Saturday, April 25, 2009

Offering Solutions to the Health Crisis

Offering Solutions to the Health Crisis

Solving the health crisis will require nothing less than a societal paradigm shift away from a disease-based, after-the fact care model to a model that embraces and encourages personal responsibility for lifetime, lifestyle health and wellness.
This paradigm shift is similar in many ways to the current push for, and shift to, a Green Economy.
To break our addiction to fossil fuels and reliance on foreign oil and to create the paradigm shift to Green renewable energy, several things had to happen. Notably among them: 
1.      dramatic, imminent, potentially catastrophic global climactic change
2.      unprecedented global increase in demand, peak oil and skyrocketing prices
3.      9/11 coupled with American dependency on Islamic nations for oil
4.      President Obama’s determination to make Green, renewable energy, profitable.
 The paradigm shift to health and wellness will happen as increasing sickness and costs:
1.      drive the national deficit and debt to the point of creating catastrophic consequences to our economy and compromise national security
2.      cripple American industry and our ability to compete in the global economy
3.      bankrupt Medicare, Medicaid, hospitals, federal-state and local governments, families and individuals.
Among other things, to create this shift to a health-based system, we will have to:
1.      Institute campaign finance reform to remove corporate influence and ownership of politicians and public policies.
2.      Pass legislation to regulate or eliminate corporate lobbying and influence in the crafting of legislation that protects their interest over that of the public.
3.      Mandate all health care public policy meetings include consumer/public representation.
4.      Restore and rebuild the FDA as an independent government watchdog agency to protect the public. Ban pharmaceutical funding of the FDA.
5.      Hold the pharmaceutical and medical device industries accountable; forfeiting ALL profits derived from creatively flawed and manipulated research that creates products that harm.
6.      Restore scientific integrity by enforcing strict standards and independent oversight to scientific research, discovery, reporting and media sensationalism.
7.      Require that all reporting on drug benefits, by pharmaceutical companies, medical journals, the FDA, and the media, be in honest absolute values, not self-serving and purposefully deceptive relative values.
8.      Put an end to all ‘routine’ medical screenings that generate huge costs and profits but have no known scientific evidence to support their use. In fact the evidence shows that while these screening do lead to further unnecessary tests and procedures, they do not lead to any decrease in overall mortality and morbidity. (ie: PSA testing and mammograms).
9.      Ban the hospital practices of cost-shifting and overcharging of the uninsured.
10.  Restore IRS Tax codes to require so-called non-profit hospitals, with tax-exempt status, to “operate to the extent of its financial ability” to provide services to those unable to pay. And, put reasonable limits on executive compensation.
11.  Ban insurance companies from charging the unemployed, self-employed, individuals and families prohibitive premiums far in excess of corporate and group rates.
12.  Create public policies that support the health and wellness we want to achieve
a.       Ban all direct to consumer advertising of all drugs and diagnostic procedures.
b.      Subsidize local farms that grow whole foods, making fruits and vegetables more affordable.
c.       Stop subsidizing Agra-businesses that grow corn and soy as cattle fodder. And, stop paying farmers not to grow.
d.      Re-define food as natural and unprocessed. Tax all processed foods to help educate and guide consumers towards healthier choices.
e.       Put an end to the US Department of Agriculture’s (USDA) jurisdiction over school lunch programs. Ban corporate syllabi and their influence on food pyramids and food choices. Ban corporate presence in the school classrooms and cafeterias
f.        Institute requirements for health-wellness and fitness curricula and activities Restore recess and gym requirements
g.       Build safe walk-ways and bike paths and promote their use.
h.       Fund Planned Parenthood, early childhood education and facilities that provide pre-natal and post-natal care and health education.
i.         Require supermarkets, convenience stores, and restaurants to include a percentage of their inventory or menu as whole foods, fruits and vegetables in order to be licensed.
j.        Create algorithms of care to guide doctor’s decisions, creating more consistent and safer care, while cutting down on unnecessary care and overtreatment.
14.  Require television public airwave stations to air public service announcements that promote personal responsibility, healthy foods and lifestyle choices.
15.  Institute tort reform to hold lawyers accountable for frivolous medical lawsuits.
16.  Make health and wellness profitable to industry and individuals.
a.       Break-up the merging and empire-building general hospitals’ and so-called not-for-profit hospitals’ monopoly in health care. Repeal any laws that restrict the creation of doctor-run or consumer-driven hospitals that can compete on quality and cost of care allowing for the creation of viable alternatives and specialty hospitals.
b.      Require that the FDA reverse or remove its directive that states ‘only drugs can cure disease’ to open entrepreneurial competition to pharmaceutical companies to find natural cures and promote lifestyle as the ultimate antidote to disease.
c.       Create tax credits and insurance premium discounts for health and wellness expenses.
d.      Provide higher reimbursement to general practitioners and health focused complementary care physicians who promote health and wellness through quality patient care and education.
This list is clearly incomplete. Many of the ideas require further development and more ideas will be generated as I learn more. Our transition to health will require input from many sources, especially the public.
I invite your comments and suggestions.

Friday, April 17, 2009

Putting the Health Crisis in Perspective

Putting the Health Crisis in Perspective

The most daunting challenge to our economy is health care spending.

This was confirmed by President Obama in his April 14th, 2009 speech at Georgetown University:

“…our long-term deficit is a major problem that we have to fix. But the fact is that this recovery plan represents only a TINY fraction of that long-term deficit…the key to dealing with our deficit and debt is to get a handle on out-of-control health care costs.”  

Perhaps for the first time, Americans will begin to comprehend exactly how big of a health crisis we have and what a threat it poses to our economy, federal-state and local governments, industries- large and small, families, individuals, and even our national security. 

Another article that appeared in Rolling Stone Magazine: The Big Takeover, may add needed perspective.

“The latest bailout came as AIG admitted to having just posted the largest quarterly loss in American corporate history — some $61.7 billion. In the final three months of last year, the company lost more than $27 million every hour. That's $465,000 a minute, roughly $7,750 a second.”

That, admittedly, is a lot of money, and we are outraged that we have to pay for it!

But, in 2008 America spent $2.4 trillion dollars on health care. That is $600 billion per quarter. Following Rolling Stone’s math: that is $6.7 billion per day, $278 million every hour, $4.6 million a minute or $77,161 per second!

But wait, health care costs are projected to reach $4.3 trillion dollars by 2017, an astounding $138,890 per second!!

How can that be? 

There are many reasons but it boils down to this: health care is a huge for-profit business having generated $2.4 trillion dollars in 2008 with projected 80% growth over the next 8 years to $4.3 trillion dollars. Heath care is now the largest sector of our economy and the most powerful political presence in Washington.  

The medical-pharmaceutical-insurance industrial-complex is successfully marketing and selling sickness to an unlimited, expanding, willing, and increasingly sick population. From their perspective, there is nothing to ‘fix.’ In fact, like any other business, they are only looking to expand their market.

While a single-payer system may help by shedding some of the massive administrative costs and trimming waste, it will not solve the fundamental problem driving the costs: the never-ending growing market of sick people and their addiction to, and demand for, care.

(In my next blog entry I will offer some solutions to the Health Crisis)

Sunday, April 5, 2009

Systems Breakdown


There was a fascinating story in the New York Times this week: Treating an Illness Is One Thing. What About a Patient With Many?

The title pretty much tells the story: that treating a patient with a single illness requiring one or multiple medications, is hard enough; filled with unknowns and uncertainties, as compounded by doctors’ time restraints and 15 minute appointments, paper work and insurance pressures. 

But, what about treating a patient with multiple morbidities (multiple health, multi-systems problems), seeing multiple specialists, with complicated histories and 17” thick patient files, taking a cocktail of 10 to 20, or more, medications per day, with the same doctors’ time restraints, 15 minute appointments, etc? 

How can doctors even begin to ascertain what is best for these patients;  what is helping, what is harming, the risks verses the benefits of all, or some, of the medications; the negative impact and/or interactions of one medication with another, etc.? 

The answer is; they can’t. 

Instead of treating people, they diagnose and treat each disease entity (co-morbidity) separately, chasing vital signs, so-to speak: trying to lower cholesterol, blood pressure and blood sugar, while at the same time battling osteoporosis, gastric reflux and depression. Doing it all with drugs that were never tested, or approved, for simultaneous usage let alone, in a population with multiple morbidities; drugs with significant individual side-effects and, all-too-often, dangerous, even lethal, consequences

These chronic degenerative diseases are, for the most part, not curable and barely manageable. By definition, they are chronic and progressive.

Ultimately, what even defines successful treatment; progressive disease and disability, and diminishing quality of life? Prolonged death? Most of the time the patients die, while on the medications for the problems being treated; or, as they say in doctor parlance; the treatment was a success, but the patient died. 

Shockingly, the article states how common these chronic diseases and their misguided treatments are: 

Two-thirds of people over age 65, and almost three-quarters of people over 80, have multiple chronic health conditions, and 68% of Medicare spending goes to people who have five or more chronic diseases.”

You do not catch chronic diseases. Chronic diseases take decades of cumulative damage to develop. These multi-systems diseases begin with a lifetime of unhealthy habits starting in youth, with decades of declining health, leading to overt diseases that interfere with living and cut lives short. 

In essence, we are not living longer, we are dying longer. 

This is so common that we accept disease and disability as normal aging when, in fact, they are not.

The answer is too obvious for most to accept. You cannot get healthy by fighting disease. By then, for most, it is already too late. 

In fact, we never get healthy, we only become sick

Health is your body’s natural state, its’ most basic survival mechanism. Your body is always working to keep you alive by maintaining health (homeostasis), adapting as best it can, to the daily onslaught of toxins we eat, drink, breathe and apply to our bodies.

That people refuse to believe this is testimony to the power and effectiveness of the selling of sickness and the magic-bullet and hope of cure we have assigned to drugs. 

We instinctively know what we need to do be healthy

When I ask anyone to name three things they know that they can do to make themselves healthier: no one ever says they need more drugs or surgery. They all say “I can eat better, exercise more, and control my stress better.”  And when asked if doing those three things more consistently would make them sicker or healthier, they all say ‘healthier’. And when asked, why, they say ‘I don’t know.”  

The answer is: you are genetically programmed for health. If you give that genetic blueprint everything that it requires, in a pure and sufficient quantity, the inevitable result is improved health.

The answer is not in treating illness. It is in creating health.