We are now entering the age of Obama – a new dawn, change we can believe in. As with the political landscape, so with health care… but is America ready for real change?
My good friend Roger Ehrenberg and I were debating (well, we actually agree with each other, so more like discussing) the current political/economic landscape, and the analogies to the health care system mess we’re in. Lack of oversight, lack of transparency, foxes guarding the hen house, short-term solutions to long-term problems, and so on. Quick-fix syndrome. Roger actually blogged eloquently about the connections over at IA, but I wanted to bring the thread here, as it’s something I’ve been mulling for quite some time.
It occurs to me that what needs to happen is not so much a mystery – we need to create incentives that encourage true preventive care and a wellness “ethic.” It is dreadfully apparent that an approach that emphasizes nutrition, fitness, and mindfulness is not only morally right but makes strong economic sense (these two don’t always go hand-in-hand). Unfortunately, most political solutions for health care “reform” include more secondary prevention – increased screening which means more testing which means more diagnosis which means more treatment. And round and round we go – more $ for pharma, more insurance reimbursement for procedures and less for primary care. That’s PRIMARY – meaning prevention and counseling about things before they happen. So what needs to happen is not the issue. But for it to materialize, we as a society will need to welcome serious changes. And I am not sure most Americans really want this kind of change.
Wait, you say – why wouldn’t everyone want a renewed focus on health and wellness instead of a high-priced disease-treatment system in which people are actually sicker than ever before? Because America is the land of what-have-you-done-for-me-lately. Fix it now and deal with the consequences later. That is the way our political and economic systems have functioned for a very long time. And every other country knows it. Health care is not a priority in America. We are one of the only “industrialized” countries in the world that does not provide health care as basic right of citizenship. How well is that working out for small business and individuals in 2008? And how many adults (never mind adolescents who think they’re invincible) would rather take pills for high cholesterol, sugar, and blood pressure rather than deal with the hard work of addressing their nutritional and fitness needs? Have a problem? We’ve got the fix. Just plug in a new kidney or liver or lung…. and yes, I’m aware there are real needs for organ transplantation. I’m not trying to be flippant. But when you look at health care dollars spent on very, very few individuals at the extreme ends of life (severely premature or very old), or on those with extreme end-stage diseases, it is staggering.
So I ask again, though – are we, America, ready to make a really hard choice? Are we committed to putting our resources into true primary care to support wellness, especially for pregnant women and children? Can someone please tell me why we are not focusing as a society on our children’s health and well-being? Not in some blah-blah-blah lip-service way, but in a tangible put-your-money-where-your-mouth-is way. Because that is how we’re going to actually make a change that I can believe in.