Re: an ownership society

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05/19/26 4:44:13am

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Subject: Re: an ownership society_v1.3.1

Author:
krz

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Date Posted: 02/ 9/05 11:01:56am
In reply to: pjk 's message, "Re: an ownership society_v1.3" on 02/ 8/05 3:14:27pm

>
but I don't see where it ends... do
>employers then regulate how much salt or transfat a
>person can ingest? How about limits to watching TV?
>Condom usage? Vacationing to developing countries
>(that have lots of nasty tropicale diseases)? Eating
>red meat? Wearing furs? Investing in GE?
>Appropriately inflated tires? If it is about bottom
>line, doesn't image/brand appeal figure in? Ford
>workers must drive ford because employment is at will?
> Pandora's slippery can o' worms!
>
I agree with the slippery slope concern. However, I wonder if science helps to offer guidelines to this. There's no one purporting that smoking is healthy and strong evidence to the contrary. I'm thinking the next 'big' issue will be obesity as folks are already reporting the costs of obesity on the health care system.

If we can establish a clear relationship between a behavior and health then perhaps we can start to shape policy to add accountability. This way we deal with the issue of body mass index (as an example - perhaps not the best measure) as opposed to a behavior. E.g., bmi needs to be within 3 points of normal for age - if you exceed you change the behavior (eat less/exercise more/eat differently) to get yourself there.

In practice in CA, I would often link receipt of therapy services (from me) to those factors that would also modify the behavior that landed the client to me in the first place. Most common - requiring concurrent participation in drug/alcohol programs in order to receive therapy. The interesting reimbursement model we were working under though was outcome driven. The insurer never paid for an hour of my time - as is typical - but paid me to get the patient to a specific outcome (like return to work, or return to being primary caregiver). That way, I could demand participation in those things that could affect my ability to achieve an outcome but that I'm not qualified nor ready to add to my treatment strategy.

I loved the system- most providers are wary.

I'm enjoying watching how the smoking thing spreads - I think it's the start of what we will see as trend....

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