Recently I read the following line in a New York Times editorial about the use of CAT scans in place of colonoscopies: "Eliminating unproven procedures and reducing needless costs is necessary if the nation is to improve the quality and lower the cost of care over all."
Sounds true enough. But look a little deeper to see how this kind of statement reflects and perpetuates the fundamental problem with our medical system of health care today. It is based on the assumption that the best medical care involves the skillful application of technology. To do this requires ongoing determination of costs and benefits of each technological test and procedure.
We are stuck in an increasingly complicated paradigm of technological medicine, which threatens to ruin our health and make us broke (individually and collectively) in the process. Under the banner of technology, the practice of medicine is fast losing the human element, and along with it the simple common sense approach to health that doesn't cost a fortune to implement.
What stands between us and our health seems to be access to costly tests, procedures and medications. If only we could figure out a way to pay for all that, we would all be healthy, ward off disease, and increase our life span -- or so the thinking goes. But wait a minute...someone's getting rich here. This whole way of looking at "health" just happens to make a lot of money -- not for doctors, but for makers of technology and tests, pharmaceutical companies, insurance companies. It may keep us alive but unhealthy and dependent on these medical products. That's no surprise. The technological medicine market wouldn't be so profitable if patients actually became healthy. It's not even clear if our medical system really is saving lives when you consider the huge numbers of patients killed by medical errors and prescription medications taken as prescribed.
Doctors are transformed from the physicians they once were into technicians who administer tests and procedures. Their hands are tied as they are bound to implement agreed-upon technological protocols to patients, and they have lost the ability to assess a patient's health by direct examination. Think of the "old school" doctors who grew up and were educated before technology took complete hold of medicine. They are a dying breed, aging out of existence. They still had the ability to create rapport with a patient, to assess a patient's health with the help of their own eyes, ears, and touch. Our doctors today have lost that ability as they've been steered towards technological means for assessing and treating medical problems. If the tests register clinical illness, you're sick, and if they don't, you're healthy. There's no in-between, and no real relationship with health, only disease as measured by our ever-advancing, but still imprecise, technology.
Has anyone stopped to notice that in this process we've lost touch with the simple principles for health that are within our own grasp? What happened to "eating right and exercising" as a formula for health? How absurd is it that a patient undergoes a quadruple bypass operation to save his heart and his life, and only AFTER that, when given the advice to exercise, eat more whole foods and cut down on fats, does the patient begin to live in a health-promoting way?
Children and adults are developing diabetes at record rates. Why does my local pharmacy have a big sign reading "Diabetes Center" where all the latest blood monitoring tools are available for purchase? The CDC estimated in 2002 that 6.3% of the American population suffers from diabetes. The incidence increases with age and is fueled by poor diet, obesity, and lack of exercise. So it's a growing medical market, very exciting for makers of testing devices and medications for diabetes. You don't see the pharmacy offering tools or tips for healthy living, because they don't make any money on that. Instead, the "diabetes centers" are a growing profit center for them, and they're all too happy to offer it.
We need to reclaim power over our own health by questioning the prevailing paradigm of medical care. The best way to keep costs down is by staying healthy in the first place.
