Baconator? Make Mine a Triple!

So I was sitting here on the couch watching Tim Lincecum, Cy Young-award winning pitcher, throw a full game shut out against the NY Mets (Go Giants!) and along comes a Wendy’s commercial for (dramatic pause)….The Baconator.  I was so amazed by the grandiosity of this thing that I looked it up on-line at Wendys.com and lo and behold, not only is there a Baconator (it is really hard to type that without hearing Arnold Schwarzenegger’s voice in my head) but there is an honest-to-god Baconator Triple!  Somewhere in Washington, D.C., Michelle Obama, who has made healthy eating her personal political platform, is reaching for a stiff drink.

Wendy’s Baconator Triple is about the size of Marge Simpson’s hairdo on a humid day and boasts the following features:

• 3 one-quarter-pound beef patties
• 9 slices of bacon
• 3 slices of American cheese
• Mayonnaise
• Bun
• Ketchup
• Tomato and lettuce available so that you can say you had a vegetable
• Pickles are optional (oh no, I couldn’t possibly)

This gourmet delight has—brace yourself—1360 calories, 820 of which are from fat.  The current dietary guidelines suggest that the average adult should eat roughly 2000 calories a day, of which no more than 30% should be from fat.  That’s 600 allowable fat calories, so this bad boy has almost 1.5 times the recommended allowance. And that doesn’t even include the fries or gratuitous Diet Coke.

Chihuahua=5 Baconators

The Baconator weighs 424 grams.  For those of you who have forgotten your middle school weight and measure equivalents, that is almost one whole pound of food.  In my house, that 424 grams equals 20% of our pet Chihuahua.  I do not think that she has the surface area to support 9 strips of bacon.

The good news:  2 grams of fiber!

Wendy’s promotional notes on the website say that the Baconator is, “…enough to make your mouth water.”

Mouth water?  Are you kidding me?  It’s enough to make your arteries slam shut so loud that the neighbors call the police to ask you to quiet down the party.

Maybe I should be happy, as I am Chairman of the Board of a highly successful cardiology company, AngioScore, whose mission in life is to open the clogged arteries that develop in people’s hearts, legs and elsewhere due to the build-up of arterial plaque.   Hey, maybe AngioScore should start giving away free Baconators to juice up the sales channel?  But I digress.

The reason I bring this up is that there has been a great deal of ranting and hand-wringing about the “criminal behavior” of the health insurance companies.  They are often written about as the bad guys of the American healthcare system, withholding care from those in need.  I’m not saying that never happens; in fact I’m sure it sometimes does.  But the insurance carriers are at the end of the food chain, literally.  If you are going to be pointing fingers at Aetna or HealthNet for their actions, you have to save at least one finger (I’m not saying which one) for the people at Wendy’s who dreamed up the Baconator Triple.  I can see them now at the brainstorming table:

Marketing Director:  “How can we make the Baconator Double even better?”

Customer Service Director:  “I know!  Make it a triple!”

Marketing Director:  “Damn, you are so creative!”

And while these gourmands are dreaming up their next culinary wonder (“I know, how about the Octo-Baconator!”), there are also good people in the insurance carrier world trying to undo this damage.

A Psilos portfolio company called SeeChange Health, in conjunction with United Healthcare, is now offering a specialized diabetes insurance plan designed to encourage those who are developing or who may already have Type II diabetes, a disease that is largely acquired as a result of years of poor diet, to take good care of themselves.  The program rewards those who agree to engage in a widely accepted diabetes treatment regimen:  regularly checking their glucose levels, seeing foot and eye doctors annually, taking prescribed medications and getting annual blood tests.   The reward to the patient, in addition to better health, comes in the form of zero out-of-pocket costs for most or all of these activities, meaning the patient pays nothing or nearly nothing for the office visits, medicines, diagnostic tests and other medical actions required to ensure that your diabetes is under control.  This is very meaningful for people in the program, as it can put as much as $500/year in hard cold cash back in their pockets.  The bottom line:  an insurance program that pays you to be healthier.

Why do they do this? Well it turns out that when people with Type II diabetes are diagnosed early and managed effectively you can treat them for a lot less money because their complications are less serious to manage.  What complications you may ask?  Well, heart disease for one.  See Baconator above.

This preventative approach to healthcare is good for the patient to be sure, but it is also good for the insurance company because they don’t have to spend as much money to pay your claims, and that is more profitable for them.  In the end, it is a win-win situation and the end result benefits the U.S. healthcare system as a whole.  We should all be delighted to see insurance carriers who provide products like this and wish them well.  If they can profit by making Americans healthier, well it’s hard to feel bad about that.

I find it not just ironic, but somewhat disturbing that so much of the health reform dialog has focused on how to fix the system that takes care of people after they are already sick.  Remember, between 70% and 80% of all medical costs are expended to treat people with chronic illnesses, not on prevention.

I am glad to see that Michelle Obama has taken up the healthy eating cause, but it seems to me that this effort should be far more integrated into the health reform discussion right up front.  The government is planning to regulate everything from how often doctors must prescribe medication electronically to how much profit insurers can make.  They are establishing a research center to decide which treatments work better than others according to clinical trials of their own design.  While there will undoubtedly be some positive outcomes from this effort to establish “comparative effectiveness” metrics, many fear this effort may also lead to the elimination of insurance reimbursement for legitimate and possibly more effective treatment approaches simply because they cost more or might serve the needs of only small groups of individual patients.

If the government can go to this effort to manage the treatment end of healthcare–those things that are oriented to fix, in part, the damage we have done to ourselves, they can surely take a look at the legitimate role of the Baconator in American society.   If the new healthcare reform law can mandate a 2.9% tax on revenues for all medical device companies, even those young, entrepreneurial companies that are not yet profitable (e.g., including cardiology companies like AngioScore that are making a positive difference in the lives of patients by cleaning out their cheddar-filled arteries) surely they can sleep better at night knowing there is a companion Baconator tax.  I think that 2.9% per bacon slice sounds about right.