A year ago, former Arkansas Gov. Mike Huckabee was out on the stump talking about health care and everything else. We reported that, campaigning in South Carolina, he “urged a revolutionary overhaul of the country’s health care system,” saying that a “Humpty-Dumpty philosophy” of waiting until Americans fall off the wall before insurance will pay is “insanity.” Huckabee, now a contributor on Fox News, has moved on to the speaking circuit, talking in some detail about what he means by “revolutionary,” and his message is a fresh addition to the national health care discussion.
During the early part of the campaign, the candidates talked a lot about whose plan would cover more of the uninsured. As it wound down, we had seemingly endless stories about the two different routes to reform proposed by John McCain and Barack Obama. But no one was focusing on what makes people healthy or unhealthy, or what makes a country’s health statistics bad or good. And ours are not so good right now. That discussion is a deeper one, perhaps ill-suited to the sound-bite one liners that characterized much of the health coverage this election season.
Yesterday, Huckabee spoke at the annual meeting of the New York Business Group on Health, an organization of employers that pay the health care bills for their workers. He didn’t talk about whose plan was best, or what the president-elect will do first, or how many people can get covered under an incremental approach to reform. Instead, he talked about the culture that makes too many Americans sick in the first place—in other words, what some economists call the social determinants of health.
Huckabee, an engaging and funny public speaker, didn’t use those words, or any economic wonk talk. Instead, he talked about obesity among children and why thirty, forty, and fifty years ago, children were not fat. They played outside, rode bicycles, and didn’t eat much junk food or sit in front of the computer playing video games. Food portions were smaller. Gigantic bottles of pop and sugary drinks were unheard of. He also talked of the serious health conditions that loom large for overweight kids, noting that, for the first time in U.S. history, children will have shorter life spans than their parents and grandparents. He talked of the cost of treating the consequences of these cultural changes, and that, down the road, financially “we’re not going to sustain the current system.” There wasn’t much discussion of this during the campaign. As Huckabee said, “the real enemy is not the health care system; it’s poor health.”
Huckabee called for a cultural transformation in the way we eat, exercise, and use our leisure time, and cited four examples of cultural transformation that have affected health: less smoking; penalties for drunk driving and little public tolerance for drunk drivers; use of seat belts, and a reduction in litter. “We’re not going to fix this in the next presidential election,” he warned. “Changing the cultural focus will take a generational cycle, not an election cycle.”
“Ours is a treat-the-snake-bite system,” he said. “We don’t cover visits to podiatrists that cost $150, but we cover an amputation that costs $35,000,” he said, referring to preventive care for diabetic patients. It seems to me that there are good story ideas in all of this—stories that might discuss health before the snake actually bites. Here’s where the press can actually lead instead of follow, the way some good media outlets did in the old days. This might serve the public better in the post-election phase than stories speculating on who will run the Department of Health and Human Services or the NIH.
A questioner in the audience asked the former governor whether he would be Obama’s health czar. “I got a show on Fox now,” he said. “I don’t have the patience to work at that level right now.” We’ll be watching to see if Huckabee as a commentator/contributor/culture change evangelist will use the Fox platform to continue preaching his message.Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.