Huffington Post~Dr. Weil~Healthcare Reform~Wrong Diagnosis

[Guest guest]

_Dr. Weil_ (http://www.huffingtonpost.com/andrew-weil-md)

_http://www.huffingtonpost.com/andrew-weil-md/the-wrong-diagnosis_b_254227.h

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(http://www.huffingtonpost.com/andrew-weil-md/the-wrong-diagnosis_b_254227.html)

Founder and director of the Arizona Center for Integrative Medicine

Posted: August 9, 2009 11:00 PM

_The Wrong Diagnosis_

(http://www.huffingtonpost.com/andrew-weil-md/the-wrong-diagnosis_b_254227.html)

I'm worried -- and if I'm worried, you should be, too.

The reason I'm worried is that the wrong diagnosis is being made.

As any doctor can tell you, the most crucial step toward healing is having

the right diagnosis. If the disease is precisely identified, a good

resolution is far more likely. Conversely, a bad diagnosis usually means a bad

outcome, no matter how skilled the physician.

And, what's true in personal health care is just as true in national

health care reform: Healing begins with the correct diagnosis of the problem.

Washington is working on reform initiatives that focus on one problem: the

fact that the system is too expensive (and consequently too exclusive.)

Reform proposals, such as the " public option " for government insurance or

calls for drug makers to drop prices, are aimed mostly at boosting

affordability and access. Make it cheap enough, the thinking goes, and the 46

million

Americans who can't afford coverage will finally get their fair share.

But what's missing, tragically, is a diagnosis of the real, far more

fundamental problem, which is that what's even worse than its stratospheric cost

is the fact that American health care doesn't fulfill its prime directive

-- it does not help people become or stay healthy. It's not a health care

system at all; it's a disease management system, and making the current

system cheaper and more accessible will just spread the dysfunction more

broadly.

It's impossible to make our drug-intensive, technology-centric, and

corrupt system affordable. Consider that Americans spent $8.4 billion on

medicine

in 1950, vs. an astonishing 2.3 trillion in 2007. That's $30,000 annually

for a family of four. The bloated structure of endless, marginal-return

tests; patent-protected drugs and " heroic " surgical interventions for

virtually every health problem simply can't be made much cheaper due to its

very

nature. Costs can only be shifted in various unpalatable ways.

So, a far more salient question that must be addressed is: Are we getting

good health for our trillions? Unfortunately, the answer is a resounding,

" No. " The U.S. ranked near the very bottom of the top 40 nations -- below

Columbia, Chile, Costa Rica and Dominica -- in a rating of health systems by

the World Health Organization in 2000. In short, we pay about twice as much

per capita for our health care as does the rest of the developed world, and

we have almost nothing to show for it.

I'm not against high-tech medicine. It has a secure place in the diagnosis

and treatment of serious disease. But our health care professionals are

currently using it for everything, and the cost is going to break us.

In the future, this kind of medicine must be limited to those cases in

which it is clearly indicated: trauma, acute and critical conditions, disease

involving vital organs, etc. It should be viewed as a specialized form of

medicine, perhaps offered only in major centers serving large populations.

Most cases of disease should be managed in other, more affordable ways.

Functional, cost-effective health care must be based on a new kind of

medicine that relies on the human organism's innate capacity for

self-regulation

and healing. It would use inexpensive, low-tech interventions for the

management of the commonest forms of disease. It would be a system that puts

the

health back into health care. And it would also happen to be far less

expensive than what we have now.

If we can make the correct diagnosis, the healing can begin. If we can't,

both our personal health and our economy are doomed.

Politicians aren't going to resolve this issue overnight. Any health care

reform bill that gets jammed through Congress in the next month or two will

be dangerously flawed. Washington needs to take a step back and re-examine

the entire task with an eye toward achieving the most effective solution,

not the cheapest and most expeditious.