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.

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)

The Next, Even BIGGER, Bubble!

The Next, Even Bigger, Bubble!

The monumental problems facing our health care system have many ominous similarities to the problems that precipitated the collapse of the housing bubble, and ultimately our banking system. This is another obvious bubble about to burst. (A bubble by definition is an artificial inflation based on spending money we don’t have.) 

Frighteningly, no appropriate steps are being taken to avert disaster. In fact, the only step alluded to, creating a unified payer, may only ensure our demise by sacrificing our long-term interests (our health) for potential short-term financial gains.

We need to recognize that this is not a health CARE crisis. It is NOT a crisis of access to, or costs of, care. It is a true HEALTH crisis; a sad indictment of the state of America’s health. 

Each year more and more Americans are getting sick and dying from the chronic degenerative diseases of obesity, stroke, cancer and heart disease. These diseases result from decades of bad lifestyle choices and toxic environmental exposures. 

What drugs, diagnostic tests or surgeries can fix that? 

What amount of money, no matter how large or who pays, can fix that? 

Moreover, does anyone really believe that if we all had unlimited access to free, after-the-fact disease care we would be any healthier? 

While the symptoms of these diseases are widely treated with drugs and surgery, the diseases themselves are not curable and most of what is done, most of the time, does nothing to alter either the progressive nature of the illness, or the course of the disease towards death. That is why patients have lifetime prescriptions for blood pressure, cholesterol, diabetes, etc, medications, and why they have more and more invasive procedures (angioplasty, stents, bypass, etc), over time, until they die; a protracted death at costs that we can no longer afford. 

As I recently told Massachusetts State Senator Ben Downing, it frightens me to think that our State, which has instituted ‘health care reform’ by mandating health insurance and drug coverage for all residents, may actually believe they have solved the health crisis. Even more frightening is that this is being looked at, and considered, as a model solution for the nation. 

The reform mandate only deals with the symptoms of access and costs.

As more and more people access the system, due to increased rates of disease and increased unemployment, the costs will only skyrocket, and the reform, as such, is doomed to fail. 

Indeed, it already is. It is being called ‘The New Big Dig.’ 

“While pledging universal coverage is easy, the harder problem is paying for it. This year's appropriation for Commonwealth Care was $472 million, but officials have asked for an add-on that will bring it to $625 million. For 2009, Governor Deval Patrick requested $869 million but has already conceded that even that huge figure is too low. Over the coming decade, the expected overruns float in as much as $4 billion over budget.” 

No amount of money can fix this problem!!         

While largely incurable with drugs and surgery, the chronic degenerative diseases are, for the most part, preventable and reversable through lifetime, lifestyle changes. This is where we, as a society, need to focus our efforts. 

To get there we first have to let go of the false notion that medicine can save us from ourselves and from the enormous and powerful corporate influences on our eating and pill-popping habits.

 

This is a huge societal issue that demands bold legislated public policy initiatives to avert disaster; policies that assist and guide us towards better lifestyle choices and demand more corporate responsibility and accountability.  

We need nothing less than the creation of a cultural paradigm shift towards prevention through improved health and wellness and away from policies and medical care models that only diagnose and treat disease.

No, You Can't Get There From Here!

No, You Can't Get There From Here!

Is Atul Gawande, MD , surgeon, Associate Professor at Harvard Medical School, and acclaimed author reading my blog? No.

However, no sooner had I posted “You Can’t Get There From Here,” his article, “Getting There From Here,” appeared in the 01-19-09 issue of The New Yorker.

His article laboriously describes evolutionary 'path-dependent’ patterns that have led to national health plans in other countries and, will hopefully do so here.

He writes: “The overarching goal of health-care reform is to establish a system that has three basic attributes. It should leave no one uncovered—medical debt must disappear as a cause of personal bankruptcy in America. It should no longer be an economic catastrophe for employers. And it should hold doctors, nurses, hospitals, drug and device companies, and insurers collectively responsible for making care better, safer, and less costly. “

All are noble goals for our disease-care delivery and re-imbursement systems that we can hope to achieve; but, once again, largely misguided, as they have way more to do with the economics of care and re-imbursement, than they do with true health-CARE reform.

Dr. Gawande writes: “American health care is an appallingly patched-together ship, with rotting timbers, water leaking in, mercenaries on board, and fifteen per cent of the passengers thrown over the rails just to keep it afloat. But hundreds of millions of people depend on it. The system provides more than thirty-five million hospital stays a year, sixty-four million surgical procedures, nine hundred million office visits, three and a half billion prescriptions. It represents a sixth of our economy.”

Keep in mind, all of that treatment, at a cost approaching 3 trillion dollars/year, for only 300 million Americans! ($10,000 per person per year, and rising! And, 12 prescriptions per year per person!)

The sheer numbers alone decry a failed medical model for health: failed any way you look at it, in terms of the rapidly increasing numbers of unhealthy and sick adults and children, in terms of the inefficacy of the treatments for them, and, in terms of the never-ending, skyrocketing, bankrupting costs associated with them.

The crisis is not one of care, but rather, a true health crisis because so many of us are so unhealthy.

The fix, the saving of lives and money, is in improved health, not in the care.

Sorry, Dr. Gawande, as I wrote in by blog: “You Can’t Get There From Here.”