Episode #13 – Health Care Needs a Colin Kaepernick

The health care industry needs an activism movement. It needs outspoken, courageous individuals who will act with their words and their wallets to bring about behavioral change. Given how unhealthy our population is – 70% of us are overweight, for one – it’s going to take some tough love to get us to where we need to be. This podcast explores ways we can act individually, as well as a call to celebrities and influencers, so we can course-correct our behaviors, setting us on a positive path to good health.

Key Citations

  • Performance of health insurance companies in the bull market: CNBC
  • Millennials: the most obese generation in history: Healthline


PDF Version for Download

Welcome to The Powers Report Podcast. I am your host, Janis Powers. The show brings you candid, unique and data-driven perspectives on the health care industry. I believe that any solution that is going to positively impact the American health care system has to satisfy two major criteria: financial viability and behavioral incentive alignment. In other words, access to high quality care can only be achieved if we can afford it, and if we behave in ways that optimize our health. Please subscribe to our show on iTunes or on your preferred podcasting platform and connect with us on social media. Again, this is Janis Powers, and welcome to The Powers Report Podcast.

In this show, I am going to talk about some different ways that we can change the conversation about living a healthy life in America. Our health care system is so bungled that it’s going to take a variety of solutions that attack different problems to get us where we need to be. We need smart policy solutions that keep patients safe, improve price transparency, eliminate devastating financial exposure to patients and cut out the negative incentives that drive up unnecessary cost utilization. We need technology solutions that encourage us to be healthier, make the system more efficient and bring us new products and ideas to improve the industry.

But we also need an attitude adjustment. A big one. One of health care’s major and under- discussed problems is that we have cultural challenges that must be overcome in order to fix the system. These cultural problems manifest in our behaviors, many of which are negative and contribute to the industry’s high cost/poor outcomes situation.

We are an unhealthy lot. We’re overweight. We take too many pills. We don’t exercise enough. We don’t sleep enough. Our diets aren’t what they should be. We’re stressed because of work, financial problems and many of us think that the sky is falling.

There are solutions out there right now that try to address our behavioral problems. We need to continue to pursue them because, as I said, there will not be one solution that does it all. So it’s great that we have employer-based wellness programs. Yes to public health programs that promote education about health in the community. Yes to grocery stores that offer more fresh, healthy food options. Major props to the individuals who encourage their friends and family and co-workers to make smart choices.

Yet we need more. What we need is a health activism movement. This movement needs multiple dimensions where people use their mouths and their money, their words and their wallets to candidly and aggressively correct our behavioral problems.

When we use our money to influence behavior and culture, it’s a form of socially-responsible investing. This is a movement that’s taking hold in investment companies across the globe. Socially-responsible investors direct their money to causes they wish to support, like the environment or education. They steer it away from companies that support causes they don’t like, such as tobacco companies and gun manufacturers. They don’t invest in these companies even if these organizations generate a handsome profit. Socially responsible investors don’t care. They’d rather take a hit to their portfolios than invest in an area they philosophically oppose. The concept is so pervasive that, according to The Forum for Sustainable and Responsible Investing, one out of every four dollars under professional management in the U.S. has been directed to these strategies. That equates to about $12 trillion.

So…if you object to the way health insurers run their businesses, then you shouldn’t invest in health insurance companies. This is a point of conflict for many people and they’re probably not even aware of it. Over our recent bull market, the S&P 500 has increased over 300%. But insurance companies have performed even better. If you own a mutual fund, it probably has a health insurance company or two in it. If you revile your insurance company, you’re probably benefitting from the behaviors you can’t stand. Real change takes some tough decisions. But a decision not to invest in health insurance company stock can make more than a financial impact. It can get you and your friends, family, investment manager (if you have one), etc., talking about the issue maybe in a way you haven’t before.

But let’s get to behavior, because changing that is what’s going to really impact the health care system. And a key area of concern is obesity. I’ve talked a lot about obesity on The Powers Report Podcast. In fact, I dedicated an entire show to the topic. It was Episode #4, “America’s Tragic Normalization of Obesity”. In the show, I bemoaned the unfortunate reality that Americans have come to accept the state of being overweight or obese as normal. That’s because 70% of Americans are overweight and 40% of us are obese. When we look around, most of what we see are heavy people. That makes it normal. And that makes it harder to stop the obesity epidemic.

Millennials are projected to be the most obese generation in history. Many of them are too young to appreciate the terrible long-term impacts of their condition. There’s even a movement of obese people who tout their healthiness. They exercise and they don’t have high cholesterol or diabetes or hypertension. So they think they’re healthy. Well, they don’t have high cholesterol or diabetes or hypertension YET. They say youth is wasted on the young. Apparently, so is health.

This generation embraces the body positive movement, which is code for the social acceptance of being overweight. Many of you are probably familiar with the magazine Cosmopolitan. It is the self-proclaimed “biggest female-focused millennial media brand in the world”. The headers on its website are Style, Beauty, Love, Politics [which I do NOT understand] and Horoscopes. There are plenty of skinny people on the landing pages of the site…but when you look further down some of the pages, there are plus-sized models. That makes sense for the magazine because a significant portion of its audience is overweight.

Nonetheless, it was a global sensation when Cosmopolitan U.K. put super plus-size model Tess Holliday on its cover last October.

Sure, it speaks to Cosmo’s audience. But it also makes a very public statement about the acceptability of being obese. Some people think it was an empowering statement. Others, like me, think it’s a dangerous one. Piers Morgan, a host of Good Morning Britain, had a problem with it. He got dressed down in a number of traditional and social media outlets. The world’s reaction to his comments demonstrates the sad reality that many people don’t want to hear that there’s something wrong with being overweight.

Magazines don’t sell with plain looking women wearing simple brown clothes and no make-up on their covers. Covers have to catch the eye so potential buyers will pick up the magazine and buy it. An obese woman in a bikini is provocative. It’s different than your run-of-the-mill supermodel in a bikini. While many argue that Cosmo’s cover was a positive step in body acceptance, I think it was done first and foremost to sell copies of the magazine.

What does that mean for me and for people who share my view? Don’t buy Cosmo. Further, maybe you don’t want to buy any other magazines published by Hearst Communications, Cosmo’s publisher. That includes Marie Claire, Good Housekeeping and O (Oprah Winfrey’s magazine). And if you like these publications, and still want to read them, maybe you’ll look at them a little differently.

Taking this idea elsewhere…if you think there are advertisements that purposefully mislead people into thinking that food is healthy when it really isn’t, then don’t buy those products. Don’t invest in those companies. Don’t hire that ad agency. Unfollow the company, the food, the celebrities that endorse the food.

Of course, there’s big business in big people. Because of the proliferation of obesity, we are starting to see more and more clothing lines designed for large people. It’s worth noting that for decades, the American clothing industry has already experienced dress size inflation. This is the phenomenon of vanity sizing. That basically means that people are inclined to buy clothing in smaller sizes than what they actually are because it boosts their self-esteem. Any woman can tell you that it feels great to “drop a dress size”. Sadly, the reverse is usually true. We haven’t dropped a dress size; the dress sizes have just gotten bigger.

At this point, we can’t make the sizes of the clothes any bigger, so now entire lines of clothing targeting overweight and obese people are on the market. Examples include Premme and Eloquii. Mainstream brands, designers and retailers are all making plus-sized clothes too. It makes business sense. Of course there should be options for plus-sized people because that’s what most Americans are!

It’s hard to wrap your head around because a lot of these clothes are really beautiful and individuals need to celebrate who they are, not matter what they look like. That’s a quintessential American freedom. On the other hand, there is something culturally problematic with making money off of products that enable obesity. What’s the incentive to drop that dress size when there’s a lovely plus-sized outfit that skillfully de-emphasizes your weight?

If you’re a socially-responsible investor, you may object to these lines of clothing being on the market altogether. If you feel that way, don’t invest in them. Don’t promote them. Don’t follow them.

Relatedly, it seems to me that if there’s a company promoting the ideas of more exercise, better eating, less stress and more sleep, it shouldn’t also be making money off of people who are overweight, right? If your company message is about healthiness, then to be consistent, you shouldn’t take any financial upside that is a result of unhealthy behavior.

So let’s talk about Gwyneth Paltrow.

Ms. Paltrow is the founder of goop, a lifestyle company that is basically the online manifestation of Gwyneth Paltrow’s brand. What is goop? According to the site, “We believe that the little things count, that good food is the foundation of love and wellness, that the mind/body/spirit is inextricably linked, and we have more control over how we express our health than we currently understand.” That sounds like an inclusive wellness motif. That’s great.

Yet there is no question who goop’s target audience is: people who want to be Gwyneth Paltrow. My scan through the site didn’t show one body image with an ounce of fat on it. Lots of yoga preening and glowing skin and chic models wearing impossibly expensive clothing. It’s worth noting that the clothes don’t come in plus sizes. I put “plus size” into the site’s search bar and one item came back – a faux fur oversized coat that came in extra small, small and medium. I guess “oversized” is a plus size on goop?

People love the brand. I get that. More power to Ms. Paltrow for creating something that strongly resonates with a specific market. But here’s what I don’t get. Why is Ms. Paltrow an investor in plus-sized clothing company Universal Standard? Isn’t that hypocritical? The models on the Universal Standard website couldn’t even get into a goop photo shoot as an observer, yet the company’s got some of her money.

Sure, some could argue that investing in a company like Universal Standard makes good financial sense. Maybe Ms. Paltrow and the goop PR team think an investment in the company might make the notoriously perfect Ms. Paltrow seem more approachable to Universal’s market of overweight women. They may not be able to buy clothes on her goop website, but they can buy her skincare and handbags and shoes. What a win!

And what hypocrisy. Paltrow is promoting skinny-person wellness on one hand and profiting from heavy-person clothing on the other. If you don’t like that, then don’t buy from goop.

Is all this socially-responsible investing going to be enough? No. We also need celebrity endorsements. Outspoken, controversial celebrities that change the way we talk about obesity. In short, health care needs a Colin Kaepernick.

Talk about someone who put his values before his wallet. This is the professional football player who started kneeling during the national anthem to raise awareness about police brutality and racism. Many support his perspective that the Star- Spangled Banner is less about American patriotism and more about the promotion of negative slavery-era values. That’s not what I think. And it’s not what the National Football League thinks either, which is why Mr. Kaepernick can’t get a contract to play in the league.

Yet some people support his activism and feel that he’s positively advancing America’s racism discussion. If anything, his persistence is admirable. And his influence goes straight to the top of Nike, a globally recognized leader in sports merchandise and branding. In early July, Mr. Kaepernick single-handedly squashed the release of a sneaker featuring the Betsy Ross flag because he thought it was racist. Can you imagine the level of influence that takes? Sure, people got angry. But Nike stood by the decision and guess what? Their stock went up. Kaepernick used his voice to impact both public opinion and the financial performance of one of the world’s most well-known companies.

Someone needs the courage to take on the social media attacks that will inevitably come by decrying the condition of obesity. It will take guts, because the individual will risk losing fans, supporters, endorsements, and most important of all, money.

Nonetheless, I think this is an ideal job for The Rock. Dwayne Johnson. He’d be great. He’s already a fitness role model, he’s extraordinarily likeable, he’s cross-cultural, he’s articulate and he’s smart. Better yet, he was able to bounce back from the epic bomb of a movie, Baywatch, so he’s resilient.

I’d like to see videos of The Rock surrounded by overweight Millennials. Just a handful of them, so we, the viewers, could see them react. I’d like to see him explain that obesity correlates to pretty much every major chronic condition out there. Cancer, heart disease, depression. He could explain to a young woman that in about 20 years there would be a strong chance that she’d be a diabetic, incapable of walking in anything except sneakers (good-bye fancy sandals of youth), with fading vision and a lower-paying job than she has today because of her physical limitations. And things would only get worse from there. She’d likely be a candidate for a hip replacement because the years of being overweight had literally fractured her bones. She’d be on multiple medications and that would further her risk of developing dementia.

It’s taking a negative view on obesity, but it’s a real one. And people need to hear it and believe it and shock themselves into better health.

Would The Rock be willing to risk his multi-million dollar paychecks to do such a thing? One can only dream.

But that’s how Colin Kaepernick started. He put his career and money on the line for what he believed. But what is gaining traction for him – and for his movement – is that an organization like Nike sees the financial benefit of his activism. So The Rock would need a high profile company to be in league with him. It would have to be a company that also had the courage to risk alienating some of its customers at the hope of creating more loyal ones. That company could again be Nike. Or maybe it could be a company in a different category altogether. Like Whole Foods. Oh wait, they’re owned by Amazon. Would the richest man in the world want to take a risk on a social cause like public health? Now that would be interesting…

We need to embrace all kinds of ideas as we seek to make the health care industry better. Let’s speak up, using our words and our wallets, so we can all be as healthy as we can be.

This is The Powers Report Podcast. Please subscribe to our show and please follow me, Janis Powers, on social media. Please see our website at powersreportpodcast.com to submit questions and ideas on the Contact page. I look forward to hearing from you. Thanks so much for listening!