Sustainable Healthcare is Prevention

SUBHEAD: One model of a sustainable national system would focus solely on providing preventative care.  

By Charles Hugh Smith on 19 August 2012 for Of Two Minds -  

Image above: Stepping away from obesity would be a big step in prevention. From 

The current sickcare system will bankrupt the nation. Longtime readers know that I have presented various options to our costly (and therefore doomed) sickcare system.

I have suggested a "cash only" system (The "Impossible" Healthcare Solution: Go Back to Cash July 29, 2009), and observed that the Veterans Administration (VA)offers a model for a national opt-in healthcare system that would offer an alternative to the hopelessly corrupt "fee for service" sickcare (Healthcare: A Large-Scale Solution January 4, 2011).

Stripped of purposefully obscuring complexity, sickcare is a system of State-sanctioned cartel skimming that redistributes the wealth of many to the hands of a few.

There are many potentially sustainable alternatives, but regardless of the options offered, it is self-evident that open competition between transparent systems is necessary to provide cost discipline and encourage innovation. In other words, one size cannot fit all, and the broader the spectrum of transparent opt-in choices, the greater the cost discipline and incentives for innovation.

Healthcare is one of those peculiarly ideological topics where people tend to conceptualize all choices as either/or: either a system is "socialized" or it is "free market" (code name for cartel skimming controlled by the State).

The idea that a system of multiple options, complementary and competitive, might be the most sustainable, is difficult for many to conceptualize, much less accept.

Advocates of the Central State taking a dominant role in healthcare bear the responsibility of explaining what will limit the capture of the State's spending and power by wealthy vested interests, a process of corruption that would quickly turn any "new" system into the same crony-capitalist, unaffordable system we now have.

Apologists for the present system of State-sanctioned cartel skimming claim that Medicare, Medicaid and ObamaCare are all sustainable with what amounts to modest policy tweaks.

There is scant evidence for this claim; indeed, the one thing we know is that the promises issued to the 306 million residents of the U.S. are claims on future national income and surplus that cannot possibly be met, and magical projections of unending "growth" and unlimited borrowing power for generations to come are fantasies. Since sickcare is unsustainable, it will eventually be replaced by something that is sustainable.

Our only choice is to either let the current system collapse and then start pondering sustainable alternatives, or begin an honest discussion of sustainable alternatives before sickcare implodes in insolvency.

In this spirit of openly discussing a variety of sustainable options, we present this essay by correspondent Lonn Gary Schwartz, O.D. Dr. Schwartz makes a compelling case for the view that the only truly affordable, sustainable national system is one that provides preventative healthcare only. Here is Dr. Schwartz's essay:
The decades-long health care crisis we continue to experience in the United States is multi-faceted and highly complex, touching every U.S. citizen and every American institution. Despite the complexities, getting to the root of the problem simply requires us to confront the following realities.
First and foremost, we can not, nor will we ever be able to arrest the aging process, eliminate illness, nor avoid death. Despite what the myriad of “Eternal Fountain of Youth,” industries puts forward, these very events define what it is to be part of the organic life-cycle on this planet.
Therefore, it would seem that we, as a society, need to let go of the illusion that we can circumvent the natural order of things. Secondly, each individual needs to take primary responsibility for his/her own health [care].
No more dependence on having others bail us out of poor life choices [insufficient exercise, poor diet, unstable mental/emotional/spiritual states]. No more squandering the nation’s wealth on highly destructive lifestyles and their outrageously expensive antidotes.
Additionally, and believe it or not, the amount of social wealth that can be allocated to health care is finite.
We can no longer tolerate insurance companies acting as health commissars, corporations that are a hideous synthesis of investment banker, tax collector, medical policy and decision maker, and grand financializer, indeed, the worst of all worlds.
If we well-understand that ignoring basic vehicular maintenance leads to pre-mature wear, mechanical breakdown, and expensive repair costs, why do so many of us fail to acknowledge that a similar outcome is inevitable when it comes to our bodies?
Although volumes can be produced attempting to figure out why people do what they do [regarding their health habits], social policy need not be concerned with the reasons, but only insure that individuals take personal responsibility for their actions, and not necessarily because it will result in a better [health] outcomes or a more productive citizenry, but instead, because there are simply no other fiscally sustainable alternatives.
The current health care system is geared to heal, repair and/or replace. Attempting to repair and re-fabricate body parts on every American within the context of the current explosion in technologic potentiality is absurd.
Imagine the possibilities when considering the varieties medical technologies already in place; transplantation, bio-mechanics [robotics], genetic engineering, and pharmacologic, to name a few. Soon enough, you will be able to spend nearly unlimited amounts of money keeping just one person alive!
The solution? There is only one solution and that is prevention only. And although this may seem harsh upon first consideration, it certainly seems to be closer to what Nature intended for all of Her life-forms.
Regardless, it is what it is. Whatever resources can be allocated to health care [within the context of a fiscally responsible government], should be earmarked to prevention, that is, actual health care. If by chance [or misfortune], you happen to contract a disease/develop a condition/be subject to an accident, then you are in the same position as people are today when there are no known treatments available.
What would probably be available are low-cost conventional, alternative, and natural remedies, provided by individuals or small businesses, and payable in cash. In order to prevent a similar sick-care system from being resurrected, health care must be de-institutionalized. No more insurance companies, no more Big Pharma, no more corporate super hospital systems designed to turn natural events into mega-profits for the few and fiscal bankruptcy for the rest.
After all, all of these institutions presently exist only through government decree. The results of a de-centralized system will be fiscal sanity, individual responsibility, and hopefully, a much healthier population.
This is not to deny that a move toward sanity in one respect will not cause much pain and adjustment in others, but the development of just social policy must have [at its core] compassion, personal responsibility, and sustainability driving the process.
Just as the welfare state could not save everybody from the natural forces of human social interaction, or give unqualified people mortgages in order to allow them to live “a better life,” we cannot promise to save everybody from the inevitabilities of our own natural life-cycle.
Getting beyond this era of counterfeit debt-money, and the resulting fiscal insanity it has guaranteed, will require the acceptance of principles that were once very much a part of who we were as Americans.
We must accept that just as real wealth is created by producing, saving, and investment guided by the principles of transparent risk/reward assessment, our good health must also be earned through sensible eating habits, adequate exercise, and some method of maintaining mental/emotional/spiritual balance.
Better times lie ahead for those willing to take responsibility for their own wealth and their own health. After all, it is the American way.

Thank you, Dr. Schwartz. The demographic and fiscal cliff are real. Hoping that we can borrow our way to prosperity by dumping trillions of dollars into fraud, malinvestment and needless, counterproductive paperwork, tests, medications, lawsuits and procedures (i.e. sickcare) is the path to insolvency and a future that fails everyone.



Gelfling said...

I agree with a focus on prevention and the removal of large organizations from health care. However historically humanity has always had remedies for anything from broken bones to fevers to arthritis. I think a return to natural sources of health for most problems, reasonable use of antibiotics, and to use the knowledge of accident repair (that modern medicine does so well) that we do have would go far, could be covered especially for children and the elderly, and would not require giant organizations or giant price tags. Additionally, treating (ie containing) communicable diseases is a public good. I agree there should be a limit to the costs which should be covered by society for a single life. Millions of dollars of public money for a few more months of life for one person is not the right answer when that money could provide a lifetime of service for many children. However I think prevention-only is an over-reaction.

Juan Wilson said...

Aloha Gelfling,

Good to hear from you. I think Charles Hughs Smith argument is that we can have traditional medicine as we did before the HMO's took over - we'll just have to pay directly for it - as in the past. I believe what he means is that universal public healthcare would be focused on prevention.

My dad was a GP doctor in the 1950's. As a general practitioner he delivered babies, mended broken bones and treated pneumonia.

People rarely came to him with insurance forms. His services were affordable and when they were not he did some pro bono work and even accepted barter for services.

What we won't be able to afford is spending a half a million dollars to treat a lung cancer patient in the last months of their life with extraordinary efforts while millions get no medical service at all.

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