Every week, if not every day, you can find somewhere in the media an article about the crisis in health care. More accurately, the crisis is about how we can finance our health care, now and going forward into the future. Prophets of doom parade their placards about the demise of Medicare and Medicaid, and others lament the growing powers of the health insurance industry. Everyone seems to have an angle about how to resolve this problem: there’s pay for performance, malpractice reform, single payer, health insurance cooperatives, reducing fraud, transferring care to Nurse Practitioners and Physician’s Assistants, and the list goes on and on. Many of these ideas are useful and pertinent, but all of them skirt a fundamental flaw in the health care system that tends to drive up costs: the biomedical model does little to promote health and focuses on “managing” chronic illness, rather than curing it or reducing it’s severity. Without addressing this fundamental problem, the “band-aid” solution to chronic illness will generate more and more costs over time. By improving people’s health through prevention and reduction in the severity and incidence of chronic illness, a more health-driven (as opposed to an illness-driven) system will save millions of dollars.
Recently, I received a letter in the mail from one of the major insurers in my area. I often open these letters with a sense of dread, wondering what new Kafka-inspired bureaucratic problem I’ll be confronted with. Much to my consternation, the letter was a review of my cost-effectiveness vis-a-vis other practitioners in the community. The scales for assessment were 1 for above average, 2 for average and 3 for below average. I was pleased to see that the insurance company awarded me a 1.01. While I was somewhat flattered to receive this grade, it dawned on me that I had done nothing special to deserve it other than practicing in a health-preventive model rather than in a disease management model.
While doctors have been given the highest prestige of all health care practitioners, many people would be surprised to realize that doctors receive almost no training in health. All of the training is directed at disease. The vast majority of health problems treated by today’s health care army are self-inflicted, and due to behavioral problems such as smoking, eating poorly, not exercising enough, using illegal drugs or alcohol, or other unsafe behaviors. The medical community has made little impact on changing people’s behaviors, and indeed, they know little about how to do this, as they receive little or no training in this type of intervention. In addition, there are no treatments available in the cornucopia of medical interventions that are clearly health-promoting. By contrast, homeopathic treatment, when successful, always improves people’s health in general, in addition to resolving the particular problem at hand. Herbal medicine offers numerous “adaptogens” that help to strengthen the body’s resilience against disease. Yoga and meditation are health promoting components of the Ayurvedic tradition that have been validated by numerous scientific studies. Practices such as ch’i gong, are drawn from the Oriental medical tradition and tend to promote health. Bowenwork is a type of body work that tends to keep the body balanced.
There are available to all who can afford them these and other health-promoting interventions that have a high probability of reducing the severity and frequency of chronic (as well as acute) illness. My own practice is but a tiny microcosm for examining the potential validity of such a claim. The first test went pretty well, I’d have to say, especially since the evaluator had no vested interest in my scoring well. However, it will be a long time before alternative and complementary medicine takes a seat alongside conventional medicine as part of the solution to the health care crisis, because we do not have the prestige of the medical profession. It will be a slow pathway to the truth being appreciated, but the truth will out. I’m reminded of a short story by Leo Tolstoy, called “God Sees the Truth, But Waits.” It’s about a man falsely accused imprisoned for an unjustly long time in a penal work-camp before his innocence is ultimately revealed. So must we all wait an unjustly long time before the truth, which is there for anyone willing to look at it, whenever they want to, will be comprehended by the powers that be.