Hot Topics! The Secret Link Between Heat Illness and Health Reform

The nation’s unfolding discussion about the Affordable Care Act — and what it means to you and to me, your most personal trainer — won’t go away. It’s too important to ignore and too complicated to fully explain, but it’s worthwhile pursuing because, let’s face it, what’s more important than your health and well-being?


On the other hand, it’s blistering hot in many parts of the country. Crops are dying, and so too are some recreational athletes who don’t understand the risks of heat illness. When is it too hot to run, to bike, to walk or play tennis? What’s a smart strategy for staying active while avoiding collapse?
So I’m torn. What should I focus on this week? How to exercise at 100 degrees or the most important piece of health care reform in 100 years?



And then it struck me. The two are mutually dependent on one simple but profound idea: personal responsibility. If you want to prevent heat illness, you’ve got to be willing to learn and practice some new behaviors. The same is true for your role in health care reform, but let’s begin with the 3 C’s — Coping with Climate Change:
— Don’t exercise outdoors at the hottest time of the day. Switch to early morning or late afternoon. Or shift your workout indoors.
— Never push yourself to the point of dizziness, exhaustion or dehydration. Be aware of how your body is responding to high temps, and respect the signals it sends you.
— Drink plenty of water but not so much that you risk flash-flooding your system, which can also create a breakdown.
This is what preventing heat illness looks like. It’s up to you to take it on board and practice the basics of self-care — avoiding doctors, drugs and emergency room visits.
Personal responsibility also figures in when it comes to the Affordable Care Act, in a few crucial ways. For starters, when Gov. Mitt Romney was explaining to the citizens of Massachusetts why it was fair and good to require everyone in the state to sign up for medical insurance, he invoked the “Personal Responsibility Principle” as the reason.
Health care is something we all use, he argued, so we should all be responsible for sharing in the costs — by buying doxycycline insurance — and not expecting a free ride. In Romney’s state, insurance companies adjusted to the mandate by offering a wider choice of lower-cost policies, and there were subsidies, too. Now 98 percent of the people in Massachusetts are insured, and by all accounts, it’s working very well.
The Personal Responsibility Principle can’t stop at citizens buying insurance. If health care reform is to happen in the best possible way, personal responsibility needs to override greed and ignorance throughout the system.
Primary-care doctors, for example, have to do more than push pills and fill hospital beds. They have to take responsibility for keeping people well, by focusing their patients on smart eating, regular exercise and stress reduction. Since most of them don’t have the time or expertise to guide you toward a healthier lifestyle, in the new system they will need to do the responsible thing and hand you over to a community health care specialist, wellness coach, nurse-practitioner or physician’s assistant — all new job growth categories.
You know who’ll be losing their jobs under the Affordable Care Act? The people at insurance companies who used to deny your claims because of “pre-existing conditions.” (Being a woman is my personal favorite.) That can’t happen to kids anymore, thanks to health care reform. And starting in 2014, it can’t happen to any of us. The president needs to take responsibility for that, over and over.
And you, dear reader, will need to take personal responsibility, too, if we want this historic shift to a more effective and humane system to succeed.
Stop asking your doctor if a drug you see advertised on TV “is right for you.” Instead, conspire with your health team to take fewer drugs, based on the healthier choices you make. Exercise more. Eat real food, in reasonable portions. Learn to cook and enjoy simple, healthy meals. Meditate daily. Make sure your kids eat well and play often. And liberate yourself by learning to embrace change, not fear it.


“This is your life. You are responsible for it. You will not live forever. Don’t wait.” — Natalie Goldberg

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