Healthy Healthcare

We all profit if our healthcare system is transformed...

and the profit will not just be financial! 

This week in Washington, the hot topic is healthcare. Those with an eye on the cost and scope of expanding healthcare are calling for reform. Those with a heart for medical care as a humanitarian mission are calling for healthcare to be transformed. Most of us, confused and concerned with how to provide healthcare for our own family and others, are somewhere in between.

The trouble is that, for everyday Americans, the national discussion seems to leave us out. Politicians, insurance executives, lobbyists, medical groups and activists accuse each other of causing the problem and exaggerate catastrophic implications with code words like market forces, public option, universal coverage and efficiency.  What do they really mean?

Actually, in reporting on the financial crisis over the past year, the media has given us plenty of understandable vocabulary that fits the mess that we call American healthcare: A Culture of Excess, Greed, Lax Oversight, Systemic Risk. Yes, Americans have abused medical care just as investors abused the markets-- and with similar results. Notice I didn't just say doctors or insurance companies or politicians. I said Americans. We are all imlicated. Here's why:

While we overeat, drink alcohol, use tobacco and resist exercise, Americans demand access to unlimited cutting edge medical care and highly proficient, caring doctors and nurses. We want that care to be at our convenience. We want to choose which tests to have, which medicines to take, which technologies to use, which professionals to see, which habits to embrace and how much medical care to get, all at discount prices (even if some therapies are not needed or are too expensive and others are unpleasant but effective!).

While we say medicine is a mission, American doctors, hospitals and healthcare companies operate as capitalists. They want to be able to perform procedures and offer services that pay well, to choose patients who are easier to take care of, to offer the procedures Americans like to have, to expand duplicated services to compete with other doctors, hospitals and healthcare companies (even if all these things drive up costs without always improving health!).

While everyone thinks healthcare "coverage" is important, private American insurance companies are also profit driven. They want to be able to take advantage of America's obsession with medical technology, to profit from our aversion to healthy lifestyle choices, to cover only those people with no pre-existing medical conditions, to leave out the poor and to control costs by deciding which things are covered, all while chasing higher and higher profits (even if this means that struggling patient families end up paying for huge insurance executive salaries). 

Last but not least, politicians purport to represent us and to have American's best interest at heart, then use healthcare as a political tool to bolster their conservative or progressive agendas.

This has to stop.  No other country in the world is foolish enough to think this is how healthcare should work, and now we, Americans, are seeing that, in fact, it doesn't work: America is less healthy than the rest of the world and our system is in crisis. Whether or not you are a Republican or a Democrat, it is time to think compassionately and creatively about healthcare.

Here are some ideas we might consider:

Americans will need to recognize their responsibility to healthcare quality by being more healthy, getting preventative care, having one primary care doctor who coordinates their care, following all medical recommendations and not expecting someone else to always pay the bill for bad personal choices.

American doctors and hospitals will need to return to the Hippocratic mission of medicine, to work together to coordinate their care of whole communities, to carefully use healthcare dollars, to scientifically determine and follow best practices, to favor quality over quantity and to guide patients in making wise decisions about lifestyles and therapies.

American insurance companies will need to go back to the original idea of insurance: collecting premiums and paying claims as a way to allow "all of us" to collectively pay for "all of us." If they are unwilling to include "all of us", they will need to compete with a public option for those they leave out. They will need to join the medical community to finding ways to keep America healthy.

American politicians will need to turn away special interests and step beyond self interest to creatively construct a healthcare system focused on the highest quality of care instead of profits, a system that is based on compassion for each American and a system that can sustain our desire to enjoy long lives of health and service to each other.

This is not just President Obama's problem. Each of us has a part to play. It's a lot to ask, I know, but the future of healthcare and America depends on it!

When We Are All Healthy, America Can Be a Blessing!

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