Health Care Reform Revisited

I have a confession to make about my last blog entry: I was not being totally honest. You see, although I made a big point about doctors and patients needing to be made more responsible for the health care costs they generate, I do not believe that anyone is ready to accept any system that is based on responsibility. It is not that people are irresponsible: it is just that they are so accustomed to being shielded from the financial consequences of their health care that the sort of change that confronts people face to face with the consequences of their health care choices is likely to prove intolerable to them. Under such banners as the need for quality care, of professional freedom, and of the evils of over-regulation, physicians will object to a system which restricts their freedom to practice as they wish. It is no matter that this type of practice, where no test, and no treatment is weighed for its financial consequence by the prescriber has led us to financial Armageddon. The medical profession is unlikely to brook any interference in its internal workings and quite frankly, non-physicians are afraid that the wailing baby of physician autonomy will bite them if not picked up and pampered, as demanded. After all, the doctor knows best.

Patients will object to having financial consequences to their health care utilization: they will object that it will be a disincentive to seeking care, and that people will go from over-consumption to under-consumption of care, which will result in worse outcomes overall. It will be objected that when people are sick, they are in no position to bring financial matters into consideration. Overall, it will come down to the same thing: patients wish to have unlimited access to health care resources and pay very little for it. Who wouldn't want that, even though it has led to the brink of financial bankruptcy?

All the objections to making the system responsible for the costs it generates have some merit, but all have potential solutions that do not require throwing the baby out with the bathwater. Injecting an element of physician and patient responsibility in the system is a necessity, if we are to avoid the race to the bottom that the current system of divorced responsibility inevitably creates. It is the delusion that this can be avoided that will die a slow and painful death. In the meantime, every other solution to reigning in costs will be tried, and health care consumption, unchecked by the need to take responsibility, will continue to grow like a cancer.

But I had another hidden agenda, which you might guess at from the theme of this blog. This is that a system that is based solely in allopathic healing is going to have a harder time paying for itself than one which utilizes other healing methods that produce better health. I am tempted to say that any such system is doomed, but such a pronouncement would be too chauvinistic. Nonetheless, it is certain that a system that tries to suppress illness will require new and ever increasing expenses in its fight against the body's vital energy, which will resist those suppressive forces. New illnesses will appear, resistant bacteria, mutant viruses, and new treatment resistant chronic illnesses will appear which will require new research, new drugs, and more expenses. This sycotic type of expansion is built into the allopathic model. We will only be able to truly decrease our health care expenditures when the health care system does more to promote health. Promoting health decreases health care expenditures because healthy people need less treatment. Homeopathy is uniquely poised to help in this regard because it is one of the few systems of treatment whose foundation rests on the improvement of health. Indeed homeopathy and health are almost synonymous, given homeopathy's focus on mobilizing the vital energy, which can be viewed as the quintessence of health. Homeopathy is not the only treatment modality that focuses on improving health: Acupuncture, Bowenwork, Yoga, and Meditation also fit this model. They are generally dismissedor considered to be of limited or tangential value because of a lack of research supporting them. It does not matter how much research supports it, it is never deemed to be sufficient. And of course, the allopathic system has little interest in re-allocating the billions that are spent on allopathic research to research in these alternative systems, so that their true value might be revealed further . The emphasis on allopathic treatments is thereby perpetuated by a Catch-22.

Physicians receive little or no training in health, almost entirely in disease, and so they are very poor at intervening in a manner that improves health. Indeed, the conventional system is financially invested in the perpetuation of illness. Healthy people who do not need intervention would put the system out of business. A system such as the legendary Chinese health care system of yore, where doctors would get paid only when their patients were healthy would make more sense, if we truly valued health. A system where doctors are paid mostly when their patients become sick would be threatened by healthier patients. So why invest in what will be financial disastrous to you?

With apologies to readers of my last blog article, I openly confess that I did not tell the whole truth about health care reform in that particular piece. I did not because what I omitted would be even more radical and less easily digested than what I did put out. The truth hurts, and our health care reforms are likely to do everything to avoid it.