Wellness and Health Care Reform

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Why Health-Care Reform Won’t Reform Health Care” Re-printed from The San Francisco Chronicle

Why Health-Care Reform Won’t Reform Health Care
By Deepak Chopra, Re-printed from The San Francisco Chronicle

hospLike most people, I was encouraged and energized by President Obama’s stirring speech to Congress last week. With rare candor, he told the truth about the three C’s of reform: costs, coverage, and character. The last C was the most emotionally charged. Staring lawmakers and citizens in the eye, the President essentially said, “Is America a society that squanders $900 billion on a dishonest war but refuses to spend the same amount to give its citizens affordable health care?” Because of the massive counter-efforts by lobbyists and the resistance of the right wing, we’re holding our breaths on the answer to that question.

But let’s say the light prevails and the Democrats deliver a bill that gives insurance access to millions of previously uninsured Americans. As great as that victory would be, health care won’t be reformed.

Isolated voices like Andrew Weil, (writing at Huffington Post and in his book, Why Our Health Matters ), and Dean Ornish, (writing as the medical editor at huffingtonpost.com and in his book, The Spectrum ), and former Health, Education, and Welfare Secretary Joseph Califano are telling us why.

Here are the basic points that aren’t being addressed:

1. Prevention, the key to future health, isn’t being followed enough. That’s why Americans are getting more obese and sedentary every year. That’s why sugary drinks are now the single largest source of calories in the average diet. Alcohol and tobacco still account for 35% of all medical expenditures. Leading causes of bad health — obesity, heart disease, and type II diabetes — could be rolled back by sensible prevention that people simply aren’t following.

2. Supply and demand for doctor care is upside down. Patients aren’t demanding the bulk of the $700 billion in unnecessary tests and procedures performed every year in this country. Doctors are creating the demand to cover their backs and increase their income. Even conscientious doctors who put the patient first are caught in lockstep habit, calling for unnecessary tests because that’s what doctors do in this country.

3. Without a public option, there’s no real incentive for insurance companies to lower their costs. The free market isn’t free when the consumer is presented with non-competitive insurance plans that basically aim at corporate profit and when Wall Street dictates how corporations must be run in order to survive.

4. To borrow a phrase from Sec. Califano, we’ve become a “sick-care system” that puts all its efforts in developing newer drugs and offering more surgery once a person is ill. Doctors are not trained to keep people healthy. They are also strongly tempted to perform needless procedures that do not extend life span, such as hysterectomies, lower back surgery, heart bypass, and balloon angioplasty.

5. We are addicted to the sick-care system, and no money is being allocated in any of the reform bills in Congress to breaking this addiction. Massive public education was successful, over a long period of time, in getting people to quit smoking. Now we need the same massive public education to get them to adopt prevention. Will doctors, insurance companies, and big pharma do the job for us? Well, did big tobacco do the job of ending smoking? Without government action, the private sector will push drugs and surgery because prevention doesn’t show up as profit on their bottom line.

I regret having to walk in the shadow this way. Pres. Obama brought a good deal of light to the whole muddled issue of health-care reform. He spoke truth and balanced it with political realism. He chastised the political reactionaries who want to kill reform by using lies, fear, and misinformation. We’re better off for having heard the speech. But costs won’t go down and Americans won’t be healthier until the five points listed above are dealt with. Right now, health-care reform has been couched in terms of economics first and morality second, with little thought to what should really come first: turning sickness into wellness.

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12 Responses to “Wellness and Health Care Reform”

  1. Nora Wolfe
    September 14, 2009 at 12:18 pm #

    EXCELLENT points! Greed is our nemesis.

  2. Anonymous
    September 14, 2009 at 2:12 pm #

    Just last week I had a meltdown at physical therapy. I’m not just a few inadequate muscles. I’m a whole person. I want to do and be better but I am cut off every time I begin to improve. I feel like I am just bits and pieces. They tell me this and tell me that and send me here and send me there and do tests and tests and nothing ever really happens. The information isn’t helpful to me. I went into a deep depression for a couple of days in sheer frustration. I know more about myself than anyone but they have protocols so I don’t really matter. I’ve been dealing with this all of my life. I am tired of fighting to get level I need support and to knokw that someone understands. I love Deepak. He is so down to earth. Thank you for sharing the information.

  3. Mark McKenzie
    September 15, 2009 at 5:25 am #

    Thank you for pointing this out. You are exactly right. “Will doctors, insurance companies, and big pharma” promote prevention? Did the insurance companies try to affordably cover folks with pre-existing conditions or put individual policy holders in a group to bring their premiums down?

  4. Phillip Smith
    September 15, 2009 at 6:37 pm #

    Likewise, I agree with you. It’s pretty much the same where I live, Perth, Western Australia. Admittedly, we have an horrendous waiting list for elective surgery cases, and overstreched resources, and spiralling waiting lists in our public hospitals, but, I guess like America, almost half of these cases are pretty much preventable, and are, more likely than not, from smokers, or morbidly obese. What they’re trying to do now here in Australia, at least here, in Western Australia, is promote healthier living initiatives, and so, to reduce the burden on the health system.

  5. Anonymous
    September 17, 2009 at 2:05 pm #

    I have to respond to point #4: “They are also strongly tempted to perform needless procedures that do not extend life span, such as hysterectomies, lower back surgery, heart bypass, and balloon angioplasty”. Really? Does quality of life not matter? Only length of life? Excruciating back pain from a ruptured disk is needless? I am a thin, healthy 46 year old, and have always taken care of my body. I eat a balanced diet, and exercise regularly. And yes, I needed low back surgery 10 years ago for a ruptured disc. I recovered fully and am back to leading a very full, active, healthy life, with no residual symptoms. I am glad I could have this “needless surgery that didn’t extend my life span”, and I am sure many people are glad for the quality of life these procedures offer, and am sure that in a lot of cases life spans are indeed extended!!!

  6. Anonymous
    September 17, 2009 at 2:36 pm #

    Actually, some doctors are trained in prevention. I am a family medicine doctor who also teaches in a residency program. Much of our training is focused on prevention, on patient centered care, on evidence based medicine (what has actually been shown to work versus ‘what we’ve always done’), and on the relationship our emotions and our spiritual beliefs to our health (mind, body, spirit). Unfortunately, this isn’t really valued when it come to reimbursement. My specialty is the lowest paid specialty in all of medicine. Talking to patients about prevention, about what is going on in their lives that might be causing them to be sick, taking time to explain the benefit on one test over another or one medicine over another is not valued by insurance companies. They say it is in their rhetoric, but they don’t value it enough to reimburse doctors for doing it. Procedures unfortunately are the highest reimbursed things a doctor can do. Removing a small mole that takes about 5 minutes of my time pays more than spending 30 minutes with a patient talking about losing weight or stopping smoking or beginning an exercise program. Patients unfortunately often fall into the same mindset. Most have no qualms about paying hundreds of dollars for a procedure but balk if they are charged the same for prevention counseling…’What…you didn’t even DO anything”.
    It’s unfortunate, but money talks. We have fewer and fewer doctors going into primary care because with the same training they can go into a specialty that is reimbursed better because it does more procedures to take care of problems that could have been prevented in the first place. (Dermatologists are paid almost 2-3 times what a family doctor is). When these young doctors leave medical school with $200,000 in educational debt, who can blame them for looking for the most lucrative speciality to get into.
    Money is also a way to let us all know what we value. When young doctors see the discrepancies in salaries between specialties, it says to them that one is valued and hence more prestigious than another and most want to feel valued for what they do so opt for the more prestigious (better paid) areas of practice.
    It isn’t all about money, though!! (At least I hope not) If done right, our health care does not need to be cost prohibitive. We just need to pay for the right things and quit making it more lucrative to treat the end stage of a disease process than it is to try to help patients prevent it from happening in the first place. It is just the right thing to do!

  7. Mary
    September 17, 2009 at 5:42 pm #

    I agree fully with Deepak. He needs to talk with our President!

  8. Rita
    September 17, 2009 at 6:26 pm #

    I agree with all the above points. My prayer is that we can get the public option this time around and prayerfully we can then begin to insist on more preventative and wellness care. This just the beginning of the process to get real health care reform in this country. We must all find ways to work for what we really want. Peace and blessings to all who hunger, thirst and work for a healthy health care system in every part of the world.

  9. Sue
    September 18, 2009 at 6:40 am #

    I agree with Deepak. Especially the comment that if we don’t get a public option premiums will skyrocket. I support Obama, but frankly, the “reform” plans currently on the table scare me to death. I’m going to be forced to buy insurance for a health care system that doesn’t make me well AND insurance companies will have no reason to hold down costs while gaining hundreds of thousands of new customers. Once again, we’re making the rich richer and the poor poorer.

  10. Robert Fobes
    December 10, 2010 at 11:41 am #

    ” It is no measure of good health to be well adjusted to a profoundly sick society.” – J. Krishnamurti

  11. Shawnna
    October 28, 2011 at 2:20 am #

    The fundamental problem is that we in the US are conflicted about whether access to quality health care is a right of every member of our society, or a privilege of those fortunate enough to work for a company that provides it or can afford to buy it on their own.

    Until we agree that access to quality health is a public health issue and the right of every member of our society, we will continue to struggle with half measures like the health reform law we have now.

    I admire President Obama for trying, but ultimately the health care reform law fell far short of what we needed.

  12. Dave
    January 17, 2012 at 4:55 am #

    I support freedom and the free market. Freedom to choose the kind of care you want and the freedom of people in the market to provide different kinds of services. For instance I think cannabis extracts are an effective treatment that the government is currently prohibiting. So in my opinion the solution to healthcare is not more government authority and power, it’s less.

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