Healthcare Reform: What's the Real Issue?

This week I attended a vigil for healthcare reform with a public option organized by MoveOn.org: http://moveon.org/. Quietly but with urgency, a series of people financially broken by our current healthcare system reminded those assembled that we mustn’t miss our current historic opportunity to increase accessibility to healthcare resources. Accessibility is certainly a key issue: how can we, as the wealthy nation we are, stand by a system that denies coverage to so many of our most vulnerable citizens?

Those that oppose a public option seem most concerned with the projected cost. This is a valid concern, especially as we watch Medicare, our existing model of a public option, slide towards insolvency. To address this concern, we must ask ourselves what basic factors are driving what have become out-of-control increases in the price of healthcare. While I don’t claim great expertise in such matters, it doesn’t take a genius to see this glaring issue: the care offered by the current system is too expensive and not adequately effective…and we can do better.

When did we decide that all health issues must be resolved with pharmaceuticals or surgery? In the emergency room these tools are invaluable, but in primary care they’ve been woefully ineffective. An example is the current epidemic in Type II diabetes, one of the most preventable conditions there is. Current standard practice is to throw medication at Type II patients, rather than empower them to manage their health effectively within their nutritional, exercise and stress management practices. The medications may be effective at lowering blood sugar in the short-term – although there are many exceptions to this - but in the long-term they simply create dependence on an expensive solution which often diminishes in effectiveness over time, necessitating more and more medication. Meanwhile, patients are left to continue the habits that created the diabetes in the first place, which in all probability doom them to poor health down the road, necessitating vastly more expensive healthcare interventions. In such a system, the cost of healthcare only spirals upward. (For a shocking look at the annual cost of diabetes, follow this link: http://www.diabetes.org/diabetes-statistics/cost-of-diabetes-in-us.jsp)

Medicine that empowers people to achieve health through lifestyle undoubtedly carries a significant upfront cost, but the benefits in improved short and long-term health and the reduced need for expensive long-term intervention are undeniable. Currently, licensed professionals that provide such preventive services – acupuncturists, naturopathic doctors, and nutritional counselors, among others – are often deemed unsuitable for reimbursement by insurance companies. Can we step away from the pharmaceutical-driven, insurance-policed model long enough to ask ourselves what it is we really want? Do we want more health, or more of the same?