The more I learn about economic theory the more I realize how we can extrapolate this to make rational decisions regarding daily life. Of course this is the core of behavioral economics, which I think is just fascinating. I have been trying to figure out a way to apply some of these theories in my practice of medicine. Especially since the majority of health concerns are related to perfectly preventable causes. I am also concerned because we are seeing something never seen before in history. Young people being diagnosed with chronic conditions such as diabetes at a young age. If you figure that this is the leading cause of renal disease and dialysis among various other health related issues such as heart disease, blindness, stroke, limb amputation, etc. etc. and then you try to imagine people in their 20’s and 30’s receiving this diagnosis at an astronomical rate (as I noted earlier 1 in 2 people born after the year 2000) it is scary. Especially considering, these youthful people with chronic conditions will be supporting parents with equally chronic conditions, and they themselves will most likely be heading toward disability, and very expensive and long term health care costs. Unlike type 1 diabetes which is a problem affecting insulin production, I can not see how medicine can out maneuver type 2 diabetes which is a problem with insulin resistance. This will cause a massive drain on our already taxed health care system, which I do not see as sustainable at it’s current levels.
Although, I have to tip my hat to human ingenuity, I can imagine our greatest hope would be in the field of genetics. Some of the latest research regarding "leptin" makes me hopeful that we can find treatments to offset poor dietary habits that are more effective than gastric bypass. Although I have observed that therapies that offer a "garden of eatin’, I mean garden of Eden approach" tend to be like Tiger woods: too good to be true. You can only get so much bang for your buck, sorry about the pun, and it tends to be impossible in life to have all your cake and not have to suffer consequences in the end. The goal: find and automation strategy to make good dietary strategies the default, some ideas:
1. eliminate fast food (we don’t need it)
2. eliminate sodas (again we don’t need it)
3. change the farm bills to support healthy food choices, and sustainable living
4. create a social safety net, to support families and decrease stress
5. Invest in and implement a better school lunch program
6. health care for all, really part of the social safety net
7. focus on people and be happy with enough instead of always wanting more.
As you can tell these are ideas that focus on many of the problems we see affecting people of lower socio-economic backgrounds, the very people who have the highest incidence of these diseases, I believe this is directly related to time and stress, something hard working Americans have too little of and too much of (respectively). I tip my hat to President Obama, who shows in his words and refreshingly his actions that he cares deeply in general about people, we are lucky to have such a compassionate leader, this is hope that we can believe in. Even if it continues to require such great compromise!