Our Health Care System is Completely Backwards

Earlier this evening, I was reading a business book entitled Breaking the Time Barrier. The book is written for small business people (like me) in service industries who bill their clients on an hourly basis. Written as a pseudo-fable, the author tries to hammer home the lesson that I should be billing my clients based on the value I bring to them…not by selling blocks of time to them at an hourly rate.

The author recommends that I…

  1. determine the goals of a potential personal training client – ie a 20 lb weight loss or a 10 pt. drop in systolic blood pressure,
  2. identify the value of their goals to them. How much do they value their health, fitness, appearance?
  3. Offer solutions designed to achieve their goals
  4. Charge them a percentage of the value of their goals in return for my solution

…as opposed to selling them hour long chunks of my day..with the implied promise that those hours are going to add up to their goals…of a 20 lb weight loss or a 10 pt. drop in systolic blood pressure.

And that got me thinking about other personal trainers…and the fitness industry…and then the entire health care system. And by the end of my pondering, I concluded that our health care system is completely backwards.

Our Current Health Care System

Currently, we have a society where rates of diabetes, cancer, heart disease, dementia, depression et al increase year after year after decade. And instead of the health care system offering solutions to help us achieve our goal of good health, it offers us products & services designed to…

  1. mask the symptoms of disease
  2. extend life after the medical condition has become critical


We’re not paying for health…we’re paying to manage pain, disability and disease.

[colored_box color=”green”]If I was a cynical man, I might start thinking that our health care system is a bit of a racket. Why focus on keeping their patients healthy when they can sell them lots of stuff when they get sick?[/colored_box]

But what if doctors could make a good living and keep us healthy at the same time?

  • What if our health care system taught us how to eat for health?
  • What if our health care system taught us how to be active for good health?
  • What if our health care system taught us how to shop for and cook healthy meals?
  • What if our health care system made healthy food inexpensive?
  • What if our health care system made health & fitness cool like Hollywood makes really bad movie sequels seem cool?
  • What if our health care system made access to exercise facilities universal?
  • What if our health care system focused most of it’s efforts on keeping us healthy?

And what if you paid for these services in advance…like you do everything else?

For example…

  • If you want shelter from the elements, you buy a house or rent an apartment.
  • If you want to get rid of hunger, you buy food
  • If you want to travel from home to work, you get a bike or a car or a transit pass.
  • If you don’t want to be lonely, you talk to people, go on dates, nod and smile at the stuff they find important…

We all pay a price in some form or another to achieve the goals that are important to us.

So why don’t we do that with our health care system?

Why don’t we pay doctors to keep us healthy? Isn’t that what we want? To be healthy…and fit…and strong…and attractive.

seniors exercise fitness

So why do we pay the health care system to mask our illnesses and keep us alive in hospital beds while our family goes bankrupt trying to keep us alive just a little bit longer?

Can anyone answer that question for me?


  1. Well Doug.
    Great blog and great questions.

    I don’t know how you locked in to all this stuff, but you have hit the nail precisely on the head.

    Unfortunately, I think it will be the next generation that finally wakes up to the fact that what you are saying makes sense.

    The next generation will have to deal with all the consequences of what the current and recently past generations got sooo horribly wrong.

    It will start to kick in when they are dealing with the costs of health care, and the fact that on average, they are not going to live as long as their parents and grandparents.

    It will come as a shock to them unfortunately, because in the main they are not listening to people like you. – And why should they? – The current “system” of “health care” is all they know. – They have not yet been forced, by either really bad economic or really bad health standards, to look for a new answer.

    Keep preaching though. I hope that the younger generation may start listening, before it’s too late.

  2. I work in a hospital. The healthcare system actually does teach about healthy living. “Don’t smoke. Avoid excessive alcohol. Manage your weight and eating habits. Exercise. Take vitamins. Don’t do drugs.” Pretty simple suggestions that are given to people over and over and over. The healthcare system does teach about health. But people have to listen and take responsibility for themselves. You can only bring the horse to the water. I am about 100 pounds and yet I am lifting 300-400 pound people in and out of bed. And you say it’s us healthcare people who don’t have it right? We do not force the 10 cheeseburgers in a week on people.

  3. The healthcare system spends less than 1% on all forms of health promotion. They spend over 99% on treating disease…with the majority of those costs going to fully preventable diseases.

    Without disparaging the fine work health professionals (like you) do every day, my contention is that the entire system is set up ass-backward. More money spent on disease prevention / health promotion could/would/should lead to lower rates of disease, higher quality of life, longer duration of life and way less money being spent on managing disease symptoms.

    I agree with your contention that people SHOULD take care of themselves…but they don’t. And because they don’t, your taxes will go up…regardless of how logical your argument is. They will keep eating crap, getting heavier and sicker…increasing costs associated to medicare/obamacare/private health insurance…and will probably end up destroying your lower back as you get them in and out of bed…putting you on disability.

    The way we do things now is totally screwed up….IMHO

  4. I’m a physician working on opening a clinic addressing this very topic. I own a gym and will be based in the gym. The health care system is terrible. I refuse to continue in the current model. And it is true, doctors do not teach health. Because they do not know the way. It’ll change….slowly!
    But I’m there and I’ll be a part of it.

  5. That’s fantastic Jacob. I never intended in my post to suggest that doctors/nurses/etc are the problem in our healthcare system (although some of them probably are)…it’s the system framework that’s the problem.

    Your plan for bring health care into a physical fitness environment seems like a no-brainer to me.

    I wonder what your MD colleagues think of your plan?

  6. So far, they are supportive of the concept but apprehensive about thinking it’s a wise financial choice.
    We’ll see how they like it when I start contradicting treatment options…

  7. It’s pretty screwed up that keeping people healthy isn’t looked at as a viable business opportunity. If you ever need any social media promo, feel free to contact me

  8. It is actually one of the most ingenious con/racket ever designed: have people voluntarily spend money on poor nutrition and bad habits, then have them spend more on masking the symptoms. A century ago, a con man would have poisoned a local drinking water source he himself owned, then sold snake oil to those who experienced symptoms. And he would have made a fortune! And when caught, he would have been hung for his crime against humanity.

    We know about today’s racket of perpetual poor health; is anyone getting the noose ready?

  9. Thanks for the thoughts. Maybe it’s about time more people learn how to take responsibility for their own health. We believe we are what we eat. Build the immune system up from the basics in live food nutrition. It’s good medicine, don’t you think?

  10. This writeup and some related comments sound funny! It is true that the health care system is not measuring up to ideal expectations all OVER THE WORLD. However, the writer of this column seems not to be in touch with the reality of science and medicine. Treatment/cure for any disease is predicated on research; and as we know research is not moving at the same pace as the incidence/prevalence of diseases. But that is not to suggest or conclude that governments and scientists are just sitting idly by and doing nothing. Every research laboratory in the world is working round the clock to procure solutions to all these diseases. I usually poke fun at some of my friends who opt out from science and medicine for other academic/professional disciplines and remind them that the solution to human health lies in the recruitment of people into the sciences to help decipher remedies that afflict human beings every day. Jumping to work in the banks and other fast-paced industries to get rich quick is no solution to this myriad of health problems. As we see that fast money cannot cure any of these diseases!

    People must be grateful and encourage those who have devoted their entire lives looking for solutions to all these health problems. Nobody is a health magician, remember. Just sitting in the comfort of your homes and casting aspersion on others in this field will yield no dividend.

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