This country needs better health care. A requisite to successful and equitable administration of any publicly funded, universal coverage system is cost containment. A pillar of that is preventive care. That means getting the population to avoid doing things which will predispose them to chronic and, ultimately costly, conditions. It’s obvious that combating obesity and smoking should be at the top of the priority list.
What about alcohol consumption?
While moderate consumption of alcoholic beverages is associated with some health benefits, humans (in general) are not apt to practice restraint in most aspect of their lives. And lack of restraint carries consequences.
Chronic excessive alcohol consumption leads directly to disease of the liver (cirrhosis and cancer), pancreatic cancer, stomach and esophageal problems (from gastritis and reflux to malignancy), hypertension and heart disease as well as cognitive dysfunction, nutritional and metabolic dysfunction. The list really goes on and on. Indirectly, immoderate alcohol use puts one at risk of traumatic injury (vehicular and other) and sexually transmitted diseases. Of course, alcohol dependence, itself, is a problem with profound social impacts on the alcoholic and those around them.
Alcohol-related health problems are not at the pandemic levels in this country as obesity is. They are, however, real and their prevalence and incidence are significant. What’s more (and relevant to this discussion), alcohol-related illnesses are absolutely preventable. That means that impacting drinking attitudes and behavior in this country may be critical to the management of a public, universal, health coverage system.
There has been an undeniable shift in attitude towards alcohol all over the globe lately. Some commentators have gone so far as to call it “neoprohibitionism“. Those who follow such discussions have no doubt seen me take a relatively middle-of-the-road position in which I do not buy into conspiratorial thinking but also point out that there are public health reasons for the alcohol policies instated by local and national governments. At the same time, I do raise a skeptical eyebrow at the campaigns, most notably in France, which aim to equate ethanol with the most potent of carcinogens. I just don’t buy that hype.
While it may be impossible to legislate behavior and lifestyle, there is sufficient past precedent that consumption of alcoholic beverages could be put in the shadow of the same kind of stigma as tobacco use. Whether it is through government-funded educational programs or the efforts of groups like thetruth.com, public attitudes can be directed, swayed and manipulated.
So, returning to my question: could the institution of a universal health care system (however that ends up being structured) imperil the health of the beer, wine and spirits industry in this country? Would Wilson Daniels become the next Philip Morris?
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