Fatimah Ali: Personal health-care reform

IATTENDED an event at the Inquirer and Daily News last week where several hundred black women from all walks of life were divided into small groups for discussions about what makes us happy, and what we'd like to see more coverage of in both newspapers.

I thirst for more info about self-empowerment because the more independent we become in every area of our lives, the better off we'll be. Particularly with regard to our health. Black women suffer disproportionately from preventable illnesses like obesity, heart attack and stroke. That's why the health-care debate in Washington requires our full participation.

A few months ago, I talked with my dad about health-care reform. Dr. Duerward Hughes is an OB/GYN who practiced in Philadelphia for more than 50 years.

HE'S RETIRED in Massachusetts, where all residents are required to have health insurance, and has been watching the national debate closely. His wife, also a gynecologist, who still practices, has a bird's-eye view of the burdens that doctors face today.

Both of them are angered by the routine denial of payments by the insurance companies for her patient's care. "It's a huge frustration," my father says, "and unfair that these companies find every imaginable excuse not to pay doctors for their services." It also eats up time and resources by keeping medical staffs swamped with paperwork.

The Inquirer recently quoted findings by the Medical Group Management Association about how much chasing down payments actually costs: "Interaction with insurers, other than for Medicare, costs medical practices $21 billion to $31 billion a year." That's money that could be used to cut medical costs - or for patient education.

It's pretty clear that the plans now being debated in Congress will ultimately shift more of the burden to us, either through higher taxes or by mandating that all families carry health insurance. But lawmakers are missing several key elements in the messy debate, not the least of which is patient empowerment.

Obviously, the government will want us to become more self-reliant about our health, and the health-care overhaul is likely to be extremely expensive, while no one really wants to pay for it.

Over the last decade, corporate America has shifted more and more of the health-care burden onto employees, either by paying for lesser benefits or reducing jobs to part-time status and offering no health insurance at all. And insurers continue to profit by paying for less care.

But while Congress continues to bicker over how to reform health care, it becomes clearer and clearer that the most essential element of good health begins at home. Despite some growing awareness of this in Washington, D.C., several key issues remain missing from the conversation that are critical to improving the nation's health.

There's not enough emphasis on teaching people about disease prevention and how to become partners in their health by making lifestyle adjustments to reduce long-term costs across the board. Having a pharmaceutically- and not prevention-driven medical industry helps keep people sick, and drives up costs while drugmakers profit.

Americans have significant health issues despite the fact that we spend nearly twice as much per-capita on health concerns as other industrialized nations. And educating Americans about healthy lifestyle changes is the best way to lessen the burden of health-care costs. Good health starts with diet and exercise and although some diseases are genetic, a healthy lifestyle is a major key to prevention.

That's why I fully applaud Lincoln University's new requirement that obese students either lose weight or complete a specialized health course in order to receive their diplomas. It will not only help them live longer, but will also benefit society.

More institutions should follow Lincoln's lead and adapt similar methodologies. Obesity, hypertension, heart disease, diabetes and asthma are directly linked to diet and exercise. Deciding to make healthier choices is one prescription that we can do for ourselves - at very little cost.

Fatimah Ali is a media consultant and an associate member of the editorial board.