The Second-Most Important Question in Health Care

In a previous article, we asked how to keep people from going to the doctor when they aren't sick.  Many people who haunt the doctor's office are simply lonely.  The medical establishment pays attention, which makes them feel better.  There's no simple cure for loneliness, but there is a simple answer to the #2 question, "Why are men such couch potatoes?"

There's no doubt that being overweight leads to all kinds of disease, heart trouble and diabetes among others.  This is so obvious that many big companies provide employee health clubs, often in the same building.

Big companies don't buy health insurance; it's cheaper to grab any profit the insurance company would make by paying medical bills directly.  It's worth a great deal of money to keep employees healthy.  Healthy employees cost less in medical bills.  Many businesses work hard to get their desk potatoes to use health clubs.

That's frustratingly difficult, most desk potatoes hate exercise.  I've consulted at big companies; they all want their employees to use the health club more.  One of my clients hired a young lady named Lynn to put up posters and run contests to try to get people to exercise.

I found her in the cafeteria; she'd dreamed up a new contest and was putting up posters.  "Is that going to work any better than the last two?" I asked her.

Lynn shook her head.  "Probably not," she said, "but what else is there?"

"Most of the desk potatoes around here are men, right?" I said.  "What does a man want more of that he could have more of if he were in better shape?"

Dead silence.  Wheels turned in her head for 30 or 40 seconds while I practiced my poker face.  Finally, she gulped and said, "There's a real problem with that."

"I know," I told her.  "My wife talks to lots of women and she's explained it to me.  Yes, it would be a burden on you, but it would shorten your widowhood."  She sighed and walked away.

Lynn recognized the differences in the ways men and women approach sex. According to the BBC, women want a relationship and men want sexual adventure.  A man's desire for sexual adventure doesn't end when he gets married.  Most husbands are willing to limit sexual adventure to their wives, but most women don't want as much sex as their husbands want.

Men are interested in "sexual adventure" pretty much all the time, but they can't have sex very often.  The more exercise a man gets, the healthier he is and the more often he could have sex.  This is OK if his wife is willing to have sex when she doesn't want it, but if she won't, her husband gets frustrated.  The healthier he is, the more frustrated he gets.  The worse shape he's in, the less often he could have sex, so he's less frustrated.

This increases medical costs in two ways: a) an overweight man is more likely to get sick and need medical care than if he were in good shape and b) he'll die young, leaving a lonely widow who may end up visiting doctors to get attention.

Cardiologists are often willing to talk on airplanes.  "It nearly makes me cry," one told me.  "I do a quadruple bypass, I tell him he'll die if he doesn't exercise.  They won't change even under threat of death."

Of course not.  If he exercised, he'd be more sexually frustrated.  Where's the gain in that?   If he doesn't exercise, he might die or he might not.  But he's sure to be frustrated if he does exercise.

The cardiologist should discuss the problem with the man's wife.  If she wants her husband to live longer, and to cut medical costs while she's at it, all she has to do is wait for the right moment and say, "We could do that more often if you were in better shape.  Let's exercise together."

Desk potatoes are the #2 issue in health care.  Presidential candidates won't talk about the #1 issue, people who see doctors when they aren't sick, and they won't talk about the #2 issue either.

How do we expect to solve the problem if we won't talk about major causes?