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.
It's impossible to make our drug-intensive, technology-centric, and
corrupt system affordable. Consider that Americans spent $8.4 billion on
medicine in 1950, vs. an astonishing 2.3 trillion in 2007. That's $30,000
annually for a family of four. The bloated structure of endless, marginal-return
tests; patent-protected drugs and "heroic" surgical interventions for virtually
every health problem simply can't be made much cheaper due to its very nature.
Costs can only be shifted in various unpalatable ways.
So, a far more salient question that must be addressed is: Are we getting
good health for our trillions? Unfortunately, the answer is a resounding, "No."
The U.S. ranked near the very bottom of the top 40 nations -- below Columbia,
Chile, Costa Rica and Dominica -- in a rating of health systems by the World
Health Organization in 2000. In short, we pay about twice as much per capita for
our health care as does the rest of the developed world, and we have almost
nothing to show for it.
I'm not against high-tech medicine. It has a secure place in the diagnosis
and treatment of serious disease. But our health care professionals are
currently using it for everything, and the cost is going to break us.
In the future, this kind of medicine must be limited to those cases in
which it is clearly indicated: trauma, acute and critical conditions, disease
involving vital organs, etc. It should be viewed as a specialized form of
medicine, perhaps offered only in major centers serving large populations.
Most cases of disease should be managed in other, more affordable ways.
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. It would use inexpensive, low-tech interventions for the management of
the commonest forms of disease. It would be a system that puts the health back
into health care. And it would also happen to be far less expensive than what we
Tuesday, August 11, 2009
A New Kind of Medicine
Dr. Andrew Weil has been a medical doctor who takes alternative medicine seriously. I've read his writings for a long time and admire him very much. Here is his take of the recent health care debate: