Is America Ready For Real Change?

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.


  1. In order to have true change there needs to be a shift in the individual citizen’s perception of health and the prevention of disease. It seems that most American’s have lost the ability to question things at the most basic of levels. Asking questions like: “Wait, do I really need this pill? Will eating these products made with words I cannot even pronounce be ok? Do I really need that test? that surgery?”
    There is a time and place for medications; however, we are bombarded with pharma ads that despite giving a list of terrible side-effects assure potential users that the consequences of their health choices are not their fault. Many in our society have come to believe that having certain preventable disorders like high blood pressure, anxiety, high cholesterol, back pain, etc. are common stages of the aging process. If we believe that to be the case-our government will also believe that as well and fund programs designed to “assist” us in our disorders.
    So many think nothing of feeding themselves and their children diets that are laden with additives, preservatives, and empty calories that if not properly balanced show consequences. We need to start telling large corporations–“Look-you’re putting this in our food–I’m not buying your product.” If we did this, I guarantee we would see changes in how our foods are prepared and sold and of course-government would likely back us up there.
    It also seems that many are just accepting developmental and behavioral disorders in children-and dare I say-it has almost become trendy–it is easy to because there are so many funded systems in place to handle these issues. Almost every other education major now adds the “Special Education” proponent to their studies–and of course there are drugs to handle the “problem” children. Pregnant mothers now get videos and large albums of their 98 ultrasounds because it is so “cute,” but do they stop and question if maybe that testing-and the so many other types of testing given to pregnant women these days is safe? Are there any possible effects? To question that sometimes leads to many a raised eyebrow. I myself got several of those when I refused an amnio, the glucose tolerance tests (I ate jelly-beans instead), and only had 2 ultrasounds. I refused to let modern medicine interfere with a natural process like birth because there is no proof that any of these common interventions are safe. But if society as a whole is basically ok with turning birth into a medical condition…what else is government to do but accomodate our wants.
    Another way to promote effective health care changes is to hold insurance companies accountable for their own interference with health. In many instances, an insurance company will think nothing of paying thousands of dollars for a preventable, invasive back surgery–but will deny an under $100 claim for alternative treatments like Chiropractic care, Accupuncture, or even Massage Therapy, which show far more documented lasting benefits to the patient, not to mention cost-effectiveness for everyone concerned. If we do not individually demand that our insurance companies provide us with fair coverage, we cannot expect our government to do the same.
    If we accept all of this as normal, what example do we as a society give to our children? We are showing them that it is ok to have disease in our lives, that unknown substances are fine to ingest, to be tested whether it has been proven safe or not, to view conditions as a designer label, and most importantly, that there is no reason to accept responsibility for our health. If we continue to accept these societal norms, government will keep funding whatever makes us happy.
    We are demanding by our behaviors the type of health care system that currently exists. We need to change our own individual behaviors so that government understands what it is we truly want and need in terms of health care-and the only way to do this is to stop, question, and take individual responsibility for our health.

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