Observations About the 2022 Mid-Term Elections
As a person who majored in political science and has been engaged actively in public
The recent tragic suicide of Dave Duerson, a great professional football player, who made a conscious decision to end his life in a way that enabled his brain to be donated to Boston University’s Center for Chronic Traumatic Encephalopathy, reminds us of a profound truth about our nation’s health care crisis: we have to address the root causes of unhealthy and destructive behaviors before we can change the behaviors.
The assumptions underlying many of our health care policies are that people are most motivated to do what is healthy for them and their families, and if we could only get them good information, and good and affordable care, they would do the right things. Unfortunately, the reality is much more complex.
As the Duerson case, as well as many other cases involving athletes, show, many athletes deliberately engage in unhealthy and dangerous activities because they value the experience, and, to some degree, the money that comes to them from playing a sport at an elite level. By the way, I do not think money is the prime motivator. Otherwise, why would scholastic and college athletes engage in the same destructive behaviors as their professional counterparts? Also, if we go back several decades in any professional sport, the financial rewards for professional athletes were not that great, but they still played violent sports.
What struck me in a TV interview with Duerson’s wife and son was the comment by his son that Duerson had died because he played a sport he loved and experienced one of the highest accomplishments an athlete can have: being part of a world championship team. If we were to turn the clock back to the beginning of Duerson’s career and tell him that playing professional football would so damage his brain that he might commit suicide by age 50, it is unclear whether he would have made a different decision.
Similarly, many athletes become heavy users of performance-enhancing substances, despite strong evidence that those substances eventually destroy their health, because they believe that the substances will give them a competitive advantage, or, at worst, allow them to stay even others also using performance-enhancing substances. The only thing that has changed in the last several decades has been the substance of choice, but the propensity for many athletes to seek out an extra edge has not.
In the rest of the population, we have found that every person has life goals and priorities, of which health is a contributor or an inhibitor. People cannot relate to “optimal health.” They can only relate to the benefits optimal health brings to them, or the problems that less-than-optimal health creates for them. Why does this matter?
If we are to use the many tools available to us to make people healthier and reduce our society’s runaway health care costs, we need to tap the more fundamental behavioral motivations that drive their health decisions:
What does all this mean?
As I have learned more about Dossia, the personal health record platform, that we offer through the Dossia Service Corporation, it has become clearer that, while we can be successful in empowering individuals to manage health and health care to a degree by providing information and insight, there need to be other motivators, such as financial incentives, recognition from winning games and contests, and the ability to engage in more life activities. We can offer Dossia as a standalone data repository, but its greater value derives from its integration with broader life goals to which optimal health contributes.