There's something seriously wrong with our modern system of healthcare in the United States and in Western countries, but this article's not what you might think -- it's not about the obvious things that are wrong. This is about something much larger. Let's take a look from a large, top-down view. In fact, I'm going to challenge the assumption that we should have disease-oriented doctors at all. I think the whole diseased-focused model of health care we have today is part of the problem.
Let's take a look at it: The job of a doctor (a General Practitioner, or GP) is primarily to diagnose disease, treat symptoms and make referrals to other specialists for surgery, lab tests or other procedures. (Good doctors also help educate patients, but that's the exception, not the norm.) Patients don't go see a doctor unless there's something wrong with them. When they do see the doctor, the doctor's job is to patch them up, make the pain go away, make the swelling go down, stitch up the cut, prescribe drugs or whatever is immediately necessary.
Think about it... the doctor only makes money when people are sick. Drug companies only make money when people need treatment for disease. And most people are only really interested in their health when something goes wrong. I think there's something terribly misguided about this entire process, both in terms of what patients are doing and what doctors are doing. So what could be a better system?
Imagine a world of health consultants
Suppose we had a system, in some imaginary society, where there weren't doctors -- instead, there were health consultants or "healers." The job of the healer would be to keep you healthy, not to patch you up when you've got a disease. In fact, in this imaginary society, every person would see a healer on a regular basis, working with them like a health
coach to avoid and prevent chronic disease. Most importantly, healers would only get paid when you stay healthy
, not when you are sick.
If you ever got a disease or experienced symptoms of disease, that would be considered a failure on the part of both the healer and yourself, and the healer would earn no money from your disease. But if the healer was doing their job, and the patient was at least marginally interested in their own health, then of course the vast majority of chronic disease would be entirely avoided.
What if we had a system where you paid your healer a small monthly fee to help keep you healthy? Under such a system, the healer is financially punished when his or her patients aren't healthy. There's actually a financial incentive for the healer to make sure that everyone stays as healthy as possible. That would be an economic incentive that turns the entire system of healthcare on its head, because right now our current system financially rewards disease.
Diseases are too profitable to prevent or cure
If you think about the way the drug companies operate, they are financially rewarded for inventing new diseases, or redefining old diseases so that more people
are now diagnosed with something. In fact, the more diseases they can invent and the more people they can convince of having some disease, the more money drug companies make.
But what if we turned that around, and we had a system where there was an economic incentive to keep people healthy? What if there was actually a penalty for having to use pharmaceuticals, because that meant you failed to follow a healthy lifestyle? What if healing foods such as fresh produce and raw nuts were offered virtually free of charge, but junk foods were very, very expensive? How might that change people's purchasing habits?
If you turn the whole system upside down, and you create rewards for keeping people healthy, then entrepreneurs all throughout the country will find new and interesting ways to keep people healthy. Business people will always find ways to make money, and if disease is financially rewarded, then disease is what they'll create. But if you offer them a way to make money by keeping people healthy, pioneering entrepreneurs will find all sorts of creative ways to improve patient health and cash in on the profits.
Modern medicine rewards disease
Right now, we have a system that rewards disease. That's why we have so much fraud in Medicare and Medicaid, so much corruption in the medical industry and so much money and effort invested in inventing disease. Yet we have virtually nothing invested whatsoever in prevention.
There's really no serious disease prevention program in this country. The government is not working on preventing disease. Drug companies certainly aren't doing anything to prevent disease, and even the national cancer associations, diabetes associations and all these health charities are doing virtually nothing to actually prevent disease. Why is that? Because everybody's making money from disease, including the doctors, hospitals, medical imaging specialists, oncologists, radiologists, anesthesiologists and, of course, psychiatrists, who are now making money by imagining that people have all sorts of brain chemistry disorders like Road Rage Disorder that they claim need to be treated with prescription drugs.
How healers would keep you healthy
What we need are healers, whose job is to keep you healthy, and who can engage in education, nutritional therapies, detoxification programs, physical therapy, stress reduction and other meaningful health therapies. These healers would be able to assess your specific nutritional needs and then prescribe foods to you. They may even prescribe exercise programs, sunshine or more water so that you stay hydrated.
Now, I'm not imagining that all of this would be easy to implement, or that the government should be the one running such programs. I realize this is a simplified description of economics, human decision processes and complexities in health care today, so this is not a serious proposal of reform. This is just an exploration of ideas of how we might turn things around by altering the way incentives are applied.
Modern medicine is an utter failure
What's very clear today is that the current system we have has utterly failed. We have more people on drugs in this country than anywhere in the world, we're spending more per capita on healthcare than any country in the world, and yet we are the most diseased population in the world (barring plagues and the like).
We have depression, cancer, diabetes, heart disease, and a long list of other chronic diseases that are devastating our population, and not just our adults and senior citizens, but now our children too. It's very clear that the system of health care we have in our country does not work.
Over 40 percent of our population has no health insurance. Approximately 99 percent of our population (and the vast majority of licensed physicians) remains completely and utterly ignorant of the relationship between nutrition and health. In this country, we continue to subsidize sugar and genetically-engineered corn on a grand scale. We continue to allow the drug companies and junk food companies to exploit consumers and brainwash people into thinking they need chemicals or junk foods in order to be healthy, feel good or be popular. We have a system that is dominated by evil industries that really have no purpose other than to generate profits. These are the food, drug, cosmetics and chemical industries, primarily.
Doctors are often trapped in the system, too
We also have a medical industry that is, in some ways, helpless to do anything in response to all these problems. I know it's easy to blame doctors, and certainly they are part of the problem, but doctors are also caught in a system where they are often powerless to do much.
Many doctors start out wanting to be healers. They really want to help people, but they soon find out that they can't stay in business if they're spending 20 minutes per patient. A clinic or a hospital won't hire them unless they can work faster and see more patients, spending an average of only 3 minutes per patient. What started out as a genuine desire to help people quickly degenerates into a drug-dispensing factory operation.
Some of that responsibility, however, belongs with the patients. A lot of patients don't want real health solutions -- they just want a prescription. They just want a magic pill, and they're not interested in changing their diet or engaging in exercise. Sometimes a doctor can give patients excellent advice, and the patient will just ignore them.
Now, if this happens to you a thousand times, and you're a doctor, pretty soon you get tired of preaching to people and you eventually just leave it up to them. I think that's where too many doctors ultimately end up. They've given up on trying to help people, and they're just pushing drugs and surgery. Every treatment in conventional medicine, it seems, comes down to pushing more drugs, and the continuing education programs (CMEs) required for doctors to maintain their licensure are, more often than not, sponsored by drug companies. Doctors are flooded by pro-drug information through drug reps, medical journals, continuing education and from patients themselves (who request drugs by name because they saw an advertisement on TV).
The bottom line is that if we're going to make some lasting changes in this industry, and actually do something to qualitatively improve the health of American citizens, we have to change the dynamics of this system. We have to stop providing incentives for disease and start finding new ways to create rewards for personal health improvements.
I think we can do that by starting at both the bottom and the top, the bottom being grassroots education, which is part of what I do. At the top, there would be reform of the FDA, and we would create a true Department of Health that is actually interested in promoting health, and not just promoting the financial interests of politically powerful drug companies and food corporations.
We've got to sever the corrupt connection between government and industry, and create some honest regulatory agencies that are actually going to do something to protect the consumer. Today, we are far from that. In fact, it's nowhere in sight. But that's where we have to start if we're going to have a chance at improving the health situation in this country.