There is so much discussion about the state of the American health care system and whether we can afford universal insurance coverage for all the citizens of our country. But the reality is we do not have a health care system at all. There is a medical care system. There are privately funded medical insurance companies and publicly funded medical insurance. But there is not a health care system in the United States.
Western medicine treats injuries and illness and gives lip-service to health and wellness. Our medical care system pushes pharmaceuticals and surgery. It is in the best interest of the doctors, hospitals and drug companies to do so. For when someone goes to the doctor they are called the patient. There already is an assumption made that the person is ill. The doctor’s job is to look for disease and prescribe a treatment. More often than not the least intense treatment is tried first, often a prescription medication. Only licensed physicians, or a physician assistant working under the physician’s guidance, can prescribe prescription medications because they are deemed to have the necessary expertise to do so. But drugs have unintended side effects that must be managed. So the doctor writes the prescription and the patient must be followed every few months in order to obtain a refill.
The outcome is that the patient relies on the medication, the doctor relies on the ongoing patient visits, the pharmaceutical companies sell more of their product and insurance premiums rise above many people’s and businesses’ ability to pay. And those paying the premiums and out of pocket costs are paying for the country club memberships for your doctor and the drug reps.
Clearly the incentives to treat this person with the much needed lifestyle changes are not in the best interests of our current medical care system because the financial incentives are misplaced. Where is the financial incentive to help this person recover so they no longer need medical care?
When someone sees a surgeon for a consultation and the surgeon is compensated handsomely by performing surgery. It goes hand and hand that there is a greater the likelihood that surgery will be recommended for whatever ails you. It is not rocket science, the more surgeons in a community . . . the more surgery that is performed. Whether it is truly indicated or not should be open for discussion.
Hospitals have fixed costs just to keep their doors open. Someone must pay to keep the lights on, compensate the nursing staff who are there 24/7. Hospitals are in the business of filling beds and providing services that they can charge for. When there numbers are down, just like a hotel, they are losing money. Not-for–profit hospitals make plenty of money, this is how they pay for their elaborate facilities. Make no mistake; modern day hospitals are not the philanthropic organizations of old. The provision of medical care is big business and plenty of people are handsomely compensated by keeping the populous using their services.
Perhaps the free market model is not the best model for our medical care system. We expect our physicians to be knowledgeable and be practicing with the patient’s best interest in mind but then we offer huge financial incentives to prescribe medications and practice aggressive medicine.
In the United States we spend 17.4% of our gross domestic product on medical care expenditures, higher than anywhere else in the world and yet our infant mortality rate is 34th in the world behind Cuba. Clearly our health care dollars are being misspent. 1 and 2
There are times when medication and/or surgery may be appropriate but so many of the health problems that plague people in our country are the result of their own lifestyle choices.
I believe in free choice. I’m not going to tell anyone how to live or what to eat but if you choose not to take care of yourself and disregard all the reasons to do so I think that you, not I, should bear at least some of the financial consequences. This is not a foreign concept for if you are a safe driver your insurance rates reflect that. If you live well and take care of your self that should also be reflected in your health care premium.
Approximately 65% of the U.S. population is overweight and of that group more than one-third or 35.7% are obese. Obesity-related conditions such as heart disease, stroke, type 2 diabetes and certain types of cancer, are some of the leading causes of preventable death. Approximately 17% of children and adolescents aged 2—19 years are obese. Since 1980, obesity among children and adolescents has almost tripled. In 2008, medical costs associated with obesity were estimated at $147 billion; the average annual medical costs for an obese person was $1,429 higher than the costs for someone at a healthy weight.3
For the first time in two centuries, the current generation of children in America may have shorter life expectancies than their parents.4
Financing and providing medical care for the consequence of these preventable illnesses is a misguided strategy and is a poor allocation of our financial resources. People need to be accountable and assume responsibility for their health. Funding a program of prevention is what is indicated and it is affordable.
Scientific reviews find a vegetarian diet is highly effective for weight loss. Vegetarian populations tend to be slimmer than meat-eaters, and they experience lower rates of heart disease, diabetes, high blood pressure, and other life-threatening conditions linked to being overweight and obesity. Rates of obesity in the general population are skyrocketing, while in vegetarians, obesity prevalence ranges from 0 percent to 6 percent. 5
In a study of over 25,000 people, vegetarians were found to have significantly lower rates of diabetes. Among men in the study, risk for diabetes was a whopping 80% higher in men who ate meat, after adjusting for weight.5
Much of the disease that plagues people in our country is based on the way we eat but when it is suggested that someone assume a plant based diet and give up eating animal products they frequently resist. “After all where will I get my protein?” asks the 300-pound woman.
Inadequate protein intake is the least of her concerns. How about portion control and nutrient dense eating to give your body what it really needs? Perhaps we need more health education, perhaps we need to shift at least some of the responsibility where it belongs and I would argue that is with the individual. What has happened to the people of this country? How can we expect others to take care of us when we do not take care of ourselves?
Oh dear God, if you didn’t know any better you might think I sound like a Republican. I do believe that the citizens of our country need universal health care coverage for when illness and tragedy strike. Let’s take another look at the medical care system.
A new study has found that antidepressant drug use in the United States has gone up over 400% percent since 1988. Over 10% of the population in the United States is taking anti-depressant drugs.6
What? What is wrong with a country where over 10% of the population is on antidepressants? People suffer from depression for a wide variety of reasons and in some cases it may indeed be biochemical but more often than not depression is related to the decisions we are making in our daily lives.
As preposterous as this may sound, but if the way you live causes you to be depressed, then you need to change your lifestyle. A pill is not the answer.
We encourage our young people not to get involved with drugs. But mommy and daddy pop pills all day long to make themselves feel better and now we are giving psychotropic drugs to our children too. Doctors prescribe stimulants in the morning so the children will pay attention in school and get better grades. Anti-anxiety drugs are given to junior to counteract the rapid heart beat and shallow breathing that accompanies stimulant use. And then we add just a little pill to help with sleep at bedtime. Repeat this pharmaceutical cocktail tomorrow and get back to school.
And we wonder why our kids don’t feel well.
The pharmaceutical industry is largely influenced by the desire for economic profit. Selling drugs is the business they are in. Between 1994 and 2001, psychotropic prescriptions for adolescents rose more than 60%. 7
Patients today are more likely to ask about antidepressants because of advertising, says study author Mark Olfson of Columbia University and The New York State Psychiatric Institute. During the study, spending on direct-to-consumer antidepressant ads increased from $32 million to $122 million.8
Does anybody else have a problem with this or am I the only one who thinks this is crazy? Public and private insurance premiums and the out of pocket cash of those who do not have prescription drug coverage are paying for more than just the medication. We are funding these exorbitant advertising budgets. This is a lot of money. To continue to spend our resources like this is just plain stupid, and to commit even more resources to this kind of foolishness defies anything that resembles rational thought.
As I see the issue, if we feel bad enough for long enough, then maybe we will make the changes in our lives that so desperately need to be made. People need to be supported and encouraged to own their lives and change the things that make them miserable. A pill may mask the symptoms so we feel better temporarily without ever really dealing with the real problems that make us feel so bad in the first place.
Research from the Harvard Medical School has found Yoga to be an effective treatment for depression, anxiety and post-traumatic stress disorder. Side effects may include an increase in overall physical fitness, decrease in headaches and back-pain, an improvement in overall sleep quality, and a general sense of well-being. I have a hard time seeing the downside of this treatment modality, except that it requires someone to make a personal commitment to their health and perhaps that it is not as easy as taking a pill.9
So who do we ask for advice on how to get well and be well? Often we consult physicians, who may not be wise enough to take their own sage advice. So many people in the health care industry participate in the same unhealthy lifestyle that is so prominent in our culture. The reality is that people’s weight goes up and down like a yo-yo when they go on a diet. They lose the same ten pounds over and over again. What is needed is a lifestyle transformation where healthy eating is a cornerstone.
The bigger question is: Just what are you willing to get rid of in your life to improve your health? We live in a world of excesses and easy answers, but the reality is that we did not become overweight or obese and grossly unhealthy overnight and it will not change overnight. The road to good health is taken step by step with one good decision after another.
How many times have I heard people say how lucky I am that I have time to exercise? Really? It is part of my lifestyle. I choose to go for a walk on the beach, ride my bike or go for a hike up the mountain or to yoga. I have made some form of daily activity a priority in my life. We all have the same number of minutes in every day. If you don’t have time to move your body, then you need to reprioritize. What no longer serves you that you need to get rid of?
Many people spend hours every day on the internet or in front of a television set and get sucked into a television drama or the media’s take on the latest crisis in the world. I choose not to watch. If something really important is happening, no doubt one of the many folks I know who watch on a daily basis will inform me. I will not give away the very precious moments of my life to the television programming that someone else thinks I need to see. I will not let these fear mongers color the perception of my day. I choose to create my own reality and it bears not the slightest resemblance to the world according to Fox News.
Instead I try to write a little bit everyday as a way to connect with my own thoughts and my own spirit. I clear away the debris and see what remains. I ask the questions and the words pour forth from the tips of my fingers one letter at a time.
I believe that the body has an amazing ability to heal itself. We need to get out of its way and let that healing take place. Feeding our selves with mountains of dead animals that have been treated with growth hormones and antibiotics is not the way to restore anyone’s health.
But what about the commercials on the idiot box that say “Milk, it does a body good?” Oh, those ads that are sponsored by the American Dairy Association. People have been lead to believe that milk is nature’s most perfect food. Perhaps for a calf it is, but the research on the human population associates consumption of dairy products with disease. Drinking milk has been associated with breast cancer, ovarian cancer, prostate cancer, diabetes, heart disease and the list goes on and on. 10
Even in our schools the beef industry is providing free nutritional handouts for teachers to use in the classroom. The information on the handouts is dated at best. And may be construed as and harmful and inaccurate as they recommend eating between 3-6 ounces of meat daily. They fund a program called Beef Check Off.11 I don’t know about you but I don’t want the American Cattleman’s Association developing the health curriculum my children are taught in school.
The China Study, an extensive longitudinal study conducted by Dr. T. Colin Campbell, “People who ate the most animal-based foods got the most chronic disease…People who ate the most plant-based foods were the healthiest and tended to avoid chronic disease. These results can not be ignored.”12
Hmm I wonder what their agenda is? Perhaps to sell more meat and milk, do you see the conflict of interest?
So back to the question I posed at the beginning of this piece, can we afford universal health care? I don’t think we can afford not to. There will be enough if the exorbitant amounts of money we are already spending are reallocated to a real public health care system. There are effective, low cost ways to improve the health of our country with diet and exercise and emotional care and education.
The medical care system is broken. It’s not working. Our citizenry is overweight and overmedicated and depressed and inactive. Things need to change.
The financial incentives need to be changed. Providers should not profit financially by their practice patterns. It is counter intuitive. We don’t allow our judges to make decisions where they or anyone else they know personally can benefit by the decisions they make. It is not objective and it introduces bias. The judge is required by law to recuse themselves. But in the medical care system it feels like insider trading and that is illegal.
We need to pay for effective treatments for people. The incentives need to be structured to help people to be productive and to get well and live well. The profits now go to keeping people dependent on their providers and we can see how that just doesn’t work.
If people choose to be sedentary, to smoke, to overeat, take drugs and participate in risky behaviors, then they need to bear some of the cost of those decisions.
Let’s stop drugging our nation and particularly our children. We are currently spending a fortune on chemical pharmaceuticals that frequently do more harm than good.
Turn off the TV. Advertisers want to sell you a boatload of things you neither need nor want and that will not improve the quality of your life. Is it any wonder that spending your time and resources like this makes you feel ill and unfulfilled. The media sells disasters and despair. Don’t allow it to color your view of reality.
Go outside and look at the beauty in the world around you. Move your body and get some exercise. Connect with friends. Eat well and be well. Speak your mind.
I just did.