This is a continuation of my interview with Mike Huckabee at the National Changing Diabetes Program conference in Washington, DC. In my previous post I asked Mike about his weight loss journey, and in this post I asked him some global questions about healthcare. My regular readers will appreciate that my digital voice recorder did not malfunction during this interview, though I did drop my Blackberry at one point out of sheer enthusiasm. Gov. Huckabee was the first to reach down and help me get it. What a gentleman!
Dr. Val: Your friend, Dr. Fay Boozman, said “We need to stop treating snake bites and start killing snakes.” Tell me what that means in practical terms.
Huckabee: Healthcare in America is reactive and is geared towards intervening in catastrophic situations, when what we should be doing is focusing on preventing them. The whole system is upside down. It’s like we’re focused on putting Humpty Dumpty back together again instead of keeping him from falling off the wall. Our healthcare system is based on a broken egg concept.
So the key thing that we have to change in healthcare is to focus our resources on prevention and a healthy lifestyle.
Dr. Val: You said that your hope was that “‘Healthy Arkansas’ will spread like a highly contagious but benevolent virus that could become the genesis of ‘Healthy America.’” Can you give me a virus update?
Huckabee: We did in fact launch “Healthy America” and it was the most successful Governors’ initiative in that we had more states participate in this than any other NGA (National Governors’ Association) initiative. Forty-three states launched state-based health initiatives for preventive health. Some were more aggressive than others.
We began the initiative because there was a new awareness of the need to change the healthcare model from intervention to prevention. The concept of Healthy America was to influence behaviors at work, at play, at home, and at school. These programs have been remarkably successful. For example, in the first year, the average productivity of state employees increased by $3400/year. And that’s not to mention the savings in healthcare costs. The average diabetic spends 8.3 days/year in the hospital. The cost of those days could pay for 7 years of diabetes counseling and medication. It’s as if the choice is between a new oil filter or a new engine – which do you think is going to be less expensive?
Dr. Val: Revolution Health is attempting to encourage behavior modification through social networking and online, physician-led programs. What do you think are the strengths and limitations of this approach?
Huckabee: First of all the strengths are more dramatic than you may realize. When we used the online approach in Arkansas, we did health risk assessments followed by online coaching for everything from smoking cessation to weight control. Online programs can be very successful because they’re instant and accessible 24 hours/day. The socialization becomes very important because peer pressure can be harnessed to challenge people to walk more steps or lose more pounds than the others in their group.
Online approaches aside, the key to improving health in America is to create an atmosphere of healthy behavior. This cultural change may take a generation to achieve, which is why most politicians don’t touch it. Politicians like to deal with issues that can be dealt with in an election cycle, not a generation.
However, America’s approach to littering, seatbelt laws, smoking, and drunk driving are four examples of real changes we’ve made in this country over time. The changes took place in three stages: attitude change, atmosphere change, then an action is changed.
Attitude change involves giving people information that changes the way they think about an issue. Atmosphere change means making unhealthy behaviors difficult to participate in (like taking away ash trays and putting up a no-smoking sign), and finally the government codifies into law the new behavioral norm.
The government is usually the last player, not the first, because people have to create the behavioral norm before the government can enact laws. If the government tries to mandate a personal habit, then the debate will not be over the merits of the approach, but over the personal liberties of people to do what they want to do. And in America, the government always loses that argument. So what you have to do is get enough Americans believing that taking care of themselves is the right thing to do, and then there will be the demand for government to put that into law.
We don’t have a healthcare crisis in America, we have a health crisis. And if we dealt with the health crisis we would resolve the healthcare crisis. The real reason we’re in trouble is because 80% of the money we spend on healthcare is a result of chronic disease. And that chronic disease is primarily the result of over-eating, under-exercising and smoking. It’s our lifestyle that’s killing us.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.