Preventive Medicine Column
Dr. David L. Katz
Healthy, wealthy, and wise is one heck of a trifecta. But what if you had to choose among them? Hold that thought.
Conventional wisdom is not always reliable, but “if you don’t have your health, you don’t have anything” is one of those times it’s spot on.
Over 20 years of patient care, I have seen- far too many times- people reach retirement age with nicely gilded nest eggs, and disastrously scrambled health. I have never met anyone seriously willing to trade their capacity to get out of bed for a large bundle of cash. I have known many people who would gladly give up large fortunes for the chance to get out of bed one more time, or get out of a wheelchair, or be free of weekly dialysis.
But now we enter the Twilight Zone, where what’s real and important, and how we behave, part company. We value money (i.e., wealth) before we have it, while we have it, and if ever we had it. We want it if we can’t get it. It’s a crime when someone takes it from us. We fight to keep it.
Health is more important, but most of us- and our society at large- value it only after it’s lost.
Consider that one of the more significant trends in health promotion is providing some financial incentive for people to get healthy. This strategy is populating more and more programs in both real space and cyberspace, and is incorporated into many worksite wellness initiatives.
I support the trend- whatever gets us to the prize is ok with me. But it is…bizarre. We have to be paid to care about getting healthy.
Consider if it were the other way around. You could do a job, and you would get money for doing the job, but then you demanded an ‘incentive.’ Money is not an incentive? No! We insist on being provided ‘health’ to incentivize us to work for the sake of wealth. Unless you, my employer, can guarantee that working for you will help make me healthy, you can take this job and paycheck and…
Ludicrous, right? It doesn’t even sound rational to insist on getting paid in health to accept benefits in wealth. And yet, we all accept that it’s perfectly rational to require payment in wealth to accept benefits in health. We all accept it, that is, until health is gone, we realize what really mattered all along, and we say: what the %#^$ was I thinking? Too late.
Responsible adults take care of their money. They don’t spend it as they earn it- they put some into savings. They anticipate the needs of their children, and their own needs in retirement. Wealth- or at least solvency- is cultivated. If you neglect to take care of your budget and your savings, you are, in the judgment of our culture, irresponsible.
But our culture renders no such guidance for those who routinely neglect their health. Those who don’t have time today to eat well- but will have time tomorrow for cardiac bypass. Those who don’t have time today to exercise, but will have time tomorrow to visit the endocrinologist. Prevailing neglect of health costs us dearly, individually and collectively, and it costs us both health and wealth. Being sick is very expensive- in every currency that matters: time, effort, opportunity cost, legacy and yes, dollars.
What if health were more like wealth?
Then, we would value it while gaining it-not just after we’d lost it. If health were like wealth, we would make getting to it a priority. If health were like wealth, we would invest in it to secure a better future. If health were like wealth, we would work hard to make sure we could pass it on to our children. If health were like wealth, we would accept that it may take extra time and effort today, but that’s worth it because of the return on that investment tomorrow. If health were like wealth, society would venerate those who are expert at it. If health were like wealth, young people would aspire to it.
But health is not like wealth. It is vastly MORE important. Just ask anyone who has one but not the other.
Which brings us back to that choice. You may have caught on by now that it’s something of a trick question. We routinely squander and neglect something we would hate to have taken from us, and would surely fight to prevent someone taking from our loved ones. It’s certainly wisdom- it’s just not yet conventional- to acknowledge that health is wealth. Making it conventional is up to us.
Dr. David L. Katz; www.davidkatzmd.com