Sanjay Gets It Right
If you read this blog then you know I can rip on everyone, including myself. Dr. Sanjay Gupta has been targeted plenty of times by me but this time he got it right. In fact, it fits in with my argument I had recently about the study comparing longevity and healthcare costs. Here are some highlights of what he had to say in his piece Better health not about Obamacare, its about you.
- Even if that seems extreme, it’s still worth asking: Does health insurance make us healthier?
- The website may be working better now, but to me that’s not the most important issue. In my mind, the real suspense comes from whether Obamacare will really make us a healthier America, even if it succeeds in its ambitions to dramatically expand coverage.
- A healthier America: That is the goal we should share as Americans, but access alone won’t get us anywhere close.
- The newly insured Medicaid population did go to the doctor more often, used more preventive health services and received more medications. Problem was, in nearly every area, they weren’t any healthier. Furthermore, the 10-year risk of having a heart attack didn’t change in those who had Medicaid. It wasn’t at all what the proponents of universal access to health insurance hoped they would see.
- In this case, I don’t mean that “good” or “bad” insurance is the critical factor, but that health insurance alone doesn’t lead to better health. None of this works unless we all take personal responsibility, and hold ourselves accountable.
- If we are serious about a more healthy America, the real change starts in each and every one of us, and it’s not that hard to do.
So the question is, Sanjay, can we force people to take care of themselves? If not, then maybe we all should have to buy catastrophic plans and let the public decide for themselves how healthy they want to be? This is opposed to what we are doing now by stuffing the insurance products with “guaranteed” colonoscopies, yearly exams, mammograms, etc that just increase the cost because there is no transparency and no one does any price shopping to bring down that cost. Just saying.
This is why I left primary care to become a hospitalist. After 15 years of telling people to lose weight and stop smoking I realized that they weighed more than when they started to see me and were developing diabetic renal disease, lung cancer, strokes etc. etc. I said “Screw it, I’ll do more good meeting you people at the hospital where I can salvage some time for you.” Fix everything about the government you want to, 95% of our patients don’t want to spend a dime or put an ounce of effort into keeping themselves out of the ER.
Of course health insurance doesn’t make us healthy. That’s not the issue. The issue is that a simple accident or a need for stitches or an unexplained fall can land people in the emergency room where then they are billed outrageous amounts for unneeded tests in the name of defensive medicine and then . . . for way to many, bankruptcy is the outcome. Personally, I think we should do away with health insurance for everyone and start pricing health care reasonably. If all the insurers were not getting their cut, perhaps the free market would make health care far more affordable and accessible.
Agreed to a certain extent. Like I said in the piece, a safety net for catastrophic coverage would do fine and then we can shop for the rest. The problem is that catastrophic plans are ridiculously high as well due to the greed of insurance companies.
We have felt secure in our arrogant belief that treatment of chronic degenerative disease consists of 1. Fit the patient’s symptom picture into a textbook name, 2. Prescribe the accepted pharmaceuticals/technology for the named disease, 3. prescribe more meds or technology if the first round doesn’t work, 4. Blame the patient (It must be all in your head) when we reach the limit of our knowledge system. Oh, and don,t forget, 5. Ridicule and dismiss any other healing system/philosophy/paradigm that we are unfamiliar with or is based on eating good food or having anything to do with nutrition. We wind up with more and more suffering individuals with their condition unchanged or worsening.
Our current “healthcare” woes are deeply ingrained in our current treatment paradigm. Perhaps the double-blind placebo-controlled trial isn’t the best method of determining how to heal our patients. Thomas S. Kuhn’s “The Structure of Scientific Revolutions” describes what a paradigm shift could look like. I think that we need a revolution in how we think about healing. Perhaps a biomedical model that considers a quantum physics -base more often and a Newtonian 18th century physics-base less so. It’s us, not them.
If we all bought catastrophic policies and were then left to the free market to care for ourselves, what would all the bureaucrats and politicians do without having control over us?
Spot on. As I’ve said for years, the TSA was never designed nor equipped to provide airline security, only the appearance of security. Likewise, federally provided health insurance is only to provide the appearance of, and not the actual delivery of care.