Tuesday, August 11, 2009

Wrong Diagnosis of Our "Disease Mgmt. System"

Washington is working on reform initiatives that focus on one problem: the fact that the system is too expensive (and consequently too exclusive.) Reform proposals, such as the "public option" for government insurance or calls for drug makers to drop prices, are aimed mostly at boosting affordability and access. Make it cheap enough, the thinking goes, and the 46 million Americans who can't afford coverage will finally get their fair share.

But what's missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what's even worse than its stratospheric cost is the fact that American health care doesn't fulfill its prime directive -- it does not help people become or stay healthy. It's not a health care system at all; it's a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly.


~Andrew Weil, MD

Originally posted at Carpe Diem.


11 Comments:

At 8/11/2009 2:22 PM, Blogger Realist Theorist said...

The whole notion of a "U.S. healthcare system" is a bad way of conceptualizing an industry.

As a consumer, the industry offers various choices. As a consumer, I can definitely use the industry in a way that allows me to become and stay healthy. Someone else might decide to use it to manage disease. That's his call!

Of course, the way Congress is going, soon we will have "a system".

 
At 8/11/2009 2:34 PM, Blogger LoneSnark said...

I don't know what he means. I don't use any healthcare, because I'm not sick. What is the healthcare system supposed to be doing for me?

 
At 8/11/2009 2:53 PM, Blogger Susan Haywood said...

Everyone gets older. Everyone will get sick, many times during old age. Disease management is what it's all about. If you don't manage disease, people die much sooner. Everyone needs disease management, by age 50.

 
At 8/11/2009 3:26 PM, Anonymous eddie said...

As much as I despise what is being done in the name of "healthcare" by the current Administration and Congress, Dr. Andrew Weil isn't exactly an outstanding spokesman for the anti-government-intervention cause. Because honestly, he seems a bit like a crackpot.

The money phrase from the article: "Functional, cost-effective health care must be based on a new kind of medicine that relies on the human organism's innate capacity for self-regulation and healing." That sets off the crank detector, albeit not very loudly.

But then his Wikipedia page says "In 1994, Weil founded the Program in Integrative Medicine (PIM) at University Medical Center and the University of Arizona in Tucson. It offers residential and research fellowship programs and operates an outpatient clinic according to Weil's principles; emphasizing prevention over treatment and focusing on nutrition, botanical medicines and mind-body interventions to complement conventional synthetic drug and surgery protocols."

There are excellent reasons to oppose Obamacare, none of them having anything to do with the "eat right, use herbal medicines, and think yourself healthy" brand of "health management".

 
At 8/11/2009 3:47 PM, Blogger KJ said...

Susan - while you have a smiling face, you make an ignorant statement about people older 50. I know plenty of folks in their 50s and 60s who are totally healthy

 
At 8/11/2009 4:26 PM, Blogger misterjosh said...

From a libertarian standpoint, It's perfectly reasonable that we have a disease management "system" instead of a healthcare system.

Health care is something your nanny does for you. Disease management is what you go to a doctor for, and "reformed" disease management is the fallback position if we can't convince those crooked bastards in Washington to use market reforms.

An example of reform: One disease management industry that is slightly less regulated than average is vision care. What has the market done?

The market can work.

What about poor people? I agree that we should help them out, but it needn't cost $1,000,000,000,000.

 
At 8/11/2009 8:50 PM, Anonymous Anonymous said...

We need more doctors (from all over the world) and let competition lower the costs.

 
At 8/11/2009 9:03 PM, Anonymous Anonymous said...

Increase the supply of health care providers and I bet the cost will decline. Too bad we don't subsidize medical students the way we subsidize law students...

 
At 8/11/2009 9:44 PM, Blogger rufus said...

Just think how good the survival rate would be if we treated, "Everybody."

 
At 8/11/2009 11:48 PM, Anonymous Anonymous said...

Just think what life expectancy would be if everyone took care of themselves; if everyone exercised; if everyone ate healthy food and put that cheese burger down.
If - if - if
Isn't it fun when we get to make things up.

 
At 8/12/2009 12:10 AM, Blogger Michael said...

The whole problem with the debate is that we are still trying to come up with a system where everybody else pays for everybody else's health care. The current structure and the current plan a both socialized medicine.

The solutions are rather simple.

1. Have a baseline $10,000 deductible per illness/accident portable coverage for catastrophic medical costs.
2. Repeal the 1,000s of laws mandating increased medical costs.
3. Cut taxes.
4. Let the individual choose what type of insurance they wish to buy to fill the gap to the $10,000 deductible.
5. Let free people make free choices in their medical care.
6. Expose people to the costs. If people see aspirin is $30 a dose, their going to put pressure on the medical community to bring costs down.
7. Tort reform. Loser pays. 95% of the time the medical community wins the claim.

People need to be more responsible. When I get the cold or flu, I stay home, rest and drink fluids. But you have people who take their kids to the doctor every time they have a runny nose and expect someone else to pay the doctor. This has to stop or government will take over and ration care.

 

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