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August 19th, 2009
09:18 PM ET

Incentives for doctors to make people healthier

Program Note: Dr. Toby Cosgrove will be on the show to talk about obesity and the need to give doctors nationwide incentives for making people healthier. Tune in TONIGHT on AC360° 10p ET

Delos “Toby” Cosgrove, M.D.
President and CEO, Cleveland Clinic

As a heart surgeon for 34 years, I feel passionately about America’s health and the tremendous burden of disease. I’ve had the unfortunate experience of holding heart and lung tissue that has been destroyed by smoking and other poor lifestyle choices. This saddens me.

The nation’s healthcare system is at its breaking point. In 2008, U.S. healthcare spending reached $2.4 trillion. Seventy percent of this cost results from treating chronic diseases, and behavior causes many of these. An astounding 40 percent of the premature deaths in the U.S. are secondary to behavior, physical inactivity, unhealthy eating habits and tobacco use.

This disease burden needs to be attacked through innovative measures. We need to provide the proper incentives to encourage personal responsibility for maintaining a healthy and active lifestyle. It should be our patriotic duty to take care of ourselves.

Fifty years ago, we learned that smoking kills. It’s taken us that long to have a significant impact on this killer, and yet, 20 percent still smoke. We have just begun to address the other behaviors weighing on our system. We can’t wait another 50 years to change the trajectory of this enormous human and economic drain on our nation.

Since the 1970s, the obesity rate in the United States has doubled. It accounts for 10 percent of our country’s healthcare costs. Obesity is associated with 20 times the incidence of diabetes and twice the amount of heart disease. Obesity puts 20 years on a person’s life and escalates the diseases they’ll struggle with over their lifetime.

As President and CEO of Cleveland Clinic for the last five years, I’ve tried to lead by example. Our hospitals are smoke free. We offer free smoking cessation programs to current employees and because we believe that healthcare organizations need to model appropriate behavior, we no longer hire smokers. More than 150 employees have signed up to quit smoking. We have banned trans fats from our menus and thousands take advantage of free gym memberships and Weight Watchers programs. They’ve lost about 100,000 pounds. We need to attack obesity as a disease, not obese patients.

We need to give doctors nationwide incentives for making people healthier. They should be rewarded for teaching wellness and prevention measures to their patients and reintroducing education into the healthcare system. It’s important that we move from delivering “sick” care to “health” care.

My goal is to bring awareness to an epidemic that is affecting the quality of life of two-thirds of Americans. I don’t want to see surgeons operating on disease that could have been prevented.

It’s my hope that if we get the incentives right, that we can unite against the preventable diseases that are bankrupting our country, our families and our futures.


Filed under: 360° Radar • Health Care
soundoff (44 Responses)
  1. Teresa, OH

    Wonderful article, Dr. Cosgrove.

    Here's an idea: find out what Americans are so depressed about, find real cures/ coping tools, and you will probably get rid of most diseases due to bad habits and physical inactivity.

    August 20, 2009 at 9:38 am |
  2. TimH

    Prevention should be at the top of the list in health care. Businesses, Doctors, insurance companies, and the government should join on this front with a massive campaign to bring early recognition seminars and prevention incentives throughout the US.

    August 20, 2009 at 7:48 am |
  3. Anne Kimbrough

    Re: the Cosgrove(?) interview: OMG!!!! We're not discrimintating against (fat) people, we're discrimingating against obesity!?!?!?! We're not discriminating against (smokers), just the health issues involved with (lung cancer)!?!?!?!?!? Please....everybody is genetically different! I've known men/women who smoked unfiltered cigarettes for more than 50 years who died at the age of 85 from freak accidents and I've known men/women who jogged, ate right, never smoked a day in their lives who have died from lung cancer, throat cancer, and all other sorts of malady's....Sounds like Hitler discriminating against those with dark skin (who could die of melanoma), that didn't fit into his ideoloigcal world!!!

    August 20, 2009 at 5:56 am |
  4. George J.

    I have five different complaints against doctors.

    1. I had gall stones about seven years ago and they wanted to take my gall bladder out. I got rid of them with a simple cure of lemon juice and virgin olive oil. Around $10.00. It would have costed about $20,000 for the operation.

    2. I had a stomach ache and my doctor put me in the hospital for 28 hours. They took a picture of my stomach and found out that I had a small ulcer. He wanted to keep me in the hospital for the entire weekend. I took the IV out of my arm and left because it seemed senseless. It costed medicare and me $7000.

    3. The hospital had charges on my bill that were non-existent like aftercare which I had never received. When I called them on it, they said that the charge was just normal hospital procedure.

    4. My doctor said that I had to see an optometrist because he said that he could see something wrong with my eyes. It turned out that the optometrist was his wife in a different clinic.

    5. I have recieved tests from my doctor that had nothing to do with why I went into the clinic.

    President Obama is right on the mark.

    August 20, 2009 at 5:54 am |
  5. ccbaker

    great idea NOT to hire smokers! ...glad the President is FOR IT! by the way, is it too late to make this a retroactive RULE to live in the WHITE HOUSE and work in the OVAL OFFICE?

    August 20, 2009 at 5:38 am |
  6. Will Gifford

    As much as i appreciate Candy Crowley and Roland Martin they ae live exmples of obesity as acceptable. Show us an example of how the words of Tony Cosgrove – become reality.

    August 20, 2009 at 5:28 am |
  7. Coy Lane

    I can agree with the fact that treating obesity realted health problems costs alot of money.

    But, I stand by my thoughts that America is a free country. And I beleive that in order to have a 'successful' decrease in obesity we would have to get rid of everything that causes obesity. Thas includes every fast food restaurant, every video game, and shoot why not vehicles (less people walk because they have cars, right?). I think that getting rid of those things would be forcing Americans to give up who they are.

    And, no, I am not obese. I know a lot of people that are very well. And some of those people can't help it. Some people are naturally 'large' due to other health problems that they could not avoid and because of those unavoidable problems they are now having problems due to obesity.

    August 20, 2009 at 4:01 am |
  8. Sandra K Ford

    Pick on Alcohol for a while. It kills whole households and car loads and family's at a moment in time! Cig's and food only hurts ones self over a life time. Get a grip!

    August 20, 2009 at 3:43 am |
  9. Rumm Morag

    Nobody questions the appropriateness of excluding felons from becoming police officers, school teachers, and physicians. Yet when an employer is selective based on social habits or body build people cry foul.
    Think about this the next time a 350 pound flight attendent squeezes past you repeatedly down the aisle and steps on your foot. Hold on, I've never actually seen that before, the airlines usually put them at the ticket booths not on the planes.

    August 20, 2009 at 3:15 am |
  10. Terry Slagle

    Hi Anderson,
    I was listening to the Doc who was talking about refusing health care to smokers and obese people,I was appalled by this. What is next not giving health care the deaf, blind or people with disibilities ? Who decides who gets health care? We the Americans should decide if we are paying for it don't you think? Most obese people do pay for their health care if they are working and who decides who is obese? Isn't it if you are over 20 lbs that you are consider obese? So wouldn't that make everyone obese and then what we all don't get health care? Just something to think about.

    August 20, 2009 at 3:00 am |
  11. Cindy

    I think that not hiring a person because of obesity or smokes is descrimination. It used to be that was something employers could not do and now announcing it on TV.
    That is not part of health reform , but adding to unemployment , and mental stress. Ok, now they can't get a job, and if they are obese and know they didn't get a job because of it , is more distress.
    It is one thing to promote good health, but not to shove it down some ones throat. I am all for good health. But to think someone else can make that choice is wrong. Freedom of choice is still part of the constitution and doing it this way is not the right way to do it.

    August 20, 2009 at 2:44 am |
  12. Marsha

    I am denied health insurance due to hyperthyroidism and mild hypertension. I have never smoked or been overweight. Smokers and the obese drain the health care system. Maybe they should be excluded from coverage also. It is called "Risk Management."

    August 20, 2009 at 1:59 am |
  13. Quentin

    Not hiring people because they're smokers sounds to me like discrimination. This is still a free country right? where do we draw the line do we not hire pale white people because they are move likely to get skin cancer or black people because they are more likely to develop diabetes. This is a slippery slope.

    August 20, 2009 at 1:58 am |
  14. cindy

    why are we always picking on the smokers, now your not going to hire them, then you have to weed out all the alcoholics, prescription drug addicts, pot smokers, people that are to thin, as all of these are a drain oh health care, and if we did that there would be nobody left to work. I think there could be a lawsuit arising its such discrimination and hypercritical

    August 20, 2009 at 1:56 am |
  15. eileen k.

    hello a.c. i dont think this is a bad idea. an incentive to promote healthy lives. even though this is a "free" country, people should have more limitations on their unhealthy habits. i know if your an adult and you know the risks then your on your own right? nope, not anymore. if you dont like it, tough.

    August 20, 2009 at 1:38 am |
  16. Tena - York, PA

    I tryed to get health Insurance years ago and the lady I talked to asked me how much do you weight. I told her and she sayed OH my dear you weight too much to get covered. Also you said about getting a job because you are heavy. I applyed for a job and they wanted you to send in your credit score and it had to be good or they will not hire you.

    August 20, 2009 at 12:32 am |
  17. KIm

    Maybe we should get the doctors to hold the town hall meetings !

    August 20, 2009 at 12:20 am |
  18. Mike

    If Toby really cared , wouldn't he hire only smokers and help them with their addiction?This just seems like a disguise for greed,greed and more greed to me. I see a book deal.........A Toby Approved Life....bubble not included.

    August 20, 2009 at 12:15 am |
  19. Frost

    I absolutely think that companies should take into account smokers when they hire. If nothing else; smokers should pay higher health insurance premiums than the rest of us. Because we're the ones who are paying for the diseases smokers will inevitably incur down the road.
    I also think that employees and doctors should be rewarded or incentivized for good health practises. IE: regular exercise and good eating habits. Our country's priorities are so out of whack. We work like crazy (when we actually have jobs), but don't work out. Stay late, eat fast food and smoke and drink our stresses away.
    It's beyond time, we as a nation, made prevention the #1 health care concern.

    August 20, 2009 at 12:14 am |
  20. Phyllis K.

    Following up my prior post, I was commenting on the segment I saw on Anderson Cooper 360 on Wednesday, August, 19, 2009, rather than the blog post above, because the comments section directly for the show would not accept my post for some reason.

    I realize now that in the post above, Dr. Cosgrove does mention the smoking cessation programs I suggested, for current employees, although the only thing that was mentioned on television was that they don't hire people who smoke.

    Of course, that would mean the President of the United States would be unfit and ineligible to work at the Cleveland Clinic were he so inclined or qualified.

    You would think if someone was highly qualified but unfortunately addicted to a legal substance such as tobacco, one might still hire them and show them the way to recovery from their addiction, if one believes it is something easy enough to overcome with available help from one’s own healthcare delivery organization.

    You would think.

    August 20, 2009 at 12:07 am |
  21. Albert Funwi

    I am so impressed with the steps the Cleveland Clinic is taking to maintain a healthy work force by banning smooking, and also letting their workers engage in controlling their weight. Obesity is one of the most devastating chronic diseases which is taking a toll on the young and the old with a lot of other diseases resulting from the obesity. Americans need to be concerned about obesity because of their lifestyle and nutritional habits which needs to be controlled. I wish all other hospitals and clinics all over the nation will take Cleveland clinic as a model and as a benchmark to follow, in that way we will maintain part of the population healthy. knowledge is wealth it is devastating to die of something when you are well aware of the after effects and as a health care worker.

    August 20, 2009 at 12:00 am |
  22. Paula Vaughn

    There is a vast difference to discriminate against smokers versus obese people. Dr. Cosgrove must not equate the choice to smoke with the complex causes of obesity. Not everyone who suffers from obesity made a choice to be obese. We don't need to set a precedence to discriminate against people for being obese. Next, we will discriminate against people for appearing anorexic. Body fat is not a disease, it is a symptom.

    August 19, 2009 at 11:54 pm |
  23. Phyllis K.

    Dear Anderson,

    Oh my God, as a fan of you as one of the few reasonable television reporter/news anchors left on this planet, I can't believe what I just heard coming out of your mouth. And the President and CEO of the Cleveland Clinic should be ASHAMED of himself for even suggesting that overweight or "obese" people should not be hired. At least he did say that it was a disease, but only half-heartedly and with what appeared to be some embarrassment . . . and then his suggestions about "good food" and “stairs” as the solution was just typical of people who don't get it.

    There are physiological, hormonal components to the disease brought on by fat cells themselves, as well as cravings no different than a heroin or meth addict might have, except that it's not so simple to deal with when the substance craved consists of components found in thousands of foods items. The multibillion dollar diet industry only promotes more obesity by setting people’s bodies up for metabolic disaster disguised as personal weakness.

    Don't you know we unlucky overweight and obese people are already discriminated against and can't get jobs most places? ! Do you all of you highly successful news media people only associate with the thin and beautiful, non-afflicted, NON-diseased people? I suppose that’s true, at least the ones of you who appear on camera, or you wouldn’t be there. Count your lucky stars if you are a “normal” thin person who has never struggled with their weight.

    Yes, obesity is a disease, and I'm sick and tired of people in the news media, including so called medical professionals like Sanjay Gupta from CNN and Nancy Snyderman from MSNBC, basically promoting hatred of fat people and discrimination against them as if they were weak, lazy, and of poor character instead of suffering from a stubborn-to-treat disease that devastates those of us who struggle with it.

    I can also think of a hundred other physical conditions that one might have that might cost just as much as obesity would, if we are factoring in health insurance costs in hiring decisions, and do we consider not hiring these people? Why the hell doesn't somebody realize that there is really no legitimate help for people like us, and there has never been any legitimate help for people like us, save the few lucky souls who have access to the funds to go to a treatment center for addiction?

    Check out the websites of these treatment centers for information; Casa Palmera in the San Diego California area, Mirasol of Arizona, Pine Grove of Mississippi, and many many others.

    Also see somethingfishy.org (about eating disorders) and follow links from there to find information that you and your medical doctor friends and colleagues obviously simply ignore or just never bothered to seek out due to ignorance of its existence.

    Oh, and by the way, cigarette smoking is a hell of an addiction as well, and I don't think it's right to not hire people because of that, either. Instead, offer them "incentives" and pay for programs to help them quit, even if it takes them five tries, because it might.

    I was so offended by the discussion you had with the man from the Cleveland Clinic that I had to turn the television off, so I may have missed the fact that you came back after the break with some more reasonable responses to the situation.

    Personally, I have a long and interesting story to tell about my own recovery from the addiction of alcoholism (18 years) and smoking (17 years) and my decades-long struggle with food. I was a normal-weight child who started dieting and starving as a young teenager in order to be much thinner and more (what I thought would be) attractive, no doubt due to social pressures, and this started me on a long road to diet/binge/diet and more weight gain than I could have ever imagined, to the point that I feel powerless and hopeless because I cannot get the help I need that I know exists, because my insurance does not cover it and I’m not rich enough to pay for it out of my pocket.

    No, I don't want that ghastly stomach surgery. I'm talking about eating disorder treatment, because I have failed to conquer this on my own after dozens and dozens of attempts, including OA, that eventually backfired and failed miserably because I need intensive help to get to the root of the problem, detox in a safe place, and give me a chance to succeed, with tools I can take home with me along with outpatient follow-up.

    So, if you want to know more about what I'm going through and how devastating it is to hear you make such statements on television, give me a call. I'd be happy to discuss my experience with you and anyone else if it will help move this discussion in a sane and moral direction and away from stereotypes, blame, and discrimination, which are becoming more prevalent by the day.

    I'm dead serious about this. I feel like my only purpose left on this earth is to change the public perception of the "obesity epidemic" and get to the real root causes and get people some help . . . along with the smokers and drug addicts that people want to shun or imprison instead of help.

    Sincerely,

    Phyllis K.
    Nashville, TN

    August 19, 2009 at 11:54 pm |
  24. Don Logue

    You need to have him back to talk more about the healthcare reform debate and the flaws in Medicare.

    August 19, 2009 at 11:51 pm |
  25. Shannon

    I completely agree with Dr. Cosgrove. I am a Respiratory Therapy student, and know that with my field that I will be entering I will be treating a lot of patients that have breathing issues due to smoking and obesity. I feel that a healthcare facility that cares enough to offer the help to their staff, should be a model facility! I am in school with quite a few people who smoke and to me its just not right to go into this field and help to take care of patients that have problems due to previous smoking, and they see you smoking on their way to the parking lot to go home. It should be completely clear as to what could happen to them in the future. It is just not right for healthcare workers to be smokers, or overweight. And I have personally lost 60lbs in the last year! So I am working on being healthier by the time I start working in the hospital setting!! 30lbs to go!

    August 19, 2009 at 11:50 pm |
  26. Lesley

    Why demonise smokers and the obese, and remain silent on the damage caused by alcohol? Unlike obsesity and smoking, which primarily impact the health of the individuals who choose to eat or smoke, alcohol, especially when abused, destroys families, an individual's ability to work, multiplies road deaths, and so on. I look forward to the Cleveland Clinic's decision not to hire anyone who drinks.

    August 19, 2009 at 11:48 pm |
  27. Pat

    What about drinkers? There are certainly health concerns with that.

    August 19, 2009 at 11:44 pm |
  28. Jeffrey Barth

    Companies not hiring smokers, or obese people? It won't be long
    before companies only hire good looking, perfectly healthy people
    who never need health care. If a company could only have a test that
    showed any health problem a potentail employee currently has or may
    acquire in the future, and deny employnent based on it, they will have it
    made. Adolph Hitler had a similar view of people. An employee can
    quit or be fired any time, no company should have the right to tell a person how to live their life or effect their weight or personal habits
    in any way. Some insurance companies already charge smokers
    more for their health insurance, taking for granted that the employee
    will be employed forever and cost that insurance company more in the future, but this may or may not be so. These actions are known
    as discrimination, but somehow companies have gotten around this.
    Perhaps we should deny employment to those people who have had
    car accidents, or don't wear seatbelts, or engage in dangerous sports. If this doctor wants to be perfect, good for him. He can have
    all the opinions he wants, but he has no right to change, alter or effect
    anyones constitutional rights to live their life any way they want. I'm sure the doctor sees many patients who are shot by guns, does that
    give him the right to not hire gun owners? This is what's going wrong
    with this country, merrit is given to opinions, even if they are facts, without merrit to our freedoms, and constitutional rights.

    August 19, 2009 at 11:37 pm |
  29. Lissa Ward

    Why not charge extra for people that smoke and are obese. I'm a smoker and think it would give me extra incentive to quit. I live in Canada and think they should do it here too. My company has just launched a weight loss challenge, everyone is involved and we're making it fun. In the end, it's not only a team building practice but also hopefully will encourage people to be healthier so to limit our health care that the company pays for.

    August 19, 2009 at 11:34 pm |
  30. Laurie

    I posted one blog and happened to see one other person write on this particular subject. Thyroid disease! Have always been a size 6 or size 8 in the "clothes" bracket, and then the blood work showed my thryoid was extemely low. Gained 25+ pounds in a year and went from above sizes, to a size 12+, with no energy, and no appetite! So how did I gain weight and become obese? According to the Cleveland Clinic they would not hire me, if their plan is initiated. This is unfair and discrimatory through no fault of my own. I eat correctly and probably not enough, exercise and take my throid medication, to no avail in the weight loss and obesity debate. This is unfair and people assume you are overeating or not taking care of yourself, and that is not right. I do not discriminate against anyone, and don't appreciate being placed in the "obesity" group because of a medical condition. Have Mr Cleveland Clinic rethink his plans, please. This is truly unfair. Thanks Laurie in Oregon

    August 19, 2009 at 11:15 pm |
  31. Michael

    Dr. Cosgrove views on smoking and obesity are very worrisome. If he is so interested in the health consequences of smoking and obesity, he and his clinic should focus on informing the public/patients, of the health risks associated with smoking and obesity. By not hiring smokers, and possibly in the future people who are obese, this is nothing else but DISCRIMINATION. He and his clinic should focus on informing and curing the sick, and not coercion of people that make different lifestyle choices.

    August 19, 2009 at 11:08 pm |
  32. Oklahoma xray tech

    I am in the medical imaging field, its amazing the frustration that an overweight person comes for an x-ray and because you are so huge we can not get images adequate for diagnostic puropses or you can not have a C.T. M.R.I or a fluoroscopic procedure because the table will not hold your weight. your so huge you wont fit in the gantry of the C.T or M.R.I machine. It is sad, it is pathetic. X-ray use to be rewarding but now its just a hand full of people with bad knees because people wont change their eating habits, they wont get off the couch. Obesity is disgusting and I agree with CEO of Cleveland hospital I would not higher obesity or smokers. Why do we waist recourses of healthcare on people that know what cigarettes do to you. Why should we take a chest x-ray of you when you are inhaling toxic chemicals? Why should we help you with your stomach problems if you smoke? The enzymes from cigarettes eat the lining of your stomach so why should we even help or higher people that do this and pay for their health care. Its like investing in parts to a crash test car. You know that the parts will be trashed just like your body parts with cigarettes and over eating.

    August 19, 2009 at 10:59 pm |
  33. Jennifer

    One vital component to the treatment of obesity and other serious diseases continues to be lacking – REIMBURSEMENT FOR COUNSELING BY A REGISTERED DIETITIAN. Registered Dietitians (accept no substitute) must have at least a Bachelor's Degree, complete an internship and pass the national registration examination. Providing reimbursement will allow people to get competent counseling. Reimbursement MUST include provision for adequate follow-up counseling.

    August 19, 2009 at 10:58 pm |
  34. Debbie Ditanna

    I think absolutely people who spoke and are obese should pay more for health insurance..I also think we need to do things to help people...like no smoking in front of office buildings, hospitals etc...the harder you make it for people to smoke the less they will..
    In vending machines..in my office it is filled with junk food...they should be filled with healthy food...tax breaks for companies that have weight loss programs in offices, plus incentives to get employees to exercise and loose weight...perhaps every 10lbs lost an extra day off etc

    August 19, 2009 at 10:57 pm |
  35. Kathy

    Under no circumstances should what one does legally away from the work place be a reason to deny employment, I truly believe that those who are overweight will be next to experience this, as soon will those who are more expensive to medically insure due to health issues that will show up on pre-employment physical, and if not there on the paper work that inquires about medications one has to take. I know laws exist that are supposed to help protect people, but some how the Cleveland Clinic has found a way around this. ps. what about age of employee, as one ages it more expensive to insure. Bottom line follow the money

    August 19, 2009 at 10:55 pm |
  36. Jessie

    I agree with making people aware and giving them choices. Freedom is a right in America and I believe we have a right to a choice. That incluces to smoke. eat what we want, and to a good job that does not discriminate.

    August 19, 2009 at 10:53 pm |
  37. Debra

    There are employers who won't hire smokers. Some wish that they didn't have to hire obese persons. So where does it end? Will employers be able to discriminate against coffee drinkers or those who drink sugary drinks? Will employers be able to discriminate and not hire someone because the person committed adultery and may put the company at risk for workplace violene? You shouldn't judge lest you are ready to be judged.

    August 19, 2009 at 10:51 pm |
  38. pat

    So according to the good doctor any one with a disease can be refused a job, Are we still fighting for civil rights?. If the doctor believes being gay leads to SDS then he can not hire them? would this hold true for type one diabetes, not having a college education, being over 60. Isn't this discrimnation?

    August 19, 2009 at 10:51 pm |
  39. Luke

    Unfortunately, many insurance companies won't pay for any stop smoking drugs, patches, etc. Nor will state health insurance plans or companies that smokers work for. Meanwhile, I escorted a neighbor to the ER room last week. EVERY nurse there was obese, as were 3 out of the 5 doctors I saw! Obesity is the cause of far more health-related bills and illnesses than smoking. And if you're going to count obesity as a disease, you should also count smoking. I don't know of anyone who smokes who can quit easily, most started due to stress or other mental health issues – depression being one of them.

    August 19, 2009 at 10:44 pm |
  40. Pam

    I believe there are ways to incent people to be healthly without discriminating against them. Not hiring people because they smoke is discrimination of smokers. Are we living in the 1950s where women were discriminated against and lost jobs to less qualified men?

    August 19, 2009 at 10:43 pm |
  41. Dominic

    I think Mr. Cosgrove should go live in Russia where he can dictate what people do and eat.........this country is getting way out of hand with laws and the hypocrites who are making them, sounds communist to me.

    D

    August 19, 2009 at 10:42 pm |
  42. john billings

    Hey Doctor,
    You are simply picking on the obvious. Smokers: Obese people? Cost too much? Cause high insurance premiums for employers. DUDE, YOU ARE OLD. OLD PEOPLE the costliest to insure. Most of them have "pre-existing" conditions, which everyone wants to exclude. If your logic prevails, then OLD PEOPLE should not be hired or allowed to keep their jobs.......strictly as a matter of cost efficiency and to encourage people to avoid what should surely be considered a very fatal disease, AGING!!
    Whatever happened to "ALL MEN ARE CREATED EQUAL" and in the image of "God"?
    GIVE PEACE A CHANCE.

    August 19, 2009 at 10:40 pm |
  43. starr, formerly known as vincent

    Dear Dr. Cosgrove,

    I wanted to write and thank you for your informative and thoughtful article.

    As a retired RN (due to disability), i can't agree with you more. I learned 3 yrs. ago, that although i thought i was on a low fat, healthy diet, i was sadly mistaken.

    Having done research into proper eating and following a diet rich in fruits, vegatable, legumes, nuts & grains (with precious little poultry), i have lost 25lbs. I also started walking a mile a day 4 years ago.

    The change in my skin, muscle tone, attitude and sleeping habits has been profound. I may be unable to participate physically in heavy duty exercise programs, but my walking and the beginning use of a total gym have made a big difference in my life.

    I have tried very hard to teach my family & friends about the importance of exercise & diet, but nobody seems to want to change. Especially my family, who are hard-wired into old family recipes and really destructive eating habits.

    They are not un-intelligent, but highly resistant to change. I will keep trying and I congratulate you and your Hospital for the tremendous impact you have had on your employees & patients.

    Respectfully yours, starr

    August 19, 2009 at 10:00 pm |
  44. Annie Kate

    What about inspiring health insurance companies to pay for programs or treatments that help you stop smoking or lose weight which help control weight related diseases, etc? Some health insurance companies won't cover gastric bypass but will cover the high blood pressure, diabetes, and high cholesterol that result because of the weight. Some will cover it after the person goes through a year long diet program where they check in with their doctor once a month (not covered either). This delays the surgery and either lets the side diseases develop or get worse. Doesn't make sense to me.....sounds like something that could be changed easily if health insurance companies weren't running the show.

    August 19, 2009 at 9:40 pm |