Apparently, a good portion of America has gone completely insane over healthcare reform.
- We’ve heard from the politicians – Democrat & Republican.
- We’ve heard from the pro gov’t healthcare crowd…[unitelligible screaming]
- We’ve heard from the anti gov’t healthcare crowd…[unitelligible screaming]
- And we’ve heard way too much from the teleprompter readers on tv – left & right & even more right
So, today, let’s take a look at what America’s favorite celebrity doctors have to say about healthcare reform in America.
First up, Oprah’s personal health guru:
Part of the challenge we face is that all eyes are focused on healthcare finance arguments in Washington, but the real action is taking place in our homes across this great land. We cannot have a wealthy country without being a healthy country, but healthcare finance solutions by themselves do not help us care for our health. An insurance card is correlated with, but does not guarantee a clean bill of health.
To control costs without rationing care, we need to improve the quality of the services we buy for our money. Economists and the few remaining car salesmen would agree that this translates to better value.
We have two principal options.
First, we need to eliminate the 20 percent of services offered that are wasteful or harmful.
Doctors need to act like professionals and police our own for doing unnecessary tests and procedures but we also need smart patients to insist on second opinions that will change their diagnosis or therapy in a third of all cases. Many of you are bashful about pushing to see another doctor, but when you get doctors to speak with each other about your case, they teach each other and every subsequent patient that sees your doctor will benefit because you were brave enough to drive quality into the system.
The second major improvement requires revisiting the business model of medicine.
Professor Christensen of Harvard Business School taught me on a show recently that two primary models exist for any business (excluding networking businesses). “Solution shops” offer intuitive insights into unpredictable ailments, something doctors (and lawyers) are superb at addressing.
On the other hand, value-adding processes like building cars in an assembly line or managing correctly diagnosed diabetes with a specific plan for chronic management are far less expensive than solution shops and usually are more effective in offering reproducible results.
In America, we lump these fundamentally different approaches together so we get highly trained doctors using sophisticated approaches to manage tasks that could often be better accomplished by other well-trained health professionals who actually like double-checking that you took your medications and watched your diet.
We speak of prevention a lot these days, but what does prevention mean?
I moderated the last White House Town Hall on Health and came away from the experience understanding that America believes “prevention” is really about making the right thing easy to do.
This includes everything from making healthy locally grown vegetables easy to find, bike racks available in our work places and a healthcare system that provides a crutch to remind us that we forgot our colonoscopy.
We cannot look to Washington for these changes without engaging the battle ourselves.
Next up is America’s integrative health guru:
The first is a general discussion of healthcare reform…..
As any doctor can tell you, the most crucial step toward healing is having the right diagnosis. If the disease is precisely identified, a good resolution is far more likely. Conversely, a bad diagnosis usually means a bad outcome, no matter how skilled the physician.
And, what’s true in personal health care is just as true in national health care reform: Healing begins with the correct diagnosis of the problem.
Washington is working on reform initiatives that focus on one problem: the fact that the system is too expensive (and consequently too exclusive.) Reform proposals, such as the “public option” for government insurance or calls for drug makers to drop prices, are aimed mostly at boosting affordability and access. Make it cheap enough, the thinking goes, and the 46 million Americans who can’t afford coverage will finally get their fair share.
But what’s missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what’s even worse than its stratospheric cost is the fact that American health care doesn’t fulfill its prime directive — it does not help people become or stay healthy. It’s not a health care system at all; it’s a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly.
It’s impossible to make our drug-intensive, technology-centric, and corrupt system affordable.I’m not against high-tech medicine. It has a secure place in the diagnosis and treatment of serious disease. But our health care professionals are currently using it for everything, and the cost is going to break us.
In the future, this kind of medicine must be limited to those cases in which it is clearly indicated: trauma, acute and critical conditions, disease involving vital organs, etc. It should be viewed as a specialized form of medicine, perhaps offered only in major centers serving large populations.
Most cases of disease should be managed in other, more affordable ways. Functional, cost-effective health care must be based on a new kind of medicine that relies on the human organism’s innate capacity for self-regulation and healing. It would use inexpensive, low-tech interventions for the management of the commonest forms of disease. It would be a system that puts the health back into health care. And it would also happen to be far less expensive than what we have now.
If we can make the correct diagnosis, the healing can begin. If we can’t, both our personal health and our economy are doomed.
Politicians aren’t going to resolve this issue overnight. Any health care reform bill that gets jammed through Congress in the next month or two will be dangerously flawed. Washington needs to take a step back and re-examine the entire task with an eye toward achieving the most effective solution, not the cheapest and most expeditious.
Dr. Weil’s second article deals with a patient of his who:
- was relatively healthy,
- in his mid-30s,
- and had been diagnosed by his GP as having gastroesophageal reflux disease — also known as GERD (aka heartburn)
His GP never took a dietary history, asked about his lifestyle or even explained the nature of GERD nor the long term effects of proton pump inhibitors.
Dr. Weil reviewed his diet and lifestyle and explained the nature of GERD and the factors that contribute to it (stress & certain foods).
Based upon the patient’s history, Dr. Weil identified coffee, strenuous exercise, long hours spent at work in front of the computer and an inability to handle daily stress as the likely causes of his GERD.
- Ditch the coffee
- Supplement his diet with de-glycyrrhizinated licorice
- Practice stress busting breathing techniques
A few weeks later, Dr. Weil weaned his patient off the drugs.
And as Dr. Weil says, this is not brilliant doctoring. Any motivated medical student can learn how to interview a patient to get to the true root of a problem. He or she can also learn simple, safe, inexpensive treatment protocols like these.
This kind of medicine should be the new foundation of American health care. It is the key to cutting the out-of-control costs that are sinking the system.
How’s that for Healthcare Reform!
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