11.30.05 - The topic of America's medical "system" has been addressed in WELLNESS REPORTS and at SeekWellness.com many times. Yet, the topic has such profound consequences to the well being of our country that periodic essays about it seem appropriate. What's more, a wellness perspective will be of inestimable value if we are ever to enjoy an integrated delivery system that resolves the problems evident in the current situation. Where better to seek a wellness perspective than right here in your Friday E-AWR?
In all key measures, this country is doing badly with the fragmented mess of separate fiefdoms that passes for a "health care system." The phrase itself is a frequent source of macabre humor. There is nothing like a "system" out there, let alone a "health" system. Briefly, the following constitute the worst features of the dysfunctional non-system that citizens have to put up with and pay for.
Medical costs per person are the highest in the world; the medical sector in the US consumes a far greater share of GNP (16 percent) than in any other society. We spend three times as much on medical care as on education.
* The system is 99.99 percent oriented to treatment with drugs and high-tech, specialty and even subspecialty interventions; primary care and prevention receive little attention while incentives to take responsibility, behave healthfully and act to stay well are non-existent.
* Despite all the spending (if not in part because of it), health status is lower than in a dozen other Western societies.
* A significant number of citizens (about 45 million) have no medical insurance or other means to pay for needed treatments.
* Business enterprises that DO offer health insurance for their employees find it difficult to show a profit or compete on a global basis due to the burdensome financial drain of rapacious medical benefit plans.
Besides these problems that concern consumers and business leaders, other issues worry medical professionals and health care policy experts. These include quality and safety of care, availability of doctors and other skilled personnel, paucity of funds for medical research, malpractice rates and much more. If these problems had come about suddenly, the mess would be called a disaster. However, nearly all the problems highlighted have existed for decades; warnings about the situation as an unsustainable situation gather little notice. "What else is new?" seems the common response to such alarms, no matter the source.
Adding to the crisis, already over the top and ready to push down the barriers (think Hurricane Katrina and New Orleans), are an aging population (including overweight and medically needy baby-boomers) with all manner of chronic diseases.
Naturally, solutions will be opposed by existing interests that profit from the current dysfunction, as parts of it are highly profitable for some special interests. These include drug companies, hospitals and many provider groups, especially insurance companies. Paul Krugman has suggested a major reason for high insurance rates is the vast expense of elaborate screening processes of insurance companies that are designed to limit payouts and services to clients! (Source: Paul Krugman, "Health Economics 101," The New York Times, 14 November 2005.)
The Congress could legislate changes, but most elected officials are dependent on these very interests for their campaign funds. At some point, an organized public, led by a coalition of consumer groups, will have to elect a critical mass of politicians to enable the passage of comprehensive health care legislation. An integrated new system that effectively addresses existing problems will have to include at least two components: 1) rational, cost-effective universal care providing, at a minimum, necessary medical attention for everyone; 2) wellness education from an early age for everyone.
Don't hold your breath. There is likely to be a long wait for a government in the form of a courageous congress that is willing to do the right things, even at the cost of lost campaign funds from special interests. Instead, keep doing what you no doubt have been doing, else you would not be reading the WELLNESS REPORT -- shaping, refining and enjoying a wellness lifestyle.
Be well. Always look on the bright side of life, even if at times it's not easy to do. Especially when it's not easy to do!