Monday, August 17, 2009

The Dark Side

Dr. Andrew Weil, an M.D. and practitioner of integrative medicine, adds continuing insights into the ongoing health care debate:

Technology has a shadow side. It accounts for real progress in medicine,
but has also hurt it in many ways, making it more impersonal, expensive and
dangerous. The false belief that a safety net of sophisticated drugs and
machines stretches below us, permitting risky or lazy lifestyle choices, has
undermined our spirit of self-reliance. The cold fact is that while Americans
live more than 30 years longer than they did at the turn of the last century,
public health measures such as better sanitation, immunizations, better food and
water, and safer and less polluted workplaces account for 25
years of that increase; medical intervention, only five years.
A recent
study showed that in the 1990s, only about one
in 16,000 Americans
had his or her life saved or significantly extended by
improvements in health-care technology.

Virtually every other developed country has a national health care program.
They are not perfect and never will be, but they generally work better than
ours. Studies in places such as Germany, France, Scandinavia, the United Kingdom
and Canada show that citizens in those countries are happier with their systems than we are, and are healthier as
, with lower rates of obesity and chronic disease. I fully support a
national health care program for the U.S.

[The growing influence of money] is the darkest cloud over American
medicine. The profit motive, once only a part of health care, now drives the
whole system. If current trends hold, a family of four will spend about
$64,000 annually for health care in the next seven to nine years (except that
they obviously can't and won't - so the system, without reform, will collapse
before then).

Virtually all of the incentives run in the wrong direction - that is,
toward high-tech interventions to make money rather than toward modest, simple
protocols that (in at least 80 percent of cases) make or preserve health. Yet
there are pockets of efficiency and effectiveness in America. The nonprofit Mayo
Clinic in Rochester, Minnesota, is among the highest quality and lowest cost
health-care systems in the country, largely because its salaried doctors have no
incentive to drive up costs by over-testing and over-treating. Similarly, at the
Arizona Center for Integrative Medicine, we train health care professionals to
use only the appropriate level of technology for the condition at hand.

I urge you to read the New Yorker article "The Cost Conundrum: What a Texas town can teach us about health
" by Atul Gawande, M.D. It's an extraordinarily clear-eyed assessment of
how and why American medicine has lost its way, and how it might return to its
healing roots.

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