Two roads diverged in a wood, and I- I took the one less traveled
by,and that has made all the difference.
Robert Frost

It began innocently enough, but in the end would have been grounds for divorce in twenty two states! I was speaking at a conference at a beautiful lake side resort and was hoping to get in a run before my morning presentation. The hotel was magnificently situated on hundreds of wooded acres with two golf courses cut from the fabric of the landscape. My wife had accompanied me on this trip as she knew of the splendor of the location and wanted to drink it in for herself. We don't normally run together as our schedules and biorhythms rarely coincide, but on this early October morning we had both the opportunity and motivation to venture out side by side. I had measured the distance from the entrance of the property to the hotel and had mapped out a simple 5 mile route for the occasion. It was a brisk morning, enough for a long sleeve shirt and gloves, and we stretched and warmed up by the first tee. It was too early for the golfers so we speculated that a run on the golf course was not out of the question if we wanted to "live on the wild side". About that time I spotted a jogging path lying parallel to the first hole and suggested we follow that instead. Susan agreed, so I started my Garmin 405 watch and off we went.

The first few miles were surprisingly hilly and we easily broke into a cool sweat. We kept a slow pace because of the topography and enjoyed the scenery. Three deer ran across our path onto the golf course ahead and with their abundant numbers, the squirrels looked like they were having a convention of their own. I had planned our departure to allow for about an hour run to get me safely back to the hotel in time to shower and prepare for my talk.

After going about a half hour I noticed that the color coordinated trail markers had changed from their original yellow color to black. I remember taking a few turns and forks, but thinking this was a simple circular route, I didn't pay much attention to the details. I mentioned this change to Susan and she didn't seem too concerned so we ventured on. After another mile it became clear that we were not going in a circle but were in fact traveling farther and farther from our home base. I have the sense of direction of a cross eyed pelican and Susan is not much better, so we soon realized that we were lost and about 5 miles from whence we started. We were obviously in a golf course neighborhood, but at 7 AM and dressed in black tights I was not about to knock on any doors and ask directions. We did the only logical thing we could think of and started to retrace our path in hopes of rediscovering the way home.

Mistake! As I said I could get lost in a mall parking lot so depending on me to follow the bread crumbs home is like a blind person following Google Maps. At this point two concerns were percolating in my brain, first, would I make it back in time for my talk, and second, would my wife kill me for turning our 5 mile fun jog into a 10 mile juggernaut?

I tell this tale to illustrate the universal law of unintended consequences. I started out with a plan in mind and ended up with my wife asking a passing motorist for the name of a good divorce attorney. President Obama's health care debacle reeks of unintended consequences. Regardless of the moral high ground and good intentions of universal coverage, it cannot and will not arrive without unforeseen and unintended consequences. Herein lies the dilemma; we won't know many of those effects until after years into the change.

The HIPPA laws passed by congress are a perfect example. They were intended for a noble purpose, protecting the privacy of the patient; however they have morphed into regulations that make nuclear facilities look tolerant and paper work that has singlehandedly deforested the Amazon basin. Be prepared for some form of restrictions (i.e. rationing) tax hikes (there is no other way to pay for it all), lower quality care (dumbing down just like in the public schools), and more fraud (unscrupulous doctors and executives unwilling to give up the house in the Hamptons). The system is indeed in need of repair, but to strap us all with a complete overhaul is like buying a new car when all you need is a lube job. Let's look at real reform like prevention, tort reform, portability, non exclusion clauses, and free deep fried candy bars on a stick for everyone. Okay, maybe we can leave off the candy bars, but we need a heavy dose of common sense so step number one is, in the words of Shakespeare, "let's kill all the lawyers." (and politicians, I might add)

Oh by the way, I did make it back in time from the run to give my presentation and my wife has not filed for divorce, so far.

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A Prevent Defense
With the health reform debate blazing forward with the speed of a pregnant turtle, it seems only right to mercilessly show the political hacks where they have fallen off the bus. I know that sounds a bit presumptuous but trust me, I’m a doctor and I don’t just play one on TV.
First, what Washington is gobbling up then spewing out is not health care reform but heath coverage and insurance reform. No sane individual debates the merit of health care for all; it’s how that is achieved that befuddles the legislators, many of whom cannot find their way out of a wet prescription bag. Having Washington revamp the health care industry is akin to having the Chemistry department at your local community college write education policy for the nation; it’s just not what they do.
The key to real health care reform is not in legislation but in prevention. And you can’t legislate prevention! True honest to goodness prevention begins with the individual, and, in the case of kids, the family. Before we explore some practical tips for family disease prevention allow me to make the distinction between prevention and early detection. Pap smears, mammograms, and colonoscopies are techniques for early detection, not prevention. The disease already exists when these tools are utilized. They are incredibly useful and important tests and I strongly recommend their use, but don’t be under the misconception that getting a regular Pap smear will prevent cervical dysplasia and that yearly mammograms will keep breast cancer at bay. True prevention is designed to prevent or delay the onset of disease, not find it earlier once it exists. If we are to truly reform health care in this country it must begin with every family taking responsibility for prevention.
Let’s examine some methods of prevention especially suited for the family.
1) Get your kids vaccinated. If you are one of those wild-eyed, Jenny McCarthy worshiping, whack jobs that thinks childhood immunizations cause autism or any other disease, then you may already be too far gone. Not only is there no credible scientific evidence that vaccines cause autism, but not vaccinating your kids leaves them, and those around them, vulnerable to known diseases that can kill them! Measles, rubella, influenza, pertussis, and encephalitis still exist and still have serious consequences.
2) Insist on at least 30-60 minutes of physical activity for your child every day. This is an absolute minimum, and you can’t rely on the school gym program to meet this need. The average teenager spends 17 minutes actively moving in an hour long physical education class! Put a lock on the computer, blow up the TV, pour molasses in the back of the Xbox, and buy your kid a nice pair of running shoes. Childhood obesity is one of the top health problems in the country and the cure for obesity is exercise.
3) Teach good dental hygiene. We don’t often think about this as a public health issue, but many good health habits are taught early and this is one that will pay lifelong dividends. Dentists report that more and more kids (and adults) are foregoing routine check ups and preventive care due to economic concerns. Have a few less Grande Mocha Latte espressos and get your child’s teeth cleaned on a regular basis.

Now a few tips for the adults. Remember, you set the tone for the family. What you do often becomes the norm for everyone else.
4) Let’s get this out of the way right up front: eat healthy and exercise! There, I said it, you heard it, so do it! Enough said.
5) Wear seat belts. If you don’t know by now that buckling up saves more lives than Bruce Willis in Die Hard II then you have been living in a cave in Afghanistan. We all freak about the H1N1 virus that has killed 1000 people so far this year, but forget that not wearing seat belts kills an average of 5500 persons and injures 132,000 every year!
6) Join a church. Now before you write me hurtful and angry emails telling me that I am an ignorant, fundamentalist, Southern fried religious nut, hear me out. A study from Harvard (that close minded, Bible thumping bastion of evangelism) concluded that people who belonged to a religious community (i.e. church) had not only lower incidences of hypertension, diabetes, and senile dementia than their non church going brethren, but they also had longer lives on average. I am not advocating populating the pews just to live longer and healthier, but what a great side effect! In fact many studies show that people who regularly attend church tend to practice fewer risky health behaviors, are more emotionally stable, and have a greater sense of purpose.
7) Go back to school. This should convince you that I have gone completely bonkers. The reality is that people who keep their mind engaged in some meaningful activity have fewer risks for Alzheimer’s disease, senile dementia, and even some forms of cancer! Granted, this doesn’t mean you have to become a freshman at your local college, but staying mentally challenged through reading, working puzzles, journaling or a thousand other activities of the mind can be as healthy as jogging a mile a day.
You want health care reform? Start today by practicing family prevention

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