Healthcare
Reform Health Care, and Start With Your Own
A substantial overhaul of our national disease management system is now highly unlikely. What we will get is possibly an alteration in its financing. Perhaps insurance companies will form cooperatives, perhaps the government will pay for the treatment of more currently uninsured individuals, perhaps some costs will be contained with malpractice reform.
And of course, those changes are desperately needed. Medical bills are, by a large margin, the number one cause of bankruptcy in the United States. It is a strong testament to the fundamental flaws of our system that two-thirds of those filing bankruptcy due to medical bills had health insurance.
Meaningful health care reform may not happen at the national level for many decades to come. However, there’s another way to reform health care in this country. It’s not reform that starts at the top level of government and trickles down to individuals. It is reform that starts with each individual. And someday, eventually, it might just trickle all the way up to the top.
It is widely acknowledged that our current medical system focuses primarily on disease management. In fact, calling it a “health care system” represents little more than habit, since it has very little to do with either health or care. The vast majority of therapies utilized by our medical system fall into two categories: block symptoms with medications, and/or perform some surgical procedure to cut out or rearrange a part of the body that isn’t working correctly.
In order to care for and enhance health, blocking symptoms or cutting out parts isn’t enough. In fact, these treatments can very commonly hide one set of symptoms while causing many additional problems. And those additional problems often lead to even more medications or more procedures. Health, in this system, doesn’t spiral up. It spirals down.
Until profound change in our approach to health changes at the national level, individuals can begin to reform health care on their own. A few guiding principles, followed through by large numbers of people, would force the change we want to see.
First, work with a primary care physician who has extensive knowledge about preventive medicine. Preventing disease before it happens has an enormous financial benefit. It is also the foundation of meaningful health care. If your physician cannot or will not speak with you at length about nutrition and about the latest research on nutrients and lifestyle changes to prevent and treat disease, find another.
Second, if your current health insurance does not fully cover all licensed care health practitioners – including alternative providers – then it is not health insurance. It is simply a plan for pre-paying your medical bills. Write a letter to your insurance carrier expressing your desire to prevent rather than treat disease, and explain that you are shopping around for a plan which supports that goal.
Third, if you already have symptoms or a disease, ask your physician why you have it. Obviously bodies do not randomly decide to start producing symptoms. There is an underlying cause for the imbalance(s) that lead to symptoms. If your physician brushes off the question, or worse, becomes annoyed by it, find another. Understanding the underlying causes of symptoms should be the primary focus of any physician working toward your optimal health.
Finally, realize that caring for health is not something that can be accomplished by any national medical system. Physicians can and should provide the education and the road map for moving toward optimal health. It’s up to each individual, though, to actually travel that road.
Those four changes would initiate a true revolution in health care, reforming it from the bottom up.
BY DR. GREGORY ECKEL
Big Pharma’s unspoken influence on health care and other musings
In a recent NY Times article students at Harvard medical school were surprised at the extent big pharma had on their education. In recent grades Harvard received an F for failure to disclose the conflicts of interest of their lecturers among other things. We have discussed this topic in our podcast ‘Nemesis of Medicine‘. This marriage of the pharma industry and medical education institutions is sadly absent from the current discussion of health care reform.
Journal of American Medical Association Dr. Catherine DeAngelis said, “The influence that the pharmaceutical companies, the for-profits, are having on every aspect of medicine…is so blatant now you’d have to be deaf, blind, and dumb not to see it.” When seniors argue for prescription rights as if this is true medical reform we are in trouble. The marketing machine of big pharma masked as health care is the big elephant in the room. What we have currently in the U.S. is a disease management, symptom based model of care and it’s very expensive.
While access is one component of the discussion, we need to question access to what? The discussion should include a change to talking about health and wellness. A system that addresses the root causes of dis-ease, not just disease management. All too often I see patients that are left coping with the dictate their doctors gave them, “get used to it, this is as good as it’s going to get for you.” All too often patients are left with this statement and don’t realize the options they have. Naturopathic and Chinese medicine practitioners have options for patients that get results. People are voting with their dollars and have been spending more out of pocket on complimentary and alternative medicine than with their allopathic medical expenses.
One would expect an increase in research dollars to study these alternative therapies since more and more Americans are using the therapies. As a practitioner I am constantly scouring the reserach to help my patients. Instead what we hear are attacks on complimentary and alternative medicine as psuedoscience in the Washington Post. A doctor from Yale university, which received a C grade in policing big pharma on it’s campus, was calling for defunding NCCAM (National Center for Complimentary and Alternative medicine ), the branch of the NIH (National Institutes of Health) which studies complementary and Alternative medicine. His suggestion was that he doesn’t like the government funding pseudoscience. Instead, this physician, like many in his field, appear to collude with rigorous “pharma” standards and hence “pharma” results and “pharma” interests.
At Nature Cures Clinic we are embarking on our own research as there is a clear need for it, however the model of research that earns institutional recognition does not reflect current practice. The current trend of reductionistic single intervention research can not capture the essence of what makes naturopathic medicine thrive — addressing root causes rather than symptom management.
We have a unique opportunity in time where the strangle hold big pharma has on medicine is loosening. Patients are looking for alternatives to help the with their health conditions, disease, and illness. And we are ready.
BY MARC DELPHINE
I do believe that the government has really created a mess of the entire health care industry, but so has the insurance industry and so have pharmaceutical companies. But most of all, we’re to blame.
Health care starts with diet and exercise and we wouldn’t have nearly the problems if we simply took better care of ourselves. Now, not all people can be helped with diet and exercise, but it’s something most of can and should do. I can’t believe no other candidate has the leadership to declare: “we did this to ourselves and we must get ourselves out of this mess. We are overweight, generally lazy (yes, I did say that) and we look to government to solve too many problems including paying for the pills we pop instead of looking to a natural way of remedy.
Here are my strategies for aiding the ailing health care industry:
- Diet & Exercise – Be proactive about your health – over 90% of our health care is non-preventative. Eat good foods and get out of the house for a walk, run or a swim.
- Allow for the self-employed to deduct their own health care, regardless of how much it costs (now, as a self employed financial planner, I need to spend almost 8% of my AGI in order to qualify for a deduction). I should be able to deduct my insurance, too.
- Allow for competition of insurance companies across state lines. As it stands, a company from Ohio can’t come into Oregon to offer their insurance. This is because of…GOVERNMENT REGULATION
- Allow the doctor to negotiate price with the patient. Costs were low when this could happen, but then came GOVERNMENT REGULATION.
- Create penalties for frivolous lawsuits from fat-cat attorneys who lick their chops at vulnerable patients, regardless of doctor negligence. Tort-reform!
- Enact Health Savings accounts with tax-credits for young and healthy individuals who are not interested in paying for insurance – this will create an incentive to save (excess proceeds can used for retirement).
- Allow the import of pharmaceuticals from other countries, if they’ve been proven to work for them. It takes an AVERAGE of 12 years for a drug to be approved from the FDA.
- I am a firm believer in naturopathic medication. This is a preventative and proactive way to a holistic and healthy lifestyle. My doctor often spends over an hour with me, makes sure he knows who I am and that I am well. He takes time to ask the right questions and gives me natural cures to any illness or ailment I may have. His cost is DRAMATICALLY less than a traditional MD and with much better results.
Most of the 42 million “uninsured” are young, healthy people who CHOOSE not to have insurance. An estimated 11 million more are illegally in this country. Take down the real total of 9 million (which is still a lot, but we have charitable doctors and hospitals who will not turn ANYONE away) and now it’s manageable.
We can fix the problems of health care, but we must first look to ourselves, NOT to the government.
You seem to be arguing that deregulation will reduce health care costs in the US, but you don’t take into account that the countries who provide a single payer system on average pay less than half the per capita health care spend in the US. These countries, including England, Australia, France, Germany, Canada, Japan, Singapore and Cuba also achieve this savings with better health care outcomes in terms of life expectancy and infant mortality rates than the US. Singapore, with both one of the highest life expectancy rates and lowest infant mortality rate spend only $678 per person while we in the US spend $4271. (see sources below)
Please how, in the face of the overwhelming evidence that a single payer system will both reduce costs and improve health outcomes in this country, you believe your system will make a positive difference for Americans.
Health care spend per capita information:
http://www.nationmaster.com/graph/hea_spe_per_per-health-spending-per-person
Life expectancy and infant mortality rate referenced from the CIA fact book:
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html
Mori, the problem is that there is little comparative analysis available for a true free-market system. We haven’t had one in this country for nearly a century. What we have now is an enormous amount of regulation in the healthcare industry and you seem to argue that “to help the heroin addict, the solution is to provide more heroin”.
All government-run healthcare monopolies, whether they are in Canada, the UK, or Cuba, experience an explosion of both cost and demand – since healthcare is “free.” Socialized healthcare is not really free, of course; the true cost is merely hidden, since it is paid for by taxes.
Whenever anything has a zero explicit price associated with it, consumer demand will increase substantially, and healthcare is no exception. At the same time, bureaucratic bungling will guarantee gross inefficiencies that will get worse and worse each year. As costs get out of control and begin to embarrass those who have promised all Americans a free healthcare lunch, the politicians will do what all governments do and impose price controls, probably under some euphemism such as “global budget controls.”
Price controls, or laws that force prices down below market-clearing levels (where supply and demand are coordinated), artificially stimulate the amount demanded by consumers while reducing supply by making it unprofitable to supply as much as previously. The result of increased demand and reduced supply is shortages. Non-price rationing becomes necessary. This means that government bureaucrats, not individuals and their doctors, inevitably determine who will get medical treatment and who will not, what kind of medical technology will be available, how many doctors there will be, and so forth.
All countries that have adopted socialized healthcare have suffered from the disease of price-control-induced shortages. If a Canadian, for instance, suffers third-degree burns in an automobile crash and is in need of reconstructive plastic surgery, the average waiting time for treatment is more than 19 weeks, or nearly five months. The waiting time for orthopaedic surgery is also almost five months; for neurosurgery it’s three full months; and it is even more than a month for heart surgery. Think about that. If your doctor discovers that your arteries are clogged, you must wait in line for more than a month, with death by heart attack an imminent possibility. That’s why so many Canadians travel to the United States for healthcare.
The Fraser Institute publication (Waiting Your Turn: Hospital Waiting Lists in Canada):
http://www.fraserinstitute.org/commerce.web/product_files/waitingyourturn2008.pdf
First, thanks for the debate. I expect most candidates would have politely just ‘moderated’ my post out of existence.
A few cases of waiting does not eliminate the merits of the single payer system. One of the major causes of American’s health care spend is that we get procedures that are at best unnecessary, but often costly. If the wait times had a significant impact on ones life expectancy, Canada (and the others) would have a shorter life expectancy than the US. Their life expectancy is longer. And it costs less. They distribute health care based on a triage procedure so that when a patients life is at stake, they get care. The US also rations health care – just based on ability to pay so those who can pay get procedures that don’t help their health while those with limited funds fail to get the procedures they might need.
Every one of those countries pays less per capita than the US for their health care. By creating a national plan, they also collectively negotiate for prices for drugs, services etc. They also often fund medical school positions to create enough doctors to meet the needs of the country.
Many of these countries have a two dual system where those who want it can purchase additional private coverage to supplement the single payer which provides a base level for everyone. This can include extras not covered by the single payer system like remedial massage, or acupuncture. I don’t know about you, but there are clearly limits to the coverage I have.
No free market will make it attractive for a company to offer health insurance for someone with an expensive pre-existing condition at an affordable price. While I’m happy to offer price breaks for people who engage in healthier behavior (staying fit, maintaining a healthy weight, or not smoking, for example) but to deny or drop coverage for a patient with a condition entirely out of their control like Type 1 Diabetes, Crohn’s disease, many cancers among others is unacceptable.
The US has come as close to a free market system as any industrialized nation has and yet our health care spend harmfully high. If professional Human Resources people can’t find a way to find insurance at a reasonable cost, why would an untrained, time constrained individual be better capable of identifying a plan? It takes doctors 7 years of medical school plus residency to learn the ins and outs the health care system. Why would individuals be better capable of finding cost effective health care? Per this Economist article free markets will increase the overall price of insurance and health care.
http://www.economist.com/displaystory.cfm?story_id=15545834
The wholesale transfers to large classes, from large classes, are not good moral philosophy unless those classes are very well specified to the moral effect you are trying to achieve. Now, if you were to be able to remove the burdens completely from the lower and middle classes, I just may part ways with my libertarian philosophies on this issue. But you can’t and it won’t happen. Whether it is the corporations or government, there is a leviathan lurking beneath.
As Americans, we embrace individual liberty. The liberty to take care of those less fortunate is definately one, so why not do it through private charity? Is not the definition of liberty to do what is right at one’s own discretion and unregulated by government intrusion? Or more to the point, by brute force? Forced into submission under some niave notion that the federal government will do what is right for us all? As a nation founded on the ideals of limited government and free-market enterprise it only makes sense to keep a far less efficient, expensive, and intrusive entity such as the government from socializing healthcare.
Mori, back to the original discussion concerning whether free market or single-payer heath care is the cost-effective answer to this dilemma, you seemed a bit dismissive of my position that we haven’t had a free market in the heathcare industry in many years. You stated “the US has come as close to a free market system as any industrialized nation” but I contend that this is a myth. If anything, the U.S. system has many more similarities than differences with France and Germany. The major difference between America and Europe of course is that the U.S. does not guarantee universal health insurance whereas Europe does.
More importantly, contrary to popular mythology, America does offer public care of sorts. It directly covers about a third of all Americans through Medicare (the public program for the elderly) and Medicaid (the public program for the poor). But it also indirectly covers the uninsured by—at least in part—paying for their emergency care. In effect, anyone in America who does not have private insurance is on the government dole in one way or another.
This is not radically different from France, where the government offers everyone basic public coverage, of course—but a whopping 90% of the French also buy supplemental private insurance to help pay for the 20% to 40% of their tab that the public plan doesn’t cover.
Do you really believe that a single-payer model will cost less or that the proletariat will have the power to force the rich to bear the cost burden through an honest representation in Washington? Otherwise you must think that the costs would simply be spread through inflationary spending against an already burdensome national debt as we get gutted by the political elite closest to the teat of the printing press. One way or another, there is no free lunch.
The only sustainable system that avoids this Hobson’s choice is one that is based on a genuine free market in which there is some connection between what patients pay for coverage and the services they receive. That is emphatically not what the US has today. Looking to these countries for solutions, as advocates of universal health coverage are doing, will lead to false diagnoses and false cures.
Remote Area Medical (RAM) is an organization solely funded by private and corporate donors, travels all over the globe providing healthcare free of charge to those in need, but unable to afford expensive medical procedures. Recently RAM set up a massive clinic at the Wise Fairgrounds in Virginia. The one day clinic drew over 1,700 medical professionals and served over 2,715 patients with ranging medical complaints. Of the procedures offered were mammograms, x-rays, pap smears, tooth extraction, and diagnosis. RAM is proof that as a nation, we can supply quality healthcare to the poor and less fortunate through private charity rather than through forced taxation. I know this and I have seen it first hand throughout my life.
RAM is but one example that charity and free market healthcare are highly beneficial and available as well.
Criticism of US healthcare – and esp criticism in the context comparative statistics with other countries – comes from the “World Health Report 2000″ prepared by the World Health Organization. Indeed, the findings in that report made their way into the popular media, including Michael Moore’s movie “Sicko.” Because it was prepared by a respected international body, the assumption is that the conclusions – and, importantly, the methodolgy used to reach them – were unbiased and objective.
But that is not the case. The WHO rankings depend crucially on a number of underlying assumptions— some of them logically incoherent, some characterized by substantial uncertainty, and some rooted in ideological beliefs and values that not everyone shares. The Cato Institute did an in-depth analysis of “World Health Report 2000″ in February 2008. They concluded: “They include factors that are arguably unrelated to actual health performance, some of which could even improve in response to worse health performance. Even setting those concerns aside, the rankings are still highly sensitive to both measurement error and assumptions about the relative importance of the components. And finally, the WHO rankings reflect implicit value judgments and lifestyle preferences that differ among individuals and across countries.” You can access the full Cato analysis here: http://www.cato.org/pub_display.php?pub_id=9236.
As a healthcare executive, I concur that our “system” is in dire need of reform. Access and affordability are without question burdensome on people, society and the economy. But reform of this perverse system is not, in my view, best achieved by introducing greater perversity, especially if reform is based on erroneous assumptions and, at their core, redistributionist policies.
I very much enjoyed reading this. As long as an article is well written then it is sure to attract a readership group. I say this should be rated a 9 on a scale from 1 to 10! I write some things myself. Is it alright to put a link on my site(
Mexico’s private health system is far closer to a free market system than ours has been in decades! The waits for care there are shorter than here. The Mexican government stays out of the private medical system and the costs there are often 10% of ours. I know many people that go to Mexico because the care there is superior to ours! A friend went to Mexicali to have knee surgery after having it done twice here with disappointing results. The MRI was done 45 minutes after the doctor recommended it and cost $300. Contrast that with a 27 week average wait in Canada and last time I had an MRI here ( horse accident 10/02) it was $2500. We must get the government out of the business of trying to run our lives. Too much government is the most pressing problem we face.
Just a quick note: I think that, while all of you have brought up key points about this issue, no one has yet addressed Mori’s original question which I will restate as follows: “Why do Americans pay twice as much, per capita, for health care than many other countries of note?”
Although I know that Americans have more elective and preventative procedures performed than people in other countries, I will assume that Mori’s statistic is honest and we’re simply paying more for health care than everyone else. So where is all that extra money going?
In large part, it’s going to the insurance companies. I’m surprised no one has yet unveiled the multi-billion dollar insurance industry conglomerate as being an instrument of the state. The U.S. has more laws and regulations regarding health care than the next 3 highest-paying countries combined.
The rules and regulations forced onto this — yes, very regulated — marketplace in essence make competition for individual health insurance policies a thing of the past. We’re all in “groups” now, by government (and corporate) design, and hence everybody is paying for everyone else’s health care in a highly convoluted and bureaucratic fashion. This is the way it is right now — not tomorrow after D.C. passes whatever well-intended reform they think will change the world.
Today’s health care industry is far from a free market, and has become less and less free over the course of recent decades. Profits go to the bureaucrats who dictate the rules and simply act as middlemen when the only people who should be involved in a purchase of a medical service is you, your doctor, and (if you wish) your own personal insurance agent/policy.
And we are to fix this problem by adding more government regulation, bureaucracy, and subsidies? Call me a skeptic.
In 2003, I was pregnant and shocked to discover I was in very poor health with kidney disease and vascular disease. Shortly after, my husband had to quit his regular career to help care for me and our children. I had to get Oregon Health Plan. I also have two autistic sons who are on SSI.
When I am in the hospital, the amount of money they charge and get back from the government shocked me. I am so thankful that I was able to get help, but the government needs to clean up the system it has in place now before it embarks on another system. They are all padding each others pockets and that needs to stop. I know it’s not as easy as it sounds, but something needs to give. Prove to me the government can run a healthcare program and then maybe I’ll be interested in a new program.
I suggest you rethink your position on importing medicines from other countries. Counterfeit drugs come from many places, and the origin of many of these counterfeit medicines come from countries that are very large world economic forces (India, China).
When most people in the US think of getting medicines from other countries, they think of Canada and Mexico. Mexico has a virtually unregulated system and I am not comfortable placing my health in their hands. Just walk into a pharmacia in Mexico and you will understand. Health Canada (Canadian version of the US FDA) has regulations that allow import of medicines into Canada without regard for the quality of those medicines as long as those medicines are only passing through Canada. So ordering medicines from Canada through the mail, does not guarantee that a patient in obtaining medicines approved for use in Canada by Health Canada. Very scary stuff.
Importing medicines from other countries is dangerous. Both Democratic (Clinton) and Republican (Bush) administrations have refused to enact regulations on importantion, despite acts passed by Congress, because of safety concerns for the public. Importation is a political issue that sounds good, but is in fact dangerous.
The FDA, and others have studied international mail order pharmacy operations. They universally have found that many medicines are counterfeit, are contaminated, are placebos, are not labeled properly, and in some cases harmful to patients.
Marc,
Your “About Marc” section has almost nothing about you. This is a nice wordpress site, but I think we need to see a little more about you, other than that we know you used the Columbus hockey team’s logo.
It seems odd for me to hear about Health care regulation being the problem, when deregulation more likely would have historically caused the problem. Insurance companies greed has been deregulated 20-30 years ago and if you look at the money made by big insurance companies you’d be assounded to learn that publically traded companies could have made you rich – more rich than microsoft or any other stock from 30 years ago. Look, if insurance companies weren’t making money hand over fist, would hospitals really be able to over charge. no. If you don’t believe it check out the stock price for United Health Group (UNH symbol) over 30 years. Compare it to MSFT Microsoft or another company of your choosing. Health Ins. Companies 30 years ago lobied to have regulations removed so they could make big bucks and now thier lobying powers stop politicians from doing the right thing and putting those controls back in. We are stuck until somebody says that it is wrong and will stand up to lobying powers – not likely. Money talks not the people’s will. Sad – say goodbye to your country.
what is the answer to the family who has a child with cancer? diet, exercise, and holistic medicine? a new drug from a foreign country? shopping across the country for insurance while their child needs care?
some good ideas are in here, but in practice they may not work.
“Most of the 42 million “uninsured” are young, healthy people who CHOOSE not to have insurance.”
Could you please provide a citation for this number?
As one of the uninsured young, healthy Americans, I can assure you that I don’t ‘choose’ to go without health insurance. For myself and many others just out of college, we can ‘choose’ between paying rent and eating or getting healthy insurance. We’re very much aware that we’re gambling with our health and well-being by not being insured, but when you’re fighting tooth-and-nail in this job market for opportunities that will barely keep debt collectors off your back, health insurance isn’t on the radar.
This all sounds very good, Marc, beginning with …
“1. Diet & Exercise – Be proactive about your health – over 90% of our health care is non-preventative. Eat good foods and get out of the house for a walk, run or a swim.”
But “Be[ing] proactive about your health” is not covered in the following viewpoint which is on another page of your site:
“Recognizing that abortion is a sensitive issue and that people can hold good-faith views on all sides, I believe that government should be kept out of the matter, leaving the question to each person for their conscientious consideration. Again, I oppose any public funding for abortion.”
“[G]good-faith views” on murder? The very worst thing a mother can do *for her health* is to kill her own child. Today, the 32nd anniversary of the death of my daughter by abortion (I could even tell you the time!), still stings, and I encourage you to pray more about your weak stance, for while you might think it will help you with votes (surely — as a health warrior — you don’t REALLY think a mother should kill her own child, thus sending her mental, physical not to mention any spiritual health she might of had, down the drain (along with her child), you aren’t pulling any strings with God. Aren’t there any holistic politicians like yourself (I *really* enjoyed reading the above; I’m a distributor for essential oils) out there that *also* has the “Rock[s]” to stand up for Life from womb to tomb? God help US.