Really cutting health costs

The key is doing a lot more to discourage unhealthy trends

Health care, regardless of which side of the aisle we sit on, is rapidly becoming unaffordable and unsustainable. It’s one of the main issues driving jobs offshore. If we look at the problem the way businesses typically look at their problems, we come to some uncomfortable realities we must address.

Whether you produce products or deliver services, the goal is to satisfy customers. When everything works well, it’s great. When something doesn’t work, we fix the problems, just like doctors and hospitals try to “fix” sick people. 

Smart companies determine the causes of these problems and work to eliminate them, concentrating on eliminating the causes of the most serious and/or frequently occurring problems first. From what I can see, this component is largely what’s missing from the health care debate, at least on Capitol Hill.

Why are so many people getting sick? What are the causes of all these illnesses, and what can we do to mitigate as many causes as possible? The cost of health care would fall dramatically, if we stop making people sick.

For instance, why do we still sell cigarettes? I know there’s nothing worse than a reformed smoker, and I quit over 35 years ago. I was only a light smoker, but quitting was still the hardest thing I’ve ever done. Getting people to quit might seem cruel, but it’s not as cruel as lung cancer and emphysema. Have you ever watched someone die that way? It’s one of the most miserable ways to go, and of course, the treatment is exorbitantly expensive.

How about the obesity problem, not just in adults but even in children? When I was a kid, fat kids were unusual. That’s not true anymore. Yet we have diet sodas and low-fat and even fat-free foods. People were a lot thinner before we had these. Have you ever read the ingredients in these creations? I’m amazed the Food and Drug Administration even allows them on the market.

I’m told they don’t actually take the fat out of fat-free. They chemically alter it, so it’s no longer legally fat. Unfortunately, our bodies end up digesting unnatural compounds they don’t know what to do with.

Many of the groceries we buy are loaded with preservatives. Those aren’t really good for us either. 

Farmers feed their animals chemicals to make them grow faster. Could these chemicals be contributing to our obesity or increasing our susceptibility to cancer?

Of course, there’s plenty of healthy food out there, but have you noticed how cheap the bad stuff is and how expensive the healthy stuff is? Some folks think eating healthy means getting vegetables on their pizza.

Everybody wants free, or at least affordable, health care, but we can’t provide that without some cooperation from the population. We can’t live as unhealthily as we’d like and expect everybody else to pay to fix us.

And since our employers are picking up part of the tab, that increases the cost of our products or services making it even more difficult to compete with offshore operations not burdened with such costs. 

Admittedly, in a “free” society we can’t force people to adopt healthier lifestyles, but we can do a lot more to discourage the unhealthy trends. The FDA can help clean up the food supply. Without preservatives, spoilage will increase, and that’s a cost, but it’s probably a lot less than the corresponding health care costs.

Taxes on cigarettes are already high, but maybe they’re not high enough. And those tax dollars should go not into the general fund but into a fund for the treatment of the resulting diseases.

When automakers amortize employee health care costs over the number of cars they sell, the cost of health care per car is the most expensive component, and it’s not even on the parts list. It’s more expensive than the steel that goes into the car and has been so for decades. As a result, we don’t pay for health care just when we buy insurance and/or pay medical bills. We pay for it with every U.S.-made product or service we buy.

If we want to compete and keep our jobs, our health and its costs are liabilities, but they can become strategic assets if we start managing them that way. 

Ronald J. Bourque, a consultant and speaker from Windham, has had engagements throughout the United States, Europe and Asia. He can be reached at 603-898-1871 or