Wellness, Health Should Be Focus

Obviously no one wants to be obese or an addict, as Jerry Miller told the crowd gathered Thursday for a health care forum in Abingdon. But obesity and addiction are crippling problems locally and doctors can – and should – do more to help patients improve their lives.
Miller, president and founder of the Holston Medical Group in Kingsport, Tenn., is a plain-talking family doctor who has treated local patients for 43 years and built one of the largest practices in the region. He was invited by U.S. Rep. Rick Boucher to give his perspective on health care needs locally.
Miller maintained there could be a 40 percent health care cost savings by eliminating waste – money that could be used to treat more patients more effectively. He also focused on personal responsibility by patients and how doctors need to be reimbursed for helping patients lose weight, stop smoking and generally live healthier lives.
Last Sunday, we wrote about a recent PricewaterhouseCoopers report showing that $1.2 trillion was wasted each year in the health care system due to excessive testing, claims processing problems, medical mistakes, using the emergency room as a clinic, and hospital readmissions. Consider this: Another $493 billion is wasted each year due to risky behaviors including smoking, obesity and alcohol abuse.
That’s the cost of a pound of cure. We want to move toward an ounce of prevention.
On Thursday, Miller told a crowd of about 1,500 people that we are stumbling in areas of personal responsibility – about 67 percent of Southwest Virginians are overweight and more than 30 percent of the population is obese. A third of adults are smokers. Many patients never fill the prescriptions that are written for them.
The audience cheered when Miller mentioned personal responsibility, but we wonder how many of those cheering folks lit up in the parking lot or on the way home. Or, how many consumed fried foods before the forum even started at 9 a.m.
Odds are at least 500 of the people in that crowd are regular smokers, and nearly 1,000 of them are considered overweight. Go back and look at the crowd photos in Friday’s newspaper if you doubt us.
Miller has an excellent demeanor, and he deftly delivered the grim news without making it personal. But make no mistake: He’s talking about us. His aim to have doctors work more intently with patients was well-received by the crowd, which included several of his patients, and this editorial board.
Doctors currently have no real incentive for preventive care. They are paid for testing, surgery and other treatment. They are not paid for focusing on wellness and preventative medicine, for working with a patient to help them quit smoking, nor for guaranteeing that a diabetic patient is losing weight and taking their insulin properly.
But these preventative steps would improve health and vitality for individual patients and lower costs for everyone.
Scientific evidence from the tobacco prevention programs recommended by the Centers for Disease Control and Prevention prove the point. Each year, tobacco use is responsible for more than 400,000 deaths and nearly $100 billion in health care costs. Twenty-one percent of all coronary heart disease deaths, 30 percent of all cancer deaths – including more than 80 percent of lung cancer deaths – and 90 percent of deaths from chronic obstructive pulmonary disease are attributable to smoking.
And even though they die 12 to 14 years earlier, smokers incur $17,500 more in lifetime health care costs than non-smokers.
Diseases attributable to obesity and high blood pressure – including stroke, heart attack and diabetes – also are killing too many of our residents and requiring too much of our system.
As Miller said, no one wants to be obese or an addict. Real health care reform should focus on strengthening the relationship between patients and providers so wellness and overall health becomes the focus.