Gov. Christie also is in the news as far as health reform goes. New Jersey apparently is going to sidestep the creation of a state insurance exchange--an option available to each of the states under President Obama’s health reform law. Thanks to the Supreme Court ruling, states can opt out of the exchanges and essentially let the feds run the show. You’d think that the GOP--with all its emphasis on state and local ownership--would jump at the opportunity to broker such an exchange (which would bring in the commercial plans as well as public ones). Christie told the Washington Post that he’s concerned about the cost of running the exchange.
He’s right on that score: health care is an extraordinarily expensive undertaking for all parties, providers and plans alike. And our costs keep going up--the main problem the President is attempting to address with the reform law. And we should emphasize the word “attempt” because to me it is unclear if the expansion of insurance--the cornerstone of the bill--will make much of a dent on rising costs.
And that’s where Gov. Christie sidesteps one of the most contentious issues facing the industry--namely the growing incidence of obesity. During his recent interview with Barbara Walters, Christie said that his weight—which he candidly acknowledges—would not be factor in his performance as president. Walters had tiptoed onto the topic, noting that some critics say Christie’s bulk disqualifies him from being president. "That's ridiculous," Christie responded. "I don't know what the basis for that is."
Perhaps Gov. Christie should bone up a little on the obesity issue, an alarming trend that is slowly engulfing our nation. Carrying large amounts of weight basically sets the stage for diabetes, congestive heart failure and even cancer. That’s the consensus of medical scientists, not political scientists. The chronic conditions spawned by obesity are among the costliest to treat. And by all measures, patients with chronic diseases account for a disproportionate amount of health care spending. The industry is attempting to tackle the issue via new models of care delivery--including models that basically shift the insurance risk back to providers. Increasingly, that risk will be shifted back to consumers as well.
Does being overweight disqualify Christie from being president? Of course not. But that’s not the issue.
I recently had dinner with a health plan CIO and a leading industry researcher, and the conversation drifted to the obesity problem. Both said that if the nation continues down this course, both our overall economy and our health care system will suffer even more. They were both strong champions of clinical I.T., but said that no amount of connectivity can solve a problem that originates individual by individual. The CIO predicted that employers will increasingly penalize employees financially for carrying excess weight, by jacking up their premiums. The role of everyday citizens in helping to constrain health costs was largely omitted during the fighting over the Accountable Care Act. If citizens cannot be accountable, then who can be?
Christie himself could serve as a national role model. If he ran for president, and pledged to shed excess weight and do it in a public manner, I’d probably be the first to vote for him. He could start an online campaign and encourage citizens to work with their physicians. Rather than just passing more regulations, he could lead the way by actually practicing healthy eating and walking to work rather than riding a limousine. Maybe I’m naïve, but I believe the majority of overweight people just need support and guidance—not insults and shame— in coping with a really complicated issue. They don’t need laws telling them what to do. We do need shared responsibility.
During my childhood, President Kennedy started a national fitness program and in school we all participated. Nowadays, many schools don’t even offer gym. Christie has a way of connecting with everyday people much like the charming President Kennedy did. So I bet Christie could even succeed. Merely being honest about his own weight struggles—as he was with Walters— would deliver a strong message to the public that no amount of academic research ever could. After all, the cost of setting up an insurance exchange is paltry compared to contending with chronic diseases run rampant.