by Barbara Berkeley, MD
It's in the headlines. It's on your mind. It's health care.
As of December, 2016 the United States was spending 17.8% of its gross domestic product on health care. That's 3.2 trillion dollars or about $9,990 per person each year. The imbroglio over Obamacare is the direct consequence of our enormous health care problem. Proper coverage is too expensive for many of us and beyond any reach for truly sick people unless there is a contribution from well people.
Despite having health resources that appear to be among the most advanced in the world, a great many of us are not happy with the care we get. Here in Cleveland where the majority of doctors have been bought out by behemoths like the Cleveland Clinic, one can no longer pick up the phone and make an appointment with a local doctor. Automated switchboards that put you on endless hold while the health care system touts its wondrous treatments in endless commercial loops are the new normal. Doctors now work on salaries which means short appointments and disengagement from patient connection. The electronic medical record has turned doctors into scribes who scramble to check all the right boxes while attempting to fit you and your medical problems into an existing computer template, taking precious time and focus away from you. Your body is divided up into systems: the cardiologist gets your arteries and your cholesterol, the urologist supervises your urination, and the gastroenterologist treats your ulcer. Who is in charge of your growing medication list?
But most of all there is this. The healthcare system in this country is simply....not. In America, our health care system is actually a sick care system.
Think about it. What would happen to insurance companies, hospitals, doctors, MRI facilities, testing labs, durable medical equipment companies, drug companies, physical therapists, and the ubiquitous square-block drug stores if we were truly focused on the care of health? What would the world be like if we were mostly healthy?
Our healthcare system survives because we are sick, not because we are well. It is dependent on diabetes, heart attacks, cancer, bowel disorders, high blood pressure and strokes. It is dependent on the billions of dollars we spend on drugs and on over the counter nostrums. It is dependent on your belief that you cannot heal yourself, that disease is inevitable, and that only doctors, drugs and hospitals can cure you. It talks a good game about wellness, but it sells treatment not prevention.
I started to write this blog after hearing a radio commercial for Walgreens, which is apparently located at the corner of "happy and healthy". Walgreens was putting a lovely spin on adult diabetes and talking about how much you could learn about your condition at their stores, while at the same time loading up on your medications and testing supplies, some of them branded by Walgreens. The overall message: once you've visited us and spent your money, diabetes doesn't need to slow you down. But that is not a health care message. A true health care message? You actually may not need to have diabetes. You can cure it or greatly ameliorate it by changing the way you live. I'm not throwing shade at Walgreens. Curing diabetes is not their business. Selling products to sick people is.
Hospitals may have wellness services but they survive by treating sick people and they depend on people being ill. A society of well people would put them out of business. Again, this is just the reality. Hospitals do sick care, not health care.
Imagine if we truly provided HEALTH care. What would that look like? Of course there would still be illness, but it would be enormously reduced.
A country focused on health care would provide body education that started in early childhood. We would all learn how we are made and what all our parts do. We would learn...in graphic detail..... what can happen to these parts if we don't maintain them. We would understand what diseases actually are, how they look in the body and how they destroy. Our culture would celebrate those who take care of their bodies as meticulously as they take care of their expensive cars and homes.
A country focused on health care would provide fun ways for everyone to keep active from bike paths to spinning classes, from yoga to tap dancing. Businesses would incentivize and encourage participation and so, perhaps, would our government. Exercise would cease to be something that cuts out after college. Physical education and fitness awards would return to our schools.
A country focused on health care would call out the American diet for what it is: fake food. Kids would be taught the value of eating natural foods that conform to our most ancient body needs from an early age. Government agencies likes the FDA and the USDA would campaign for this type of eating and stop playing coy with food manufacturers (who rely on our addiction to calories, sugar and fat). Subsidies and incentives would support those who grow fresh natural food and unsullied meats.
A country focused on health care would have doctors who are trained not just in treating illness, but in supporting wellness. It would provide doctors with the time to talk to patients...really talk to them. It would produce doctors whose mission was minimizing medicines rather than drowning people in them. It would encourage healthy bodies to fight off their own colds and viruses without killing off the micro biome with doses of antibiotics. It would reassure us of the body's truly miraculous ability to heal itself if it has been well maintained.
A country focused on health care would pay far more attention to the over 60 crowd. Most illness occurs later in life, but so much of it is unnecessary. We can strengthen muscles and teach better balance to prevent falls. We can get rid of the word "retire", which means to step backward. We can provide exciting opportunities for our seasoned citizens to compete in the world both mentally and physically.
A country focused on health care would finally say, once and for all, that healthy weight is a vital key to enduring wellness. It would support and incentivize maintaining weights at which blood pressure, cholesterol and blood sugar are normalized.
Please remember that most of the health care messages you receive have very little to do with health. You are by nature a healthy, self-healing being. While "stuff" happens in life and none of us is immune to illness, there is so very much you can do to give yourself the best chance of living a strong, healthy existence and of healing from the inevitable dings.
Embrace health.