflex for us. I want to start a movement to bring justice in the health care system.

THERE ARE 50 MILLION OF US!! Let’s make some noise! Let’s make our own justice. Our country affords us that opportunity. Here’s the plan, my fellow un-insured, under-insured and insured-but-over-charged-Americans. Do everything you can to make yourself healthy. In Fat, Sick and Nearly Dead, a man in his 30’s who weighed 425 pounds went on a two month juice fast. After juicing for 60 days, adopting a plant-based diet and exercising everyday, he rounded into his normal weight of about 225 pounds. He saved his own life. Took him a year. You might not need to be that extreme, but I nevertheless firmly believe that if you eat mostly plants and you exercise, you won’t need to see the doctor except for an emergency or if you’re going to have a baby.

I love this country. I love the liberty it protects and the marketplace of ideas it fosters, where “if a man…can make better chairs or knives, crucibles or church organs, than anybody else, you will find a broad hard-beaten road to his house, though it be in the woods.” —Ralph Waldo Emerson,

I’ve got an idea. But since I’m a writer and not a businessman, I won’t ever start this venture. Therefore, I’m giving it away. I hope someone can do something with it. It’s my way of getting my justice—and hoping that some of the 50 million un-insured, the added under-insured, and the many insured-but-overcharged Americans read this blog and are compelled to respond with their own thoughts about how we can build a fairer health care system.

I want to start a movement. The founding idea: healthy citizens should get justly priced health insurance. I’m not sure how we will get there, but I think it is a good idea, and one that can make someone rich. And America loves good ideas—especially those that make a lot of money.

Here’s the idea for any entrepreneur who wants it: Start a health insurance company that offers affordable insurance to people like me.

If you’re out there and agree with me, respond to this blog. Let’s build some support for this.

Maybe this idea needs support from the government or from someone running for office. This isn’t a political blog, but as you can see I touch on some hot-button issues. I ask you to withhold your judgment until you hear the whole idea. I’ll explain below how this can be a win-win for most of us—business, government and individual citizens. And not just with financial profits for the enterprising person (or firm) willing to take a chance, but with improved human health and benefits for all Americans.

If I had an entrepreneurial spirit, (instead of my writing itch) I’d consider starting a business venture, based on positive answers to these founding questions:

1.      WHAT IS THE MARKET?

50 MILLION UNINSURED AMERICANS. Some of us have money and all of us need medical insurance. Offer us insurance! What if we needed only preventative care, and little curative care? Insurance is all about proper risk assessment. Wouldn’t insuring us be low risk?

Granted, many of the 50 million are too poor to afford any premium. And it’s true that these poor—those living just above the poverty line—are sicker than the middle and upper classes. So it would cost more to insure them. (But Medicaid, Medicare and state health insurance plans partially tend to them—such as with an emergency room visit.) They are poorly educated about their health and diet. They don’t have as much choice in their local food markets. Even if they had a farmer’s market or a Whole Foods in their neighborhood, the fast food joints are very tempting, easy and cheap. The large food corporations have figured out how to mass produce unhealthy food at a low cost. So how can a $6 carton of organic strawberries beat out the dollar menu at the fast food restaurant?

50 million uninsured. I’ll take a guess at the total percentage of these 50 million who are just above the poverty line, and scratching at the middle class. 70%. That’s 30 million people (not counting the 46 million who are in poverty and are covered by government and state run medical plans—aka Rich Uncle Healthcare) who barely have the money for a car payment, let alone a monthly health insurance premium that should average $100-$300 a month once we’re done. They are not in the market. Yet. But read below, we might be able to put the poor people just over the poverty line into the market, with a culture-changing education and incentive plan, and maybe some subsidies from the government.

That leaves 15 million people like me. Give or take a million. We’re the independent contractors. In 2005, the Bureau of Labor Statistics put us at 10.3 million. I’m sure we’ve grown since then. Good for you: we’re a fast growing segment of the workforce population and hence a burgeoning market. Also in the market are the young adults coming out of college who can no longer clip onto their parent’s policies and haven’t found jobs that offer insurance. Those younger folks are found at service industry jobs like restaurants and retail stores. The market will be comprised of them, too.

The market will also include wealthier independent contractors who currently can afford to pay the $800 a month premiums, but who probably have had the same thoughts as I do. Why should they have to pay into an unjust system? An unbalanced system that spends money mostly on curative or palliative medicine? On keeping obese sedentary people alive with $100,000 surgeries and expensive aftercare and therapy?

2.      CAN YOU MAKE MONEY FROM THIS MARKET?

Yes! Get a bunch of healthy people together—out of the 15 million uninsured who can afford it—and insure them! Lots of them will be young. Young people mostly need emergency care and can be easily educated. An education plan founded on a plant-based diet will be a HUGE part of your business—you’ll be growing your healthy market with it. You’ll be selling plans to healthy people who procreate and raise healthy babies—thus growing the market. But I’m getting ahead of myself.

To start, we’ll need thousands of healthy uninsured people. Healthy people cost less to insure, no? You’ll have to pay for some medical care, but these healthy folks will in no way cost you as much as the unhealthy population that get a pass from Rich Uncle Healthcare.

Let’s take me. For about 10 years I followed the RDA that the USDA puts forth. Equal parts meats, grains, dairy and fruits and veges. I’ve been to the hospital once in those 10 years of being uninsured. I got pneumonia. Paid a huge bill (for me). It ended costing me $2,500. ER visit. Ex-rays. Doctors bill. Medications. I’m sure it would cost a large insurance company much less.

With my improved diet, eating mostly plant-based food, I’ll hopefully never go back to the hospital. I want to be disease free well into my 90’s. I’ll live longer and thus pay more money. I won’t need medications. For a healthy person like me—we’ve got to start somewhere with some figure—I’d say $150 a month is a fair price for me to pay for insurance. Get 200,000 of people like me together. Multiply by $150. That’s $30 million gross profit a year. I’m over my head with these figures and what would make money, but I’d guess $30 million is a good starting point. Maybe today there are a million of us out there who will hit the high standards of health. That’s $150,000,000 a year. And even if we don’t number 1 million, an education and incentive plan will create us.

3. WHAT WILL BE THE COSTS?

Certainly some in the plan will get sick. Some will need surgery, but mostly it will be from accidents, not from diet-based diseases. We will have babies so there will be maternity costs. I think there are insurance standard actuarial tables to give you some overall idea. Apply those actuarial tables to vegans—that’s the closest group that will mirror your insuree-class. I’ll bet you’ll be pleasantly surprised at how little risk you are taking to insure healthy people.

One important cost you will have is evaluation. Evaluations will be the cornerstone to your business. Kick it off by opening evaluation clinics in healthy cities. Focus on the states of California, Oregon and Washington. Smart, educated and health-conscious cities with lots and lots of independent contractors in the computer industries. With lots of vegans—so the culture of healthy eating is already in the air. Wealthy places too.

Employ nurses and technicians to measure the health of the human body. Medical personnel who take blood pressure, blood and cholesterol tests, perform physicals, etc. Only accept applicants who are in optimal health. Do a visual evaluation even before they are pricked or fastened to a blood pressure wrap. Look at their midsections. If they are not packing on the extra pounds, put them through rigorous tests.

If we eliminate the extra weight around the midsection or hips, eliminate the high blood pressure, high (bad) cholesterol, and high blood sugar—the prospective insuree is at low risk for heart disease. Insure him! We only want people who are not going to need curative care. Take only applicants who can reach the optimally healthy level of a person who eats mostly fruits, whole grains and vegetables, and exercises regularity. Also check for their Body Mass Index (BMI), rule out any blood diseases, screen for cancer, test for diabetes. See if they can run, bike or walk quickly on a machine for a specially determined amount of time without becoming exhausted to the point of failure.

Write into each health care contract that the insuree will have to submit every six months to these same health tests. We want to keep everyone healthy. You’ll get their premiums. We get to be healthy and live longer—but have access to reasonably-priced emergency care and maternity care.

If they don’t pass the rigorous health standards don’t write them off! The fact that they showed up means they have potential. As they are up against the wall with unfairly priced insurance or none at all, they are easily coach-able. Send them away with literature that promotes healthy plant-based eating, as well as the benefits of exercise. In a few years they might become your customer. If they believe in and follow the advice of the documentary Forks Over Knives, they might be back in a couple of months and actually pass your tests.

It’s a win win for you and your customers and your potential customers. If you are successful, the implications for our eating culture is huge.

It’s not a financial win for everyone. Two big losers will be the health businesses making gobs of money with curative care, and the meat and diary and grain producers (who supply the grain that feeds the cattle). But why do we care? The horse farmer didn’t outlast the internal combustion engine—thank God. Thanks to our free-market ideals, the marketplace picks the best idea and the backers of the best idea get the profits. We’re all better off that the horse farmers and wagon manufacturers lost that battle (Imagine if they won.) And we’ll eventually all be better off with your new health care company.

And the corn, cattle and dairy farmers can go back to growing vegetables and fruits and whole grains that we all should eat more of.

As far as our national health we’ll all be winners. We can defend our nation with healthy warriors. We can reduce one of the largest drains on our economy—our excessive health care costs. We can live longer and see our grand kids and great grand kids.

In all of America, I’m sure there’s 200,000, 300,000 uninsured, under-insured or insured-but-overcharged independent contractors and young people. I wouldn’t be surprised if there’s a million!

That is your money-making market.

4. CAN YOU EXPAND TO ADDITIONAL MARKETS?

Certainly. (Shhsh. Here’s where the real money is.) Down the road, go after firms and businesses with this exact same plan. Tell the firm that you’ll give them a big discount if they can get half of their employees to hit the high health parameters. Firms can offer a “health bonus” —couple hundred dollars, to their employees around the holidays if they help the company qualify for your high health standards.

Now you’re in the big time: Your 1 million customers just burgeoned to 15-50 million.

The 10 or so large health care companies in America all insure 15-50 million people.

And you won’t have to pay for nearly as much curative care as they do.

You’ll get rich off a much needed service that actually improves the nation’s health.

So where is the entrepreneur/philanthropist in you?