Disease Proof

American Healthcare Making Us Sick?

If you’ve been following DiseaseProof’s mini-series The Mammogram Debate, you’ve probably noticed that modern healthcare sometimes isn’t all its cracked up to be. In fact, it often appears as if there are other motivations at work, and not just a patient’s best interests. This is a rather controversial topic and, Dr. Fuhrman would agree, not readily covered by mainstream media.

So, to say the least, I was surprised to encounter this essay in Tuesday’s New York Times. H. Gilbert Welch, Lisa Schwartz, and Steven Woloshin contend that American medicine more often than not simply facilitates a precarious epidemic of diagnoses and not simply the pursuit of successful treatment. I’ll let them explain:
This epidemic is a threat to your health. It has two distinct sources. One is the medicalization of everyday life. Most of us experience physical or emotional sensations we don’t like, and in the past, this was considered a part of life. Increasingly, however, such sensations are considered symptoms of disease. Everyday experiences like insomnia, sadness, twitchy legs and impaired sex drive now become diagnoses: sleep disorder, depression, restless leg syndrome and sexual dysfunction.

Perhaps most worrisome is the medicalization of childhood. If children cough after exercising, they have asthma; if they have trouble reading, they are dyslexic; if they are unhappy, they are depressed; and if they alternate between unhappiness and liveliness, they have bipolar disorder. While these diagnoses may benefit the few with severe symptoms, one has to wonder about the effect on the many whose symptoms are mild, intermittent or transient.
Now, I’m a layman, this type of issue is a little over my head. So I asked Dr. Fuhrman for his thoughts, and here they are:
Our modern medical care delivery system is a big money making machine and has very effectively increased the need for medical services and drugs, but it does very little to foster better health in the population. From cholesterol lowering drugs, antihypertensive medication and diabetic medications to chemotherapy, Americans get disease care, not health care. Except in some unusual cases such as childhood cancers, medical care for chronic disease (which is usually drug care) is not the best way to prevent disease, reverse disease and prolong our life. Modern science has given much evidence (largely ignored) that lifestyle modification and nutritional excellence is much more effective than drug care. Nevertheless, the economic system funds and drives the population to respect and believe in our drug-centered medical delivery system and gives an economic disincentive to pursue lifestyle medicine as a field of research, study and practice.

If many doctors had the chance to observe what happens when nutritional excellence, exercise, light therapy and structural balance is taught as the foundation of health care they would see headaches, asthma, adult diabetes, blood pressure and heart disease resolve easily without the need for high tech surgical interventions and drugs. Lifestyle medicine is very rewarding work because we see people get well and they are able discontinue their drugs. How many asthmatics have most doctors seen recover? Lupus patients? Arthritis patients? Are they mostly increasing medications for their patients or decreasing them? Medical students, residents and other physicians have rotated and observed these routine occurrences, in my office and the body of research is slowly growing, but most doctors are skeptical and disinterested, or they will claim insufficient research. The bottom line is that the best health care is the right type of self-care, it is delivered in people's homes and kitchens and we really need less medical care and intervention, not more of it.
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Comments (1) Read through and enter the discussion with the form at the end
John Gilpin - January 5, 2007 2:23 PM

Here is my take on the health care crisis. This is taken from The Health Care Blog, where I first posted it on Dec 1, 2005. It is very compressed because the rule there was 250 words or less.


The problem
1. People have been encouraged to believe that they have a right to as much as they want of whatever medical science can provide (driving up demand).
2. Providersâ€"physicians, hospitals, drug companies--operate as collective monopolies (greatly restricting supply).
3. The incentives for most providers are to profit by providing (or denying!) services; only a few profit by actually maintaining health.
4. Payment arrangements largely disconnect cost from benefit, depriving almost everyone involved of crucial feedback information.
5. A pervasive and oppressive orthodoxy, enforced by the collective monopolies, prevents many promising innovations from becoming established, or even studied.

The solution
1. Remove all barriers to entry of new providers, products, and services. Require full public disclosure of relevant training, experience, and record (for providers) and validation and quality-level (for products/services, including, for example, hospital infection rates).
2. Require every provider to maintain a public list of fees that are the same for all clients.
3. Abolish all health insurance, except genuine health maintenance (where the provider and the insurer are the same entity) purchased directly by the consumer.
4. Provide income support to people as judged necessary, but not specifically tied to healthcare. Eliminate all tax provisions related to healthcare.
5. Institute a vigorous public education campaign to enhance the ability of healthcare consumers to make sound decisions.

These steps, enabling all healthcare stakeholders to better determine where their actual interests lie, will strongly conduce to effective pursuit of those interests.

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