America is getting deeply mired in increased deficit spending while such issues as access to prescription drugs distract us from other more basic problems of the health care system...and more generally, the health culture, as it is operating today.
There is widespread agreement that the system, which is more accurately called a disease care system, isn't working well for anyone except trauma, accident, catastrophic disease and acute emergency patients. Some might add to that the "very well insured," who are happy despite their lack of insured access to popular and often effective modalities of complementary and alternative medicine. There are the 40-50 million people who have no insured health care and perhaps tens of millions suffering from chronic diseases which our basic approach to health care has no constructive way of addressing. There are the many doctors whose lives have become balancing acts of bureaucratic responsibilities, overly scheduled days, high levels of malpractice premiums, and increasing burnout or turn-off because they really do want to spend more than a few minutes with their patients.
As a long-time practitioner of another system of medicine which involves healing, I have become increasingly confident over the years that what I, and others in the healing professions have had the honor to learn and do, is what people need. If a short series of acupuncture treatments helps numerous patients avoid surgery for carpel tunnel syndrome, wouldn't you think the insurance industry would be beating a path to our doors to sign up for my services? This question applies to numerous other conditions and to other treatment modalities. However, it is only part of the story.
There is a need for a culture of health promotion, leaving acute disease care and management to the conventional system..or even better, evolving over time, to a system based on healing and health promotion once there is stability in each situation.
I tell everyone who comes into my office that my job is to put myself out of business.
The way I plan to do this is by encouraging each patient toward the skills and resources to maintain their own life and health, and then, through various modalities of treatment, get them to the point where they have the energy and enough sense of well-being to do so. ("'Heal thyself' is the same as 'healthy self"). This idealistic thinking is mitigated by, for instance, the fact that lots of young ghetto dwellers have no control over the heavily polluted air in their neighborhoods which lead to explosive rates of chronic asthma, or that tens of thousands of farm and other workers exist in toxic environments which contribute to short- and long-term disease. If we aren't living healthy, there's only so much good even natural medicine can do us. In addition, the complementary modalities tend to be available primarily to the privileged.
Ultimately each person becomes, or more correctly, becomes aware that they always have been, their own primary healthy care provider. Of course this is only logical, as everyone agrees that only healthy living can lead to health. We agree with this idea, but we don't live by it. We don't fight for our right to go outside in the midday sun and make some Vitamin D which is absolutely essential to our health. We have somehow been hypnotized into needing no suffering, sickness or pain or needing someone else to fix it when it happens because we have no skills or realistic expectations about life and health. We also have a generation gap here that makes the situation even worse. Today's youth, except the few who have been raised in TV-free homes, have been saturated with ads for drugs which teach them that the solution to all health problems is a pharmaceutical drug and that only their doctor knows the correct information for obtaining and using it. This generation, like many of their parents' generation, has been throughly dis-empowered when it comes to maintaining health and understanding their innate capacity to heal and be well. It often takes years, if ever, for them to understand that they have an option for healing and health as opposed to continued management of symptoms with drugs or other conventional therapies. On the other hand I find myself asking: "Can women be healthy today when their environment is pervaded by hormone disrupting chemicals, stress and poor quality food at every bend in the road?" As a result, the first maxim of the current health care crisis is that:
1) Access to "health care," as it currently exists, does not mean access to health.
The underlying reason for this is that the current disease treatment system is not based on prevention and healthy living and is organized as a business. We know that the entire gigantic industry has no built-in incentive at all to really keep people healthy. It is a problem-dependent system. In fact, it would not exist as it is if people were generally very healthy In too many cases the system does nothing to get at the causes of health problems, which are in many cases, products of life style: poor diet, stress, lack of exercise, toxins, etc.
Do you simply accept that a giant company that runs huge big box pharmacy/dept. stores all over the country profits from 75 different kinds of candy, cookies and other complete junk food in the front of their store, and then also profits from an almost equal number of prescription medications which treat diabetes and its terrible effects, at the pharmacy in back of the store? This kind of dual profit: first profit from products that may add to health problems, then profit from the medicines that treat those problems is rampant in our whole life style. Yeah, yeah, I know, people have a right to not buy candy, but as the judge in the famous case against a large fast food chain pointed out: the average person can't possibly understand how bad these modern "foods" are for them without special instruction.
In preparation for this post, I interviewed a group of college students about their health care concerns.
"We call our college health service the Death Service," one of them offered. They told me that the care they got has no imagination and no resources. "They give ibuprofen for everything...or suggest that the problem is related to sex." On the other hand, one of them volunteered: "The problem with people's health today is that nobody eats enough greens." So there you have defined in one amusing set of remarks the difference between health care/health services and "healthy care."
So maxim #2 is:
2. Spending lots of money on health care as it now exists will not make people healthy. We can't buy health.
Is there hope? Can the situation be improved? Some people point to the so-called alternative medicines and healing modalities for answers. Certainly these do offer a different approach and fundamental philosophy of care that differs from the main stream medical system. However Maxim #3 says:
3. Access to alternative and complementary health care will not make people healthy unless they are living, eating and working healthy. Short of that, complementary and alternative medicine can too easily become a feel-better form of allopathic care.
Mainstream health care administrators have become lured and fascinated by the so-called alternative system because they see it as lucrative, but too often they approach it in much the same way that they approach all allopathic treatments, as an applied treatment, disconnected from requisite changes in diet, work and lifestyle which will really sustain and maintain health and well-being.
Maxim #4: Concern about access to health care has to be shifted to concern about access to healthy care (also called "living healthy"). This is the primary care which comes from the person's home environment and day-to-day life and relationships.
While the disease care system has largely thrown up its hands and accepted that people will not make the changes necessary to prevent and heal disease, the healthy care system will be based on the belief that people must and will learn to provide healthy care for themselves and their families if the cultural climate encourages it. This implies policy changes. This implies that the government will help protect us from unhealthy products despite their profitability. This implies really supporting families. In Scandanavia, parents have well-paid for parental leave after the birth of a child. The mother's nurse their babies for a healthy length of time. Here, we don't have well-paid automatic parental leave after the birth of a baby, and many, if not most, mothers don't nurse their babies for the recommended amount of time. This issue is critical to the long term health of babies and mothers. So to repeat again from my first post: the central assumption is that access to the possibility of healthy living is a more vital right than access to the current "health care" system. However, as many people are already sick and in need of care, they should, of course ,have affordable access to the best care possible as a step toward reclaiming and reestablishing health.
What are the focuses of healthy care and how would it work? That will be the subject of the next post. Please be ready to comment and make suggestions.