Sustainable Medicine

If you read the newspapers, or, as in my case, the e-paper, you may have noticed that the buzzword of the times seems to be "sustainable." References are commonly made in the press to sustainable energy resources, sustainable agriculture, sustainable economic policy, and sustainable environmental policy. So much has this term appeared in the press lately that one might consider it symbolic of a new zeitgeist -- one of preservation, of a growing awareness of our limitations as a country and even as a species.

For those of you familiar with the current homeopathic theories about the periodic table, you might recognize in this transformation the characteristics of the twelfth or even the thirteenth row of the periodic table, as described by Scholten, Sankaran and others. The twelfth stage is one where the structure (analogize freely to person, group, or nation) has gone beyond its apex, and is now clearly in decline, and desperate efforts to shore up its weaknesses are being made. There is a feeling of crisis (Jayesh Shah observed this) -- that unless some drastic measures are rapidly implemented against the growing threats that are mounting, the system will go into decline. By the thirteenth row, there is already the beginning of a feeling that the structure's best days are behind it, and the most that can be done is to try to prevent further damage to its integrity. The situation remains desperate, but now there has been measurable damage done, and the structure is weakened.

There is a crisis of global warming, a crisis of pollution more generally -- there are toxins in our food, in our commodities, and in every life-sustaining natural resource, and a crisis in our economy -- we've mortgaged our future and can't keep up the payments. The first decade of the twenty first century may be remembered as a time where the United States moved from maturity into middle age. The question is being asked nowadays what kind of old age lies ahead of us -- one of continued decline into progressively greater states of debility, or one of stable sustenance of a lower level of productivity, but with the gracefulness and wisdom that can be attendant to the latter years of life. Graceful decline sows the seeds for healthy renewal. The karma that we accumulate in these years of our lives benefits the next generation.

In medicine, the awareness of its non-sustainability has grown more slowly. Government, businesses, doctors, health care administrators, health insurance companies, and the public has been aware for at least two if not three decades that there were serious problems in the economic viability of our health care system. Since the Hillary debacle of the early 1990's, the government has sat in nearly paralyzed silence as the crisis has mounted. In the past two years there has been a growth in community health centers, thanks to legislation passed in 2006 to make funds available to promote their development. But the number of uninsured has remained relatively stable at about 16% of the population, and the costs of health care have grown yearly at triple or quadruple the rate of inflation over this time. The Medicare Part D plan has led to many Medicare recipients simply not taking their medications since they can't pass through the dough-nut hole. Businesses continue to shed health care costs at increasing rates because they are unaffordable. Yet in all of this spiralling of health care costs, we rarely hear that our health care system is unsustainable.

The elephant in the room won't go away, although noone likes to admit its presence. Cadillac care for all simply can't be bought, unless it is with Madoff money -- that is with money that isn't there. But who is talking about down-sizing the health care system? Instead, the main focus nowadays seems to be on increasing coverage for the uninsured and the underinsured. We are trying to prop up a system that is collapsing under its own weight. The tree simply won't support Horton the Elephant any more and (with apologies to Dr. Suess) the egg is cracking under his massive weight.

Bloomingdale's style health care has to go, and no one is willing to say it. In part the reluctance to acknowledge that we have to cut health care expenditures is based on the misconception that no safe alternatives to Bloomingdale care exists. It is also based on the fact that cost-saving measures, while good for the public and the government, are bad for the health care industry, which thrives on copious health care spending. The more health care is consumed, the more money for doctors, hospitals, the pharmaceutical and medical device industry, and for health care corporations. Insurance companies do not benefit directly from greater health care consumption, as their costs rise, but the need for health insurance just increases as expenses sky-rocket, so their product is in greater demand.

If an inexpensive wonder-drug came along that would cure 90% of people of 90% of their problems, it would spell disaster for the health care industry. A healthy population would consume less health care. Doctors, hospitals, nurses and countless bureaucrats and administrators would have to close their businesses. The health care industry would be a victim of its own success, and would probably get in line for the next big government bailout. So who in the health care industry wants a healthy population, when it means economic ruination? Homeopathy has been "dissed" for centuries for many reasons, but this one may be the best one yet. Homeopathy purports to cure at least 90% of health problems, although probably not at a 90% rate. Still, with skillful care, at least 50% can be substantially benefited or cured, and in the hands of experts 75% - 80% cure rates have been reported. Homeopathy is accustomed to being treated as a cipher, notwithstanding the growing body of evidence that has accumulated to support it. But it is the lack of economic utility towards sustaining the medical industrial complex that will help to keep it from becoming a more popular form of treatment. Medical care is still in the 11th stage of the periodic table. There is a perception of threat, but the feeling exists (in spite of the obvious evidence that contradicts it) that the structure is sustainable. Like all that grows, the health care system too will age, and when it reaches stage 12 or 13, homeopathy will be ready to be called into service. Because homeopathy is that wonder-medicine. Understandably, those unfamiliar with it will smile at this proclamation with self-assured skepticism, but those familiar with homeopathy know it to be true, since they have experienced it themselves, are acquainted with the scientific evidence, and see it daily, if they are practitioners, in their practices. Cheap, effective, safe treatment. What could be better? What could be more sustainable? Our time will come.