By Martin Harris
It isn’t often that a local Fourth Estate enterprise scoops one of the national pro’s, but that happened last week when the Denton Publication’s Eagle was, after a gap of several weeks, followed by the Murdoch Empire’s Wall Street Journal on the subject of health care plans designed to reward healthy consumer behaviors. Both op-ed writers were amateurs with non-Fourth-Estate day jobs; one is your Humble Scribe, writing several weeks back on the Safeway Health Care Plan and its applicability to Vermont; and the other is one David Gratzer, MD, who was accorded more than 24-column-inches on the op-ed page of the Journal’s 21-22 May edition to discuss Vermont’s embrace of the “public option” or single-payer health care strategy. Towards the end he argues, as had your HS earlier, that Vermont would have been a particularly fertile field for a plan with a “wellness-reward” component, and that “it’s a pity” that Vermont chose not to. Clearly, he’s quite right, even if he didn’t first get his argument from the pages of the Eagle. Nevertheless, as Ralph Kramden (your college drama-studies undergraduate won’t recognize the name) often said on such salutary occasions, “how sweet it is”.
Dr. Gratzer recites all the usual reasons why Vermonters, in the State which scores #1 in the nation, health-wise, according to the United Health Foundation, using various wellness measures, “…could receive incentives to prevent diseases caused by obesity, tobacco, and other life-style choices…” but then, recognizing Vermont’s political disposition, closes with “…but don’t expect Vermont…to test it any time soon. Not while the public-option itch is still out there waiting to be scratched.” Exactly. But, unlike your Humble Scribe, he addressed zero column-inches to “why is Vermont #1?”. The answer is in some readily available statistical rankings. Warning: some viewers will find these statistics displeasing to the point of requiring censorship.
We start with the recognized positive correlation between citizen health and citizen IQ. This subject has been broached, cautiously, in a number of domestic general-readership publications, but, knowing that they would be dismissed by a majority of County Eagle readers as identifiably infected with a conservative bias, you HS chose to cite a pair of academic publications instead. One is a collaborative effort between the Universities of Delaware and Edinburgh, in which authors Gottfedson and Deary document the epidemiological fact that “Intelligence Predicts Health and Longevity”. The second is similarly respectably European in origin: the February issue of the European Journal of Cardiovascular Prevention and Rehabilitation. It’s on the Web here at physorg.com, where you can read that “IQ is among the strongest [negative] predictors of cardio-vascular disease…” and “…lower IQ scores could elevate cardiovascular disease risk, notably the application of intelligence to healthy behavior [choices…” and (viewer discretion advised) “…IQ may well be one important factor behind the place of social class as a fundamental determinant of inequalities in health…more so than access to[health-care] resources …a low IQ…as suggested in this study, may be a further independent explanation.” In layman’s language, smarter people are statistically predictable to make smarter personal life-style and wellness choices than not-so-smart people. So, inquiring minds want to know, what’s the correlation between smartness and wellness, not just at the individual statistical level, but at the State level? After all, it’s now the States which, as “laboratories of democracy” in the famous words of the Progressively-politically-oriented Mr. Justice Louis Brandeis, are designing and adopting a variety of health-care plans. Such State smartness rankings are readily available.
You’ll see one such ranking on the Website of “The Audacious Epigone” (test your college classics major on definition) where you’ll see MA, NJ, and VT in the top three, with IQ’s in the 101-102 range, and NM, MI, and DC in the bottom three, with IQ’s in the 91-94 range. VT is the nation’s healthiest state, according to UHF rankings; bottom-ranking IQ MI is the unhealthiest. From another source, Estimating State IQ (Intelligence Magazine), M.A. McDaniel, 2006, we learn that the highest IQ’s are in MA (104.3), NH (104.2), and VT (103.8) while “…IQ’s are lowest in the Southeastern States.” The three lowest are in MI (94.2), Louisiana (95.3) and AL (95.7) and you can read McDaniel’s summary (viewer discretion strongly advised) as follows: “…these differences in State IQ’s are associated with differences in average earnings, with per capita Gross State Product, with violent crime and health.” His IQ calculations come from analysis of public-school NAEP scores for achievement (or not) in the several basic literacy and numeracy subjects. To prevent additional viewer distress, your HS has redacted certain other demographic rankings totally, and will just briefly refer back to an earlier Safeway Plan discussion wherein the City of Memphis is found to be one of the unhealthiest jurisdictions in TN, while adjacent rural counties in TN and MI score much higher. Overall (urban-plus-rural) TN scores #47 in the UHF health rankings of States and its healthiest counties are mostly in rural Appalachia, with socio-economic structures and development patterns not unlike Vermont’s.
From a University of North Carolina study (Reeves and Basalik, 2010) we can read that “…more mothers in States with high IQ’s breast-feed their babies, ensure that infants are immunized, take better care of their teeth, get more exercise, and refrain from smoking. At the same time, high-IQ States have lower infant mortality, lower rates of HIV infection and AIDS, lower overall mortality, lower rates of heart disease, and lower rates of adult and child obesity.”
Both your Humble Scribe and the WSJ’s distinguished op-ed contributor draw the same conclusion: Vermont would have been an ideal venue for a trial run of a State Health Plan with incentives-for-wellness components. Heck, VT is already the healthiest State. Why, then, did the Golden Domers and the Guv reject such an obvious quality-up/cost-down element? The answer was offered long ago by Prez #32 FDR (test your high school history student on full name) in his observation that “nothing in politics happen by accident”. He knew. First-hand.