While reading an editorial in JMPT, I came across the line: "The system for the delivery of health care services is broken."1 This serves as just another reminder that America believes it is in the midst of a health care crisis. That is the conventional wisdom, right? The country's health care system needs fixing? Medical costs are out of control, while millions of Americans are devoid of health insurance; and with baby boomers entering retirement age, things surely can only get worse.
As it stands, the proposed solution is to socialize - I mean universalize - the entire health care system. Let government take the industry by the reigns and steer it into submission. Control costs, provide every American with health insurance and make doctors accountable for their service. Some have even suggested that doctors be paid on a success-only basis: heal the patient and get paid. Fail, however, and: "Well, sorry, but you've got to eat this one, doctor." Sounds like a plan.
I always chuckle when I hear about the supposed health care crisis. I say we are not in a health care crisis; we have the best medical care in the world. Where would you rather be following a serious accident or illness other than an American hospital? Europe? Canada? I doubt it. We have the best teaching institutions in the world, the highest medical standards and the most modern technology money can buy. What crisis? Nobody beats American medicine.
"But it's so expensive," critics cry. No kidding. Saving lives is expensive stuff. Research and development is costly. Who pays for that? High-tech diagnostic equipment is pricey, too. Let's not forget that neurosurgeons, cardiologists and anesthesiologists have to pay their student loans just like the rest of us. Why should they study for years and not get duly compensated for their work? Great medicine costs big bucks. Period.
So, where's the crisis? Medicine is appropriately expensive and saving your life is worth it. Who said that having one's life saved is a God-given right? It costs money. We are unquestionably fortunate to have the means by which to have our lives saved, but are we entitled to it? We can't afford that entitlement. Seen from this perspective, I think it's evident that we are not in a health care crisis at all. Instead, we are in a health-paradigm crisis.
Yes, medical care for anything other than saving lives is too expensive. When people use medical care as their primary form of health care (we all get that misnomer), what else can they expect other than a large portion of their income going to medical bills?2 The typical American either does the bare minimum with regard to health maintenance (periodic light exercise, ordering salad for lunch, taking daily aspirin) or neglects their health altogether. What does this lead to? Neglect leads to dysfunction, eventual breakdown and disease; and this is usually the point when most people run to their doctors for "fixing."
Does anyone else see the calamity here? Neglect your health and pay top dollar for medical care; it's not rocket science. We should all know beyond an inkling of a doubt that health is directly related to lifestyle choices. The more one invests in healthy behaviors - good nutrition, exercise, regular chiropractic care, sufficient sleep, and so forth - the less one will have to pay for sick care later. Now that's a fact.
So, I reiterate: We are not in a health care crisis. On the contrary, for what medicine does best - saving lives and fighting disease - the system works quite well. However, by wishing for it to be something that it's not - an inexpensive way to keep us healthy - then we are, in fact, in a crisis of paradigms. But there is a solution.
The first step is to appease public demand: find a way to provide affordable health coverage to all Americans who want it. This is a good thing. Don't mandate coverage, as Hillary Clinton suggested; give everyone the opportunity to buy into the government health plan if they want.3 President Obama has it right there. This will cover people for catastrophes and it might even give people access to wellness care.
Tom Daschle, former nominee for Health and Human Services (HHS) secretary, had it right when he proclaimed that to change the health care climate, we have to change the way we think about health. "Wellness has to be cool," he said. "And prevention has to be a hot thing."4 Prevention and wellness need to be marketed heavily if we are ever going to overcome this so-called crisis. I couldn't agree more. Hurrah for somebody in government who finally gets it. Pushing wellness is really the only way to make the necessary changes to our current health care paradigm.
This certainly shouldn't come as any surprise to chiropractors. Chiropractors are the quintessential health and wellness advocates of the modern world. We've been pushing this agenda for decades. It is only fairly recently that the rest of the health care world has acknowledged the importance of prevention and wellness. That said, the medical community is still trying to fit the wellness concept into its current sick-care paradigm. Prevention, as currently discussed in medical circles, usually means taking drugs prophylactically, such as aspirin to prevent heart attacks, Lipitor to prevent arteriosclerosis, etc.
Medical doctors might mention fitness programs and good nutrition, but often only as a side note. That's fine: They know their role as life savers, so there's no confusion there. But as far as the medical conceptualization of wellness, it's like trying to fit a square peg into a round hole.
Chiropractors need to continue their role as the wellness and prevention specialists of the health care world. The profession needs to get politically stronger. More than ever, we need to push our message to the public and lawmakers: Chiropractic is an integral part of a complete wellness prevention regimen; it is invaluable in helping people to stay healthy. Chiropractic as prevention is a real money-saver, and as a form of wellness, it can keep health costs down. However, for that to be tested, we would need to see Obama's proposed health care plan pay for chiropractic maintenance.
Whoa! Step back, I've said the dirty word: maintenance. Never utter that foul expression to health insurers or other health policy-makers because health maintenance hasn't yet caught on with that segment of the industry. Remember, America is in the midst of a sick-care paradigm. Not until we change that aspect of our consciousness will we be able to seriously discuss universal health maintenance care.
Daschle was on the right track with "cool wellness" before he had to withdraw his nomination as HHS secretary. We can only hope that Obama's next nominee [Kathleen Sebelius, sworn in as HHS secretary on April 28] gets the cool wellness concept as well. It's the only way out of this health-paradigm crisis.
References
- Triano JJ. What constitutes evidence for best practice? JMPT, 2008;31(9):637.
- Carpenter E, Axeen S. "The Cost of Doing Nothing: Why the Cost of Failing to Fix Our Health Care System Is Greater Than the Cost of Reform." New America Foundation, Nov. 13, 2008.
- D'Angelo G, Winfree PL. "The Obama Health Care Plan: A Closer Look at Cost and Coverage." The Heritage Foundation, 2008.
- Smith D. "Daschle Vows Aggressive Reform as Health Leader." Reuters Health News, Jan. 8, 2009.
