A foreboding observation

One of my relatives has had the misfortune of breaking a hip, which is not a fun thing to do. Since I have been the principal chauffeur for her many doctor and rehab visits, I have made an unfortunate, but telling observation that is foreboding for us all.  Based on my observations in the waiting room, the dominant majority of patients over the age of 30 in an orthopedic office are obese.

I recognize fully this is not an unbiased statistical sampling. Yet, I kept thinking of what a nurse friend told me about our bodies. Our bone structures are not designed to carry so much extra weight. They will break down. I believe I was seeing first hand evidence of such. This is a foreboding lesson for us all.

Over the past five years, through brief morning stretching routines, walking and smaller portions of meals and snacks, I have lost forty pounds. My goal is to walk on my own for the rest of my life. A geriatric doctor said there are two inflection points on the demise of an elderly person. The first is the inability to drive. The lost freedom is impactful both physically and mentally. The second is the inability to walk unassisted. When this occurs, all sorts of challenges evolve for the patient.

Through my work as a benefit consultant and manager, I became aware of a key data point. The United States is the most obese nation in the world. We are all train wrecks waiting to happen. When we add all of this together, the lesson to be learned is we must do something about our weight. Even a little bit helps. While I have lost forty pounds, I could use about five to ten more less. Or, at least I would like to come in closer proximity to one or two pack abs. Six pack abs would be a pipe dream.

The stretching I do is a combination of Pilates, Yoga, Isometrics and mild weightlifting. They last fifteen minutes and are so limited in exertion that I do them after my shower. The key is they vary daily and are sustainable, which is vital. One day it is stand-up stretching, the next day is floor stretching and the third day is light weightlifting. Then, I start again. The fact I vary them keep me engaged. If I did the same thing everyday, I would get bored.

The above is balanced out with walking and swimming. Plus, the yard and pool boy is the one typing this post. As for the eating, it has taken time, but I eat smaller meals and snacks. Portion control is key, but another contributor is little bread. My wife is on a low-carb diet and that makes a huge difference. We love bread, pasta, potatoes and rice, but we now eat much less of them.

Folks, we must get a better handle on our weight. I am not saying we must look like the after pictures advertised on TV, but we could benefit from exercise and eating better. The alternatives are not pretty if we don’t. Higher blood pressure and risk of falling become more pronounced. So, let’s get moving and eating better.

Two Macro trends we need to heed

Since our public debate in political circles tends to focus on what donors want or who is winning the political “gotcha” game, I thought it might be important to repeat some comments about macro trends for which we need to plan ahead. Looking forward from a report sanctioned by the World Economic Forum (WEF) and Organisation for Economic Cooperation and Development (OECD) that was done in 2008-09 timeframe, several macro trends were identified by leaders in business, education, foundations, and governments. Two are highlighted below.

First, a key concern is simply demographic and it has and will shape our economy and budgets for some time. The world population is aging. It is getting worse here in the US, but it is much worse in places like Japan and Greece, e.g.  In fact, a key reason Greece is struggling today is trying to fund financial commitments made to people who have already retired. You can address the benefit commitments to future retirees, but much of the liabilities owed are for people who have left the workforce and being funded by fewer relative workers per retiree.

This is hitting the US in our cities and states and will continue to do so. Just count the number of states who are grappling with serious underfunding issues on pensions and seeing higher retiree medical costs. It impacts our federal Social Security and Medicare programs as well, but with the earlier retirement opportunities in state pension plans, the cost impact is exacerbated there. With the tandem problem of communities not growing due to suburban flight and poor planning, a number of cities have had to declare bankruptcy. This why it is critical for all governmental pension and retiree medical  plan sponsors to address the future issues now so costs can be spread and mitigated.

Second, a key macro trend that makes the above problem worse, not better, is we are an increasingly obese world.  Unlike the aging ranks, the US can lay claim to being the most obese country in the world. We are number one. This is one of the reasons we can lay claim to the most expensive healthcare system in the world. A former UK colleague, who helped companies with developing global health management plans, noted that the greatest export of the US is obesity. That was not meant to flatter us.

As a former actuary, I can tell you the medical cost rate for people in their fifties is generally 2 to 2 ½ times the medical cost rate of the average workforce.  The ratio goes up for older populations. Yet, as we have grown in size through obesity, we are even greater train wrecks waiting to happen. This is why it is critical we get as many people insured for healthcare as possible, so they can see doctors now, be prescribed treatment patterns, and attempt to ameliorate future health catastrophes. We spend a lot of time talking about and fighting cancers which is great, but heart disease will kill 10 times more people, especially women, who tend to ignore symptoms more so than men and wait longer to seek help. And, heart disease risk is heightened when patients are more obese.

There are other key macro trends noted within the WEF and OECD report. It is worth the read to understand other key drivers of our global economy. But, these two are overarching problems which we need to deal with now before they become worse, as the more we wait, the higher the cost impact.