MICHELLE OBAMA DOES HEALTH-CARE THE RIGHT WAY

First Lady Michelle Obama introduces her healthy kids initiative today. Her campaign to fight childhood obesity, if successful, could drive down health-care costs in this country by billions of dollars a year.

Nearly one third of children in America are overweight or obese. In the Latino and African American communities this number jumps to almost half. As these children grow up, they stand an increased chance of developing diabetes, heart disease, and joint problems, plus increasing their risks of several cancers. The costs to our health-care system and to quality of life are devastating.

Ms. Obama's initiative focuses on healthy school lunches, promoting physical activity, and accessing affordable healthy foods. It may sound easy, but as anyone who's tried to lose a few pounds knows, it's not. It will take a combination of government action, parental fortitude, and a pop culture shift to turn around America's "fat" problem.

Government could start by directing farm subsidies away from corn (think high fructose corn syrup) and toward healthy foods grown locally that could be used for school lunches. Sugar-laden soft drinks could be taxed (see the October 20, 2009 Qmuse titled "Health-Care Part 2). I like the idea of the tax revenue going directly to health-care subsidies. Soft drink companies could make-up for lost revenues from sodas by selling more bottled waters--if it's possible to add vitamin D to water this would be a good start.

In a conversation I had with Michael Pollan, author of "Food Rules: An Eater's Manual", he suggested that one of the most important things parents could do for their children's nutrition is cook. I was a little stunned until I remembered a conversation that I had with one of my son's elementary school teachers: When I picked my son up from school, this teacher always asked me what I was making for dinner. One day he explained that I was one of the few mothers that actually "cooked" dinner. When I queried Mr. Pollan on "what" I should cook, he said that almost anything "home cooked" was better than what people were "picking up" to feed their kids. As parents our mantra should be: cook for them, read to them, take them for a walk--we would all benefit.

The First Lady is making every attempt to shift pop culture: She has been seen extolling the benefits of healthy eating on "The Food Network", "The Iron Chef" and "Sesame Street". She has planted a vegetable garden at the White House and has hula-hooped for the cameras. If she is successful with her healthy kids initiative, she will have done what her husband and congress have failed to do--improve health-care. Go Michelle!

HEALTH-CARE: PART ONE

I have been attempting to write about health-care for weeks. As the debate has raged, I have made an effort to read, listen, study, and question the myriad intricacies of this polarizing subject. I was overwhelmed! Therefore, for the next few Tuesdays this blog will explore health-care bit-by-bit. My approach is to deliver to you—simply and succinctly—ideas on how, I believe, health-care can be improved. I welcome your feedback.

Today: Palliative Care

If you were paying attention to the health-care debate this summer, the words palliative care probably ring a bell. The house bill addressed palliative care, and it needs to be addressed. Sadly, and wrongly, Sarah Palin tweeted that this would create death-panels that would choose whether ill people should live or die.

A disproportionate amount of health-care dollars are spent during the last year of life—this simply needs to change. I have encountered numerous stories of how expensive test and useless x-rays are ordered for patients, that save a miracle, will be dead in a matter of weeks, maybe months. The following link is to a story of an oncology nurse's view inside the trenches of what’s happening with end-of-life care, and why it should change. The story takes about three minutes to read and is very insightful.

http://well.blogs.nytimes.com/2009/09/09/prolonging-death-at-the-end-of-life/?scp=3&sq=cost of palliative care&st=cse

President Obama explained in his nationally televised health-care speech, and I paraphrase: Palliative care is not about death panels; it’s about insurance providing funds so that families can sit down with doctors to talk about options for terminally ill loved ones. I agree that money is better spent to inform families of the options for dying loved ones than throwing money on delaying the inevitable. However, regular doctors and nurses are not always the best people for this job—they’ve been trained to do everything in their power to save lives; helping families let go is counter to this training. Palliative doctors are trained in medicine, but also in hospice care and even spiritual care. As the baby-boomer population ages, this relatively new discipline should be in demand.

As I was ready to post this story, I got an email from a friend who was at the hospital with his dad who has been fighting lung cancer. My friend was faced with the excruciating ordeal of deciding on breathing and feeding help for his dad to prolong his life a few days or weeks, or making him comfortable with drugs, in which case he was looking at a couple of hours, or maybe a couple of days.

I know that if my son or daughter were lying in a hospital bed and I was faced with this decision, I would be so tempted to prolong the inevitable; even if it was just so that I could watch their chest rise and fall.

Palliative care is not about “death panels”. While the dollars and cents of keeping people alive needs to be addressed, make no mistake, the biggest cost is the emotional one.