Friday Thinking Joke: Embarrassing

(Attribution to the creator of this cartoon was not available)

The Four Mile Donut

"Consider the Four Mile Donut. If we were to walk as fast as we could for an hour, we’d cover a breathless, heart pounding 3-4 miles. If we then decided to celebrate our workout with coffee and a donut, we would eat more calories in a minute than we burned off in an hour."

The above quote comes from Brian Wansink, Ph.D., author of Mindless Eating. No one here at the Hotel has read it yet, but we will be.

Number One, With A Bullet

At left is a graphic representation of the percentage of Americans over age 15 with a body mass index (BMI) greater than 30. According to our government - and to common sense if you saw such a person - a BMI of 30 or more constitutes obesity, a condition with a raft of chronic illnesses (diabetes, heart disease and more) close behind.

Now click here to see how we compare with 26 other countries who are part of the Organization for Economic Cooperation and Development. But wait, these graphics are based on numbers compiled at the end of 2003. According to the CDC's just-released Behavioral Risk Factor Surveillance Survey (BRFSS), the proportion of Americans with a BMI greater than 30 grew by 24 percent. The same report projects a 25% - 100% increase in health care costs for individuals with BMI greater than 30.

Was there ever a time when 31% of our population over age 15 smoked two packs a day? We demonized tobacco because it needlessly took the lives of people who didn't necessarily understand the risks, because social mores and values were inappropriately supportive of tobacco use and because individuals needed help to tackle their addictions. And I'm not even sure it ever got as out-of-hand as the situation with obesity has become.

We certainly did something as a nation about smoking. It took time and energy, but we did accomplish a great deal. And those who choose to smoke still can, in most cases without it negatively impacting those who choose differently.

It's past time to wake up, step up and move forward on addressing the obesity situation.

Headscratchin' Hospital Huff and TIGGGER01

USA Today wants everyone to know: the uninsured pay nearly three times more for hospital services than health insurers pay for the same services. The paper posted this article online in a format that allows reader comments. Lucky for us all, one has come in from TIGGGER01 that reads "They are adjusting for what the illegals use and are not charged, someone has got to pay for their free ride."

Now which part should make us scratch our heads more, the finding or the comment?

Darned illegals...power-wielding insurers...bureaucratic hospitals...mutter, mutter, muttter. Wait, hold the phone. "They" is us. We are them. TIGGER01's "someone" would also be each one of us (after all, what we pay for what we get in the health care system borders on what should be illegal).

Makes all of us at the Hotel wonder...would we like to create more convenient and myopic rationalizations, or might we like to think a little more about the situation, how the system works (or fails to) and how we can make it better?

Either way, you've got to love participatory journalism.

Friday Thinking Joke: Seeing the Light

It's late at night. A man is on all fours underneath a street lamp, searching for something. A policeman happens on the scene and asks the clearly drunken man what he is doing. "Looking for my keys," answers the man. The policeman scans the area, seeing nothing and asks "did you drop them here?" "No," the reply comes back, "I dropped them in the alley."

The cop is both bemused and baffled. The drunk only registers the baffled part, and explains, "but the light is much better here."

An apt tale to reflect upon for those who are stumbling drunken down the alley of health care reform and thinking that the keys to making improvement will be right where the light is shining.

The Leak Under the Sink

This past weekend was the third installment of "the leak under the sink," an issue I had called a professional repairman to fix (didn't work) and then surely 'fixed' myself last week. Not so. Turns out that all the parts below the sink are interconnected. Simply remounting the disposal that inexplicably fell last weekend wasn't enough. The drain the disposal connected to had a problem, and the pipes and their fittings had all been disturbed by last week's trauma in measurable ways. Measurable, that is, in ounces of water that had accumulated in the under-sink cabinet. Hmm.

Have you already guessed that I might see this as an analogy for the health care system? Without a setup that contains the entire flow, we end up with a trickle, a leak, and ultimately a mess that someone's going to have to clean up or pay to clean up. Attending to one part doesn't get the entire thing to perform right. It sure as heck matters how much water flows in and what's going down the drain with it. Each piece has to be able to deal with what's thrown at it.

Once something does happen, I learned the hard way that it is a whole lot better to take the entire system completely apart, examine the flaws, and then start all over again - some new parts, some old, some different - to build a system that meets the current need and keeps me from coming back in the future to do it again (like next weekend).

Next time you're thinking about health care reform, remember my leak under the sink.