Prevention is hard

What I’m thinking about this weekend…

We don’t do prevention. We do crisis reaction. We don’t do moderation. We do excess.

The pandemic made this incredibly clear. We've come to learn about the severe fragility of our healthcare system and public health infrastructure these last 3 years. Our healthcare system is designed around who gets paid and how — not how to keep people well. Hospitals and clinics in the U.S. are crumbling because of the loss of hyper-inflated fees for procedures and recurring visits. Where is this most acutely being felt is by our rural hospital system. Since 2005, 193 rural hospitals have been shuttered.

A episode of The Indicator podcast explains our health care fragility from the view of the front line.?

Our system of care needs you to be broken; to be sick.

But what happens if the population experiences a mass illness that penetrates communities and is prolonged??

A new balance must be struck?between the desire for a sophisticated, high quality, and personalized healthcare system, and sense of collective responsibility that my ill health — that can be prevented — can have a devastating impact on my family, neighbors, and community.

But, prevention is hard. It requires thought. It requires sacrifice — at least at first. It requires commitment to new habits and change.?

Here’s one action to think about that could have incredible personal and collective impact for the greater good.

The Japanese, specifically, Okinawans, have a common saying, “Hara hachi bu,” or “fill your belly to 80 percent.”?

When we overeat — guilty — we actually make our body work harder than it should when processing or digesting food. This actually wears down our body and shortens our life.?

How do you know when you’re 80% full? It’s trial and error to feel that. But one thing you can do, is fill you plate with your “normal” serving then remove about 20% of your helping. Then, put that smaller serving on a smaller plate.?

Do this over and over and over … and now you have a new normal and you’ll have an innate sense of your 80% full.?

That's just one behavioral example individuals can make. But what is often stated by economists and climate experts, is that theses individually meaningful changes are hard to capitalize into mass-scale impact necessary to save a system.

That's a pretty dire view. I'd like to not be that cynical, but I understand the math a little to recognize that unless systems are re-oriented, people will be people and go where they are guided.

So, this is what I'm musing on this weekend.

You may notice a slight change with this newsletter.

There's a new title: The Equation. That title reflects my reclaiming of this space for my individual analysis and thinking, not a space to push and promote the specific work I do with my company, Commonly Well (albeit they're related).

The Equation is also a reflection of a quote that is one of my core principles: "Everything in life is an equation; work the equation."

The quote comes from Steven Little, fitness coach and former Peloton instructor. He was kicking my ass during a ride one time (damn I miss him) and blurted out this wisdom. It rattled around in my brain for months, nay, years! It expresses the fundamental notion behind my idea that we will solve addiction when we don't solve for addiction.

In other words, most of what we do now in addiction care (and healthcare, see above), is create a bunch of hammers. Therefore, everything we look at is a nail. This might be necessary on some level, that is, there are sick people and sick people need specific interventions for them to no longer be sick. But, see above thought about prevention, the sick care solution never gets any substantial traction (i.e., solving the bigger problem), because it is predicated on another idea I hold -- the inevitability paradox. That is, addiction is going to happen, it is inevitable. So we just accept it and wait for the suffering souls to find us at the bottom of the waterfall.

That is bleak and inhumane.

So, The Equation. If we work the equation of addiction, I think we get to something much more interesting in terms of how to address the issue and all it's complexities. That's what this space is going to be about.

Look for something new every Friday.

As always, I look forward to your thoughts, your pushback, your adulation, your scorn. Whatever. Let's have a dialogue.

Until next time ... Be Well.