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Column: Whole Foods CEO says we can lower healthcare costs by not getting sick

John Mackey, CEO of Whole Foods, in the produce section of a market.
John Mackey, chief executive of Whole Foods, says it would be better if we ate well rather than take “a bunch of drugs.” That advice may not sit well with sick people.
(Austin American-Statesman )

It was, by even the most generous interpretation, a really dumb thing to say.

John Mackey, chief executive of Amazon-owned Whole Foods, said in a recent interview that a big problem with the U.S. healthcare system is that people, you know, keep getting sick.

“The best solution is not to need healthcare,” he declared. “The best solution is to change the way people eat, the way they live, the lifestyle and diet.”

A nice sentiment from the head of one of the country’s most expensive supermarket chains.

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Mackey added: “There’s no reason why people shouldn’t be healthy and have a longer health span. A bunch of drugs is not going to solve the problem.”

His comments were made in November to Freakonomics Radio but picked up this week by CNBC.

I asked Whole Foods if they cared to clarify Mackey’s remarks. No one got back to me.

But I’ll take the liberty of presuming Mackey was clumsily trying to say that if Americans did a better job of watching their diets and staying in shape, they’d spend less time at the doctor’s office.

Which is good advice — to a point.

While lifestyle is obviously a big factor in people’s well-being, the simple fact is that this country doesn’t spend $3.5 trillion a year on healthcare solely because we’re a bunch of Fritos-munching couch dwellers.

We spend twice what other developed countries spend on healthcare per person because our medical system is the most expensive in the world.

We have hospital and drug prices that are based primarily on maximizing profits rather than reflecting the actual cost of treatment.

But what was most outrageous about Mackey’s eat-more-apples argument is that it’s deeply insulting to people who are responsible for the bulk of healthcare spending — those with chronic conditions such as diabetes and heart disease, not to mention those who might be grappling with cancer and other no-fault-of-their-own ailments.

Just 5% of the population accounts for about half of all healthcare spending. Being sick isn’t cheap.

Moreover, Mackey made his remarks as the United States topped 13 million coronavirus cases (the total is now more than 21 million) and had reached 267,000 COVID deaths (now more than 356,000).

But, yeah, have some kale and do some push-ups, you’ll be fine.

I don’t want to make too much of one CEO’s simplistic comments. But Mackey’s remarks hit the spotlight the same week it was announced that a major healthcare initiative launched several years ago by Amazon, JPMorgan Chase and Berkshire Hathaway is being abandoned.

That effort, dubbed Haven, was an attempt by three of the country’s most influential CEOs — Amazon’s Jeff Bezos, JPMorgan’s Jamie Dimon and Berkshire’s Warren Buffett — to reform America’s employer-based insurance system and find more effective and affordable ways to treat people.

They failed.

“Haven worked best as an incubator of ideas, a place to pilot, test and learn — and a way to share best practices across our companies,” Dimon said in a positive-spin memo to JPMorgan employees after the collapse of the program was announced.

My colleague Michael Hiltzik boasted this week that he knew all along Haven wouldn’t get anywhere. I was more optimistic.

After the joint venture was announced, I quoted Dana Goldman, interim dean of the USC Sol Price School of Public Policy, as saying that “everyone talks about tipping points. This could be one of those moments.”

It wasn’t. Haven didn’t specify what went wrong, but it’s fair to assume that the participating companies couldn’t find the secret sauce for lowering healthcare costs when the entire U.S. system is pulling in the opposite direction, placing profits before patients.

Here’s a big part of the problem: America’s employer-based healthcare system is a fantastically bad idea, saddling businesses with costs they’d rather not have and leaving workers to fend for themselves if they lose their job.

You may not know it, but our employer-based health system is a historical accident. Businesses began offering coverage during World War II to attract workers amid a government-imposed wage freeze. Once the war ended, that benefit became the status quo.

Now it’s an impediment to reform because most Americans are accustomed to their employer-provided insurance plans and won’t consider anything different — even if an alternative form of coverage, such as Medicare for all, would be cheaper, more reliable and available to everyone.

That was my hope for Haven. I wanted to think that business leaders with the clout of Bezos, Buffett and Dimon would be able to spearhead a shift away from employer-based insurance and align us with nearly all other developed countries that use single-payer systems to affordably cover all residents.

That the CEOs never came close to this indicates their to-do list was more modest, likely focusing on using technology to cut administrative costs rather than seeking nationwide policy changes.

Gerald Kominski, a professor of health policy and management at UCLA, told me this week that the failure of Haven leaves all hope for healthcare reform in Washington’s hands.

If three of the country’s most powerful companies couldn’t remedy things, he said, “maybe it’s time to acknowledge that government intervention really is the most effective way to control costs, achieve universal access and assure equity.”

Which would be fine if our politicians were interested in governing and protecting the welfare of the American people. That wasn’t the case for the last four years, however, and it’s hard to see how things will be much better going forward.

Perhaps foolishly, I remain an optimist. The inefficiency and dysfunction of our healthcare system is indisputable. The relative success of our economic peers shows that better ways exist and are within reach.

We just need leaders willing to take us there. I’d hoped Bezos & Co. might be those leaders. Now we’ll have to wait for others with more ambition and courage to step forward.

In the meantime, we have Whole Foods’ Mackey to guide us.

Eat right. Keep fit. Hope you never get sick.


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