9 July 2009

Basil, Cabbage, Cucumbers, Green garlic, Lettuce, Marjoram or summer savory, Sugar Snap peas, Radicchio, Squash

For years I have been telling potential workers that my health plan consists of a steady supply of fresh produce. Which is and is not a joke because it really is the best health care plan I can offer my workers.

Well, that is not entirely true. I could buy health insurance for them. I could provide a masseur and a well equipped coffee bar too while I was at it, both of which would also enhance the work experience. I would just have to go into debt to do so. At least the masseur and the coffee bar are conceivably affordable. Health insurance, on the other hand, would probably finish off the farm.

Not that a steady supply of fresh produce is just a joke of a health plan. We could come up with a lot worse ways in this country to improve our health than large doses of produce. In fact, we have. Fruits and vegetables have a number of things in their favor. Aside from being good for us—especially compared to what we eat much of the time—they are widely available and cheap. They are also generally safe to use and made right here in the U.S. (often by foreigners, of course), and they come in a remarkable array of colors, shapes and textures to match just about any décor.

I don’t mean to suggest that produce would cure all our ills. I am unaware, for instance, of a good vegetative fix for a broken arm, though I suppose you could work up some sort of sling using various greens if you had to. But getting a lot more people to eat a lot more vegetables would significantly reduce the incidence of any number of medical problems—diabetes and heart disease just for a start. Simply getting people to eat kale or bok choi once a week would probably save us a few billions dollars in health care costs each year.

Unfortunately, I have not the vaguest idea how you would get most Americans to eat kale regularly. People will, at enormous expense, ingest vast arrays of pills and undergo all sorts of dangerous procedures in a quest for good health. But I suspect they would consider a weekly dose of kale rather too high a price to pay. Perhaps if we improved the packaging, added an X or two to the name and put a hundred million dollars into the promotional effort…

My workers eat plenty of dark leafy greens. They even like them. And so far I guess it has been working. No serious diseases I know of. In fact, so far nobody has had to go to the hospital.

Well, except me. Eating kale may be good for you, but fifteen years of bending over or crouching to pick it takes a toll. Hence the screws in my spine. Fortunately, I have health insurance thanks to Liz’s job off the farm. Forty thousands dollars of transforaminal lumbar interbody fusion cost me $18.

Take away that insurance, though, and I would be facing some tough choices, trying to find a balance between pain and debt I could live with. That’s a form of health care rationing that critics of a national plan tend not to talk about so much. But it is the form our system forces on people without insurance, people like my farm workers—and most other farm workers in this country too. Socialized medicine, like kale, is no panacea. Neither, however, is to be feared any more than our socialized street lights or socialized Coast Guard. If we are going to have to make choices about how we dole out health care, we can find a better way to allocate it than basing on the patient’s net assets.

For instance, we could make it contingent upon patients having eaten all their vegetables. We make kids finish their vegetables in order to get the stuff they want. I don’t see why the rest of us cannot live by the same rule. Want an appointment with your dermatologist? Have some radicchio first. You can eat it in your salad or cut it into quarters, dunk it in water, brush it with olive oil and grill it. Need a new pair of glasses? Then get to work on that head of cabbage, perhaps in a slaw or sautéed with bacon and scallions. Hoping for a refill on that prescription? Eat some squash—sliced and sautéed with green garlic and herbs—and then ask for more pills. Eager to talk with a doctor about the pain in your back? Why not snack on some snap peas (boiled in salted water for no more than a couple of minutes) or cucumber salad before you start that conversation. Back operation? Salad, then surgery.

Imagine if we actually go with this system. We will be helping you to get to the head of the line every week. And suddenly my produced-based health care plan for my workers will make real sense. No joke.