Last night, I was lying in bed reading a book while my wife watched a recorded episode of 60 Minutes. The theme of the episode was about Americans making a difference. A segment came on about the Health Wagon, a mobile clinic that travels the back roads of Virginia in Appalachia country providing health care services to those too poor to have health insurance, but too rich to receive Medicaid.
I learned two very important things by watching that segment, both of which I already knew, but hadn’t really grokked (The book I was reading was Stranger in a Strange Land by Robert Heinlein, hence the use of the word grokked).
Lesson #1: Individual Health Requires Individual Responsibility
Every one of the people featured as Health Wagon patients had conditions or diseases linked directly to poor lifestyle. Diabetes, emphysema, heart disease. Every one of these conditions can be prevented and even eliminated by making good lifestyle decisions. Decisions as simple as stop smoking, don’t eat nutritionally vacuous food, walk. To be fair, the folks featured in the story probably don’t have the education to know these things, as their lifestyle choices are likely a result of bad information passed down over a couple of generations. The agricultural policies of the federal government haven’t helped either, promoting crops that maximize calories rather than nutrition. The key to changing the health landscape of this country has got to start with what goes in the body, not how to repair the damage.
Lesson #2: The Jobs in the Coal Mining Industry are not Coming Back
At one point, Scott Pelley made a comment about how coal is mined, “In coal these days, they just take off the top of a mountain, and you don’t need many men for that.” The people who rely on coal for their livelihood are in a tough position. The opportunities they grew up with are quickly disappearing. The only hope they have is to learn how to do something else. Most likely that would require them to leave the only home they’ve known and go to where the educational and economic opportunities exist. That’s hard. It’s hard financially, it’s hard emotionally, it can be hard physically.
Part of solving the health care problem might be in solving the economic opportunities problem. Both problems require education and a bit of hard work.