If the U.S. Government ever decides that colonoscopies shall be mandatory for people at the age of 50+ (you know, as part of the Internal Revenue Code) federal officials will have to assign a SWAT team to enforce Vik Khanna’s compliance with that requirement.
“Did you know there is scant evidence that getting a colonoscopy actually reduces deaths from colon cancer? Well, you might ask, why then do we pitch colonoscopy as an essential screening? Because we have developed an industry around colonoscopy, and medical care providers generate a great deal of revenue from doing it.”
That quote came from the book I just read, “Your Personable Affordable Care Act, How to Avoid Obamacare,” by Vik Khanna. Although, I kind of like “Warrior Wellness” as an alternative title.
No Ralph Waldo Emerson quotes here. Think Sun Tzu, and “The Art of War.” Khanna’s book is 105 pages of lean, mean, hard-hitting advice on life and health. Khanna dislikes the Affordable Care Act (ACA) and offers a colonoscopy of sorts of the U.S. healthcare system.
And here’s how the author qualifies his readership,
“Victim wannabes will not like this book… Health is not a medical product; it is your (birth) right, but like all inalienable human rights, it is exercised fruitfully only with serious attention to its attendant responsibilities.”
As I read the book, it’s as if Khanna had Milton Friedman in his right ear, and Ralph Nader in his left. That, and he delivers information like it was coming out of a high-powered fire hose, which gives one the feeling of being whiplashed, while experiencing 9 Gs of force. By the time I got through the Introduction, I was at my maximum exercise heart rate.
Check with your physician before reading this book to make sure your heart is healthy enough to take it. OK. Somebody please tell Khanna I was just joking about that.
The Author Is Not a Lunatic
(not that my validation is even required. Just saying)
As you read this, you might think the author is exaggerating (or has completely lost his mind). I urge you to take a look at the actual ACA law (when you have a couple spare years). Just don’t hit the print button and leave the house. It’s almost 11,000 pages, (about 11.5 million words). Hey, what could go wrong?
Khanna highlights a few things that have been going wrong in healthcare, and are now accelerating – corruption… crony capitalism… lack of transparency… collusion… higher cost… rationing care… higher taxes… poor to harmful care… bad health outcomes… and a distorted U.S. economy. He touches on all these issues with convincing data and true stories. He’s lived in the beast. He says, “… because for the past 30 years, I have seen the American healthcare industry from the inside out.” And then it hit me. Of the handful of people I know who work in the healthcare industry, almost all of them sound like Khanna when they talk about their frustrations and outrage. And they all have the same frustrations and outrage about the things he exposes.
The observations in this book about the ACA were also recently reinforced by Steven Brill, author of “America’s Bitter Pill,” who was featured on CBS’s 60 Minutes with Lesley Stahl, “What Obamacare Doesn’t Do.” According to Brill, “Obamacare is an orgy of lobbying and backroom dealing.”
And Avik Roy, author of the book “The Case Against Obamacare” and a Forbes opinion editor, piles on the data that demonstrates healthcare costs are skyrocketing under the law.
The point Khanna and other ACA critics seem to be making is this:
a. The U.S. healthcare system is totally screwed up and corrupt.
b. The ACA law reinforces that bad behavior – because it was actually written by the lobbyists whose industries benefit the most from it.
All at the expense of patients and the U.S. taxpayer.
Khanna acknowledges the ACA has some good aspects. He agrees that eliminating pre-existing condition clauses, making your benefits portable, and offering more people healthcare coverage is all good and was needed.
As he explains however, the ACA addressed these issues like a homeowner who needs new carpet but replaces the whole house instead. I think of it more like going duck hunting with an aircraft carrier (just trying to stay with my warrior genre).
From my perspective, I’d organize Khanna’s book into five main themes:
1. How to survive the U.S. healthcare system primarily by avoiding it.
2. Why personal physical fitness trumps everything else in health.
3. “Eat less. Eat less crap.” (pg.6)
4. The power of personal responsibility.
5. Get off your lazy ass! (Another possible title for this book.)
The book is a great primer on the status of our current healthcare system, and the hundreds of linked sources are interesting and insightful in every part of the book, even if you disagree with the author.
Relative Risk vs. Real Risk
Khanna wastes no time in getting at one of the key, underlying problems in why ordinary people put up with a corrupt healthcare system. He’s one of the few who understands the folly of the healthcare industry using relative risk instead of real risk to explain treatment options.
The author explains, “… media reports exclaim a study’s 50 percent (!) reduction in mortality (a reduction in relative risk), without disclosing that the actual death rate for a particular problem was only 2 per 1,000 (0.2 percent) to begin with, meaning that absolute risk of death after the intervention is now 1 per 1,000 (0.1 percent).”
I finally got my biofueled, C+ grade brain around this concept a few years ago after reading, “Helping Patients Understand Risks, 7 Simple Strategies for Successful Communication,” by John Paling, PhD. When addressing this issue, Khanna demonstrated to me that he has a deep understanding of why our healthcare system is not only screwed up but dangerous for the average person to navigate.
According to Khanna, the medicalization of America is also taking place at work. Wellness programs have morphed into what my colleague, Jon Robison, coined as “Wellness or Else.”
Robison says, “For many of us who have been involved for decades with wellness and health promotion, punishing people for not doing wellness is an extremely disturbing trend.” Robison was referring to the financial punishment many employers are starting to levy against people who don’t sign up or comply with the pry, poke, prod, and punish wellness programs. Which means workplace wellness is almost totally about clinical screening.
And it turns out the ACA uses the tax code to incent workplaces to conduct more of these types of wellness programs. Also see, “Surviving Workplace Wellness with Your Dignity, Finances and (Major) Organs Intacts,” by Al Lewis and Khanna.
The authors and I are brothers-in-arms about the failings and risks of using the healthcare system. Here’s my take on the subject, “Wellness vs. Illness: How to Use 21st Century Medicine to Your Advantage Without it Eating You up Like a Paper Shredder.”
Personal Health Advice
The book has a big dose of personal tips for improving your physical fitness, mental toughness, and how you eat. The personal stuff is a little too prescriptive for me, but Khanna pulls back the curtain on his life and lets you peek inside. That insight frames his style, and makes the specific, to-dos and not to-dos more tolerable and relevant.
In fact, Khanna is at an elite fitness level for his age (late 50s), so it’s interesting and informative to learn what goes on in his head to accomplish that status. He thinks if he can do it, you can too. If you survived the Introduction of this book, you might be able to do so.
He tells us he’s been disciplined in his exercise and eating habits most of his life. And he’s now working on his black belt in Karate. His approach seems like healthy living as a Kata. That’s not wrong. It’s just his style, and it might work for you. When I read the book, I sometimes felt like The Karate Kid getting advice from, Sensei Kesuke Miyagi, “wax on, wax off.”
There is, however, an aspect of “tough love” in his message. He’s passionate, and he cares about you and your potential to live a life in health. It’s like getting a hug from a battle hardened, Marine drill Sergeant. Khanna says, “A lot of what you should be doing for yourself is physical but the biggest challenge you’ll have to overcome is believing you are tough enough to create health with the propulsive force of your own intelligence and imagination.”
He probably walks around singing “Lean On Me” all day, while wearing his favorite t-shirt, which reads, “I work mine off so I can kick yours” on the back. It makes for a very interesting read. And at the end, you’ll learn that Khanna does balance that yin and yang in a unique way.
My wife would tell you that I’ve got a slightly elevated, competitive nature myself. And I found this guy got inside my head a little. I notice I am watching what I eat more, and pushing a little harder when I work out. Could I be asking myself, “What Would Khanna Do (WWKD)?” Nah. Well, maybe.