Recently, I read an article by Dr. Kenneth L. Davis, president and CEO of Mount Sinai Health System, on the reason that healthcare is bankrupting America. Although the article presents excellent points, there are elements which need to be further examined. There is a totality of America’s history which needs to be taken into account, as well as current micro-management of the system which actually forces healthcare professionals to perform tests which, based on clinical research, are not needed.
Lets start at the history leading to where we are. Over the last eighty years, we have invented and marketed everything from herbicides to medications which have only been marginally tested. Today, we are finding that these products have significantly contributed to the overall deterioration of the populations health. An example is Roundup which was flying off the store shelves during the 1970s through 2000. Despite the political and politic-economic pressures to state that it was harmless to humans, it has become increasingly clear that it is not. This is especially true when the combination of glyphosate with other substances is examined. Also during that time, the utilization of microwave technology and electromagnetic devises has increased, adding an additional form of pollution. I remember back during the late 1960s and early 1970s when Ralph Nader was warning of various problems which could occur. Even in the last episode of Michael Landon’s Highway to Heaven, warnings of our own hubrius in polluting our environment was put forth to help educate watchers on the dangers. Now, in 2019, we are being faced with the contributing damage the rush to making money on various products has had on our health. Since those who have the longest exposure to pollutants are likely to be affected, the increasing senior population in America is likely to continue to increase the costs of healthcare. Perhaps it is past time for the government and healthcare funders to demand a portion of the profits made by the manufactures of the products, which have caused people harm help pay for healthcare for the population they have impacted.
The unfortunate reality is that the strength of a country is in the development of their youth and the ability of older members to pass on knowledge based on lifetime’s of experience. There is significant evidence that many products which have impacted the environment, and continue to do so, are resulting in conditions ranging from learning disorders, to leaky gut syndrome, to cancers, to autism. As we continue down this course of putting profit first, we will find that our healthcare costs and the increasingly deteriorating healthcare in America will collapse from the overwhelming weight.
Although accountability is important, rules have been made requiring physicians to use x-rays and CT scans when clinically these techniques are unrevealing; when use of a MRI would be best. Our penny-smart pound-foolish thinking is costing us more than we can imagine. It is delaying proper care, and trade thorough treatment for “fast fixes” which frequently only allow the problems to get worse. Part of this is because frontline healthcare providers are having to deal with rules made by those with narrow or limited scope of clinical experience. In some cases, individuals with only healthcare administration knowledge are making decision which should only be made by the practicing healthcare provider whose license is on the line.
To give you an idea about the cost of fast fix or limited care, one only needs to examine the trial documents of the case of Kip Kinkel. The boy had been seen multiple time by various psychologists and professionals who each provided services which were limited to specific concerns (i.e., educational ability, mood problems, etc.). Due to the limits placed on the examinations, and the lack of an in depth assessment of need, he was expelled from school, killed his parents, killed two fellow students, and wounded 25 other students. The economizing on thorough assessment and care resulted in not only the loss of life, but months of legal costs, traumatization of a community and multiple families, and other residual effects.
The argument against “fee-for-service” healthcare is based on the premise that healthcare providers are taking advantage of their position. This is more likely the exception rather than the rule. The limitations of funding for healthcare is actually resulting in problems becoming bigger. We live in a very politically based system which does not put the well-being of the individual citizens first, despite the rhetoric.
What is interesting is that over the years there have been many attempts at passing laws and treatries to “hold harmless” corporations, including chemical manufacturers and pharmacological manufacturers, from any liability their products cause. Compare this, and the untethered promotion of potentially harmful products, against the current restrictions and limitations placed on healthcare. It results in putting the cost of this political dance in the laps of the American people who were the one’s harmed. The fact that lawsuits which are costly and place undue burden on individuals, such as the ones against Monsanto/Bayer, is unfortunate. If companies had to pay for any damages that their products caused, the quality assurance before marketing would be significantly higher. This is also part of preventative medicine.
Since we prohibited cigarette and alcohol advertisements on television, limited effort has taken place to limit the persuasive media aimed at unhealthy behaviors. Some pharmaceutical companies have included some of the risks of their medications in television advertisements.
We have slowly usurped the autonomy of individual healthcare professionals, blamed them for the increasing problems with healthcare delivery and cost, and forced them to treat more patients than is realistic if quality care is to be provided. With the politics as they are, the attraction of becoming physicians and other healthcare practitioners is reduced. Why would one elect to complete more than 10 years of education, multiple testing, and required supervised experience, if they can make the same living with a bachelor’s degree going into business or other fields? The need for medical care is like a freight train speeding down hill gaining speed with each second. It is too late to tout prevention without addressing other more pressing issues. If we are to address prevention of health problems, perhaps we need to examine the course industry has taken.
The lack of adequate healthcare is seen throughout the nation. It is difficult for those living in metropolitan areas to realize the extreme limitations which face many American communities. For example, although it was estimated a years ago that there were approximately 28,000 psychiatrists in the USA, many counties and communities do not have a psychiatrist. Even with the utilization of Psychiatric Nurse Practitioners, the demand has far overwhelmed the availability. Left untreated, individuals have turned to self medicating with alcohol, THC, and other drugs. We readily acknowledge the presence of dual diagnosis where individuals with psychiatric issues also have a substance abuse problem. We spend a significant amount on law enforcement and the prison system, but we have failed to see the connection between adequate healthcare and these expenses. Select members of the psychological community have elected to complete training, obtain supervised experience, and the vetting in psychopharmacology and related medical sciences to help, but acceptance of these specialists and inclusion for prescriptive privileges has been limited.
We need to change our thinking about healthcare if we ever expect to solve this problem.