Fatal Race

It feels weird to be posting about this tragedy right after writing about the so-called "Death Race." But this is bugging me.

Near the finish line of yesterday's Kaiser Permanente San Francisco Half-Marathon, one of the runners collapsed and died. Peter Hass, a Bay Area resident and president of a pet toy company, was just 36 years old, and appeared to be trim and healthy.

You'd think that a race sponsored by one of California's largest health care providers would have medics at the finish line, ready to respond to such a serious medical emergency, but then you'd be wrong:

Witnesses say that Hass didn't have a "fighting chance," since medical staff and paramedics didn't arrive for another 20 minutes. 

After Hass fell to the ground, race volunteers pleaded for help. An announcer made repeated calls for medical assistance, yet only runners standing around came to Hass' aid and performed CPR, according to media reports.

I understand that Kaiser Permanente didn't organize or manage the race -- a company called RhodyCo Productions did. But given the not-insignificant numbers of runners who suffer cardiac events and other injuries, you'd think that an enormous healthcare consortium like Kaiser Permanente would have (and could have) done more to ensure adequate medical care at this event.

Long distance running can be rewarding to some, but as I wrote last October, too many people blindly assume that it's low-risk, too, when in fact:

[M]arathoners – beginning with the very first one – keep dying mid-run. And not just the couch potatoes who push themselves too hard -- we're talking about ostensibly “healthy” runners (like this guy and this guy). Yes, only about 1 out of every 50,000 marathoners die of heart attacks during races, but almost half a million people finished marathons last year, so statistically, we're seeing roughly ten or more fatal mid-race heart attacks per year. And how many more die during training? (Incidentally, how come CrossFit -- which hasn't yet experienced a single reported fatality -- is invariably described as "controversial" and "dangerous," but long-distance running is viewed by most people as normal and healthy?) 

Did Kaiser Permanente and/or RhodyCo fail to take the proper precautions because of simple negligence, or were they lulled by "experts" and shoe companies -- into the (incorrect) assumption that endurance events are "heart-healthy"?

Food Conglomerates: Get Ready for a Smackdown

Michael Pollan’s opinion piece in today’s New York Times is an eye-opener about a critical but largely-ignored part of the health care debate. Pollan's argument is simple: Regardless of what version of health care reform is ultimately passed, the system's going bankrupt unless insurance companies help to address the American obesity epidemic. And the way it's looking, they may soon have no choice.

According to Pollan’s research:

We’re spending $147 billion to treat obesity, $116 billion to treat diabetes, and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending over the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly a tenth of all spending on health care.
…

The American way of eating has become the elephant in the room in the debate over health care. … But so far, food system reform has not figured in the national conversation about health care reform. And so the government is poised to go on encouraging America’s fast-food diet with its farm policies even as it takes on added responsibilities for covering the medical costs of that diet. To put it more bluntly, the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup.

It seems nonsensical for insurers to turn a blind eye towards addressing the obesity problem -- isn't the prevention of chronic diseases good for the insurance industry? -- but as Pollan points out, “under the current rules, it’s much better business simply to keep patients at risk for chronic disease out of your pool of customers, whether through lifetime caps on coverage or rules against pre-existing conditions or by figuring out ways to toss patients overboard when they become ill.”

No matter what version of health care reform is passed, however, these rules are going to change. “[E]ven if we get a health care bill that does little more than require insurers to cover everyone on the same basis,” carriers will be forced to insure “everyone at the same rates, provide a standard level of coverage and keep people on their rolls regardless of their health. Terms like ‘pre-existing conditions’ and ‘underwriting’ would vanish from the health insurance rulebook -- and, when they do, the relationship between the health insurance industry and the food industry will undergo a sea change.”

The moment these new rules take effect, health insurance companies will promptly discover they have a powerful interest in reducing rates of obesity and chronic diseases linked to diet. ... Suddenly, every can of soda or Happy Meal or chicken nugget on a school lunch menu will look like a threat to future profits.

Pollan concludes:

[P]assing a health care reform bill, no matter how ambitious, is only the first step in solving our health care crisis. To keep from bankrupting ourselves, we will then have to get to work on improving our health — which means going to work on the American way of eating.

It’s about time.