Thursday, March 25, 2010

Health Care Reform

I am not in the 20% of Americans who feel they will be benefitted.[1]

Before you jump to conclusions, allow me to explain: I was a republican in school, democrat as a rebellious young man and now, as a middle aged integrative doctor, naturally, I am an independent.

A year ago I felt we desperately needed health care reform, specifically, a Public Option. I never bought the argument that insurance companies would go out business with a government-run alternative. After all, the Post Office is not doing well competing against FedEx and UPS. Public schools are not putting private schools out of business, either.

The reform passed will do NOTHING to implement cutting-edge science that is consistently showing that a focus on nutrition, environmental detoxification and Mind-Body issues are the best way to care for public health. On the contrary, it will send more dollars after those who sell sickness, namely, Big Pharma and insurance companies:

“There is a lot of money to be made from telling people they are ill… The social construction of illness is being replaced by the corporate construction of illness… Some forms of medicalization may be described as disease mongering, extending the boundaries of treatable illness to expand market for new products…

“Alliances of pharmaceuticals, doctors and disease groups use the media and expert witnesses to frame conditions as being widespread and severe… Disease mongering can include turning ordinary ailments into medical problems, seeing mild symptoms as serious, treating personal problems as medical problems, seeing risks as diseases and framing prevalence estimates to maximize potential markets... Corporate funding information should be replaced by independent information.”[2]

No wonder the health industry spent a lot of money lobbying for passage of present health care reform. The most disappointing issue for me was to learn that President Obama, no doubt trying to compromise, promised insurance companies and Big Pharma that their profits would not suffer. Sure, the industry will make some concessions; they are smart enough to throw us a bone. That is how they avoided the threat of the Public Option, arguing that they could not have competed with a government-subsidized program (See above.)

But, doesn’t capitalism thrive on competition?

No, it doesn’t; corporations and robber barons have always conspired behind closed doors to avoid competition against each other, in order to squeeze as much money as they may from the public.[3] This has happened time and time again in practically all societies, even in the United States. Rockefeller notoriously stated “I would rather have regulation and control rather than free competition.”[4] That is exactly what the health care industry just got handed on a silver platter: a smattering of token regulations to avoid… the Public Option.

I don’t want to be forced to buy into a sick system that does not teach people Health at the Speed of Light (The title of my next book.) Arguing that nobody should be forced to do buy insurance for purely libertarian principles, Attorney Generals from 13 states have already announced their plans to oppose such mandate; they feel it is unconstitutional. But, they are likely to be defeated; I guess I will be paying the fine for not getting insurance in 2014.

I will continue to put my eggs into living healthy and not be driven by fear of disease, Sure, accidents do happen; get catastrophic insurance for emergencies. Motivated by health, you will minimize the risk of disease.

Doctors who maintain that insurance encourages prevention are only partially correct: insured patients, if “prevention” is covered, may find out about a disease as it is getting started; they are dealing with secondary and tertiary prevention. Those who choose Health at the Speed of Light choose primary prevention, or the avoidance of disease before it gets started at the cellular level.

Health Care reform could have been better had we followed the recommendations of the National Institute of Health in 2001:

“Implementation of contemporary quality improvement results remain far from ideal in daily medical practice. [There are] multiple studies over the past five decades documenting simultaneous overuse of ineffective treatment and underuse of beneficial care… How is it possible that modern medicine still does not provide care of known benefit sufficiently and correctly? ...due to inadequacies of organization, delivery and financial reported by the Institute of Medicine’s Committee on Costs of Medical Care in the late 20's…

“The patchwork approach has served us ill, as we run from crisis to crisis, allowing the fear of cost to drive all attempts to define and solve the problem. Such an approach is doomed to promise much and deliver little…

“The problem is worse than we thought, and delaying implementation [of solutions] may lead to catastrophe...The enormous body of evidence to support the analysis and recommendations are difficult to refute. There is prodigious evidence to warrant wholesale internal system changes of clinical practice and delivery of care.... Developing a new medical care quality system is a scientific enterprise; implementing it is a political one.”

“‘Crossing the Quality Chasm’ is the state of the art report on redesigning our health care system. It is required reading for all of us in health care. If we implement the committee’s recommendations, we will truly have created a health care system revolution. Even with partial implementation, change would be profound.”

“The American Health Care system is in need of fundamental change. Many patients, doctors, nurses, and health care leaders are concerned that the care delivered is not the care we should receive. The frustration levels have never been higher. Yet the problems remain. Health care today harms too frequently and routinely fails to deliver its potential benefits. Between the health care we have and the care we could have lays not a gap, but a chasm…

“The burden of harm is staggering. It requires urgent attention. Meeting this challenge demands a readiness to think in radically new ways about how to improve quality. Our present efforts resemble a team of engineers trying to break the sound barrier with a model T Ford.”[

That is what we are getting; the promise of better access to over-prized Model T technology. Ironically, better health care (prevention, nutrition, etc.,) is cheaper, more successful and more sustainable.

[1] CBS News, March 22nd 2010

[2] “Selling Sickness: the pharmaceutical industry and disease mongering,” British Medical J. 2002;2:339

[3] Book “The Wealth of Nations,” Adam Smith, 1776

[4] Book “The Creature from Jekyll Island,” G. Edward Griffin; American Media, 1994

[5] Book review on NIH report “Crossing the Quality Chasm: a new health system for the 21st century,” J. of the American Medical Association 2002;287:646