This is in response to the March 14th blog about managed care. In particular I would like to address the issue of preventive care. It is not really our lifestyle that needs to change but our culture. Culture is what drives lifestyle. As an example, being a nurse I meet many people from all walks of life, rich to poor. Whether poor or rich, both sides tend to work long hours, have high stress, lack exercise, and eat poorly all of which leads to chronic disease. Why, because whatever extra money Americans make is spent on stuff.

Our culture’s idea of a "good life" or "quality of life" is based on the perspective that the more "stuff" you have the better off you are. Who’s got the biggest house, latest fashion, nicest car, newest electronics, etc. In America we work our behinds off for a 5000 square foot house with granite counter tops, a flat screen television, and leather sofa where we can sit for hours eating fast food, getting fat and stressing out about how to pay next month’s mortgage, new car loan and credit card bills all the while popping anti-depressants like candy. That’s the American culture which drives our lifestyle.

As an example, I recently had a conversation with a single friend who makes a very good salary. We discussed the benefits of organic food and her response was that she would love to eat more organic foods but she can’t afford it. Meanwhile, she just traded in her 2-year old BMW for a new one "cause it’s so cool," purchased a 3500 sq. $400,000 home two years ago with a three year ARM coming due next year, and is thinking about having breast implants.

A culture based on high quality (not quantity) living would value financial stability via savings, leisurely enjoyment of high quality food with friends and family, any extra time spent on physical activity or enjoyment of hobbies, etc. This type of culture leads to better overall health. As an example, the French diet is very high in fat yet their rate of heart disease is less than ours because they eat freshly cooked, low processed foods in smaller portions, they take a long time to eat with friends and family, and are more physically active. (Wine of course has a beneficial affect as well.) Our insane lifestyles lead to the intake of highly processed, low quality foods which are fast and convenient because our culture views time as money and not time as precious.

Dorothy also added a comment "from the front lines" on socialized medicine:

In regards to the March 19th entry: In the past I worked in the operating room for many years and had many citizens from Canada and the UK come for surgery here in the US (combining surgery and a vacation) because the waiting lists were too long in their home country. (Now the trend is to go to developing countries as they are cheaper than we are). It is because of that experience that I often tell others who want socialized healthcare that it is not the best alternative.

When connected to the trend of obesity, these plague-level stats are enough to make news headlines regularly. It's hard to ignore a figure like 74 million, the total number of Americans with prediabetes, Type 1, and Type 2 diabetes.