That's a lot of hot dogs
"Chronic drunks' treatment costs S.F. big bucks"

A good idea about health and health care, but some not-so-good economcs

Associate Professor of Family Medicine Katherine Schlaerth writes that if want to do something about high health care costs we should eat better and exercise more. (Just like the CEO of Whole Foods recommended in his infamous Wall Street Journal piece. We'll see if Professor Schlaerth gets slammed the way he did.)

I would estimate that something like 50% to 70% of my patients' medical costs would be eliminated (not reduced -- eliminated) if their diets and exercise regimens were optimized. But the government seems to be working on the other end of the problem, not taking direct input from actual healthcare providers. Motorized scooters are provided free to morbidly obese patients with weight-dependent arthritis, when the best remedy for these people would be to ambulate through their pain or avoid excess weight gain in the first place. School lunches are often made up of very fattening, but tasty, food. The examples are endless.

But I disagree with what Professor Schlaerth wants to do about this:

So how do we save money on healthcare? We need to get out the old carrot and stick. How about a tax credit for those with a body-mass index (measure of weight to height) of less than 26? Or for mothers who exclusively breast feed for the first four months of their baby's life? Or a credit for documented miles on a treadmill or a bicycle? Or a tax on fattening foods with little nutritional value, as others have suggested?

Nah. Such specific taxes and credits are too inefficient--tax fattening food and pretty soon they'll be gray markets in Crisco and smuggling of soda --and they infringe too much on personal freedom. Better just to give people general incentives to be healthier such as Health Savings Accounts or cheaper but higher-deductible health insurance.

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