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This was the admonition from the Pediatrician today when our son took #1 grandchild in for a routine check-up. He's 95th percentile in heigth but only 25th for weight. The trouble is, how do you get a 2 year old to eat their veges? I suppose we could drizzle some milk chocolate sauce on them. I did purchase a juicer as a gift for their family and encouraged them to try juicing some veges/fruit mixtures and have him drink his veges...we'll see.
So, in general, how do ya get folks to do what they're "supposed to do" for the best health and outcomes at a reduced expense? All this Accountable Care and Value-Based Purchasing under the Patient Protection and Acountability Care Act (aka healthcare reform law) kinda demands it and health care delivery models are theorized to prompt success...but there's just one thing missing from all the plans, research, evidenced-based interventions, best practicies and so-on...the patient still needs to comply!
Is mandating a behavior make it so? Heck no. How about financial penalties, you know, the "stick" approach versus the "carrot"?...I bet folks will just pay the penalty. Hey, why am I being such a pessimist?...well, I suppose I know myself too well. Oddly enough, the more I'm educated about something and know intellectually the consequences, it doesn't always motivate me to change or even modify my approach to healthy living. If I have a "bad habit", just knowing I "should be eating more vegetables" doesn't translate into me actually doing it.
So, what will it take? Good question and I am frustrated that I don't have an answer, nor does the federal/state government. The Congressional Budget Office released a preliminary report on some trial/demonstraton projects for alleged cost savings for the Medicare population under disease-management and care coordination projects...their findings are not all that surprizing...there was NOT material cost savings.
Our future will be fascinating for certain. Hope to see ya in it. We've got a lot of work to do!