Most of us never think about the current monopoly that exists in our current healthcare system. As in all monopolies, costs are extraordinary and the quality of the care is not necessarily better, it’s just more expensive.
Like you, I grew up going to the pediatrician as a child, having memories of the kindly doctor spending time, administering a vaccination and even visiting me at home when I was ill. Ah, those were the days when the doctor was almost part of the family. It was not unusual for doctors to spend the time to help figure out what was wrong with you and help the family through your illness. When a doctor was paid, it was usually by you, and the cost was generally reasonable.
Then in the 60’s, the American Medical Association began to transform healthcare, by producing more specialists, who drove the rise of the many diagnostic tests that are currently used today. They also behind the scenes attempted to destroy competitors such as chiropractic, while other professions like Osteopathy took the path of least resistance by assimilation into the allopathic system we had at that time. Medicare came along in the mid 60’s, assuring a cushion would be there for seniors if they became ill and made sure they could get healthcare affordably.
As healthcare began to become more specialized, they also realized as well as hospitals and other healthcare facilities that they could raise their prices and Medicare would just pay them. As healthcare costs continued to rise, and the medical schools produced more specialists, costs began to soar. No longer, was the doctor spending as much time because primary physicians were being paid less and many specialists were being paid quite well in comparison. Eventually, economics forced most primary doctors to spend less time with their patients, and thus the 10 minute office visit with the help of managed care became the norm.
Managed care promised us better care at a lower cost. When Managed care was born during the latter part of the Nixon Administration, the conversation was that people would pay the same for less care. Not to say that more care is necessarily better, but over the years, many of the reforms from the insurance industry has made care more expensive, rather than less so.
In today’s model of care, the primary doctor is the portal of entry into the specialist system. Each doctor looks at a small part of you. But wait a minute; aren’t we the sum of our parts and don’t these parts work as parts of systems? Therein lays the problem. In many encounters with people who have lived in places like Europe, they will tell you the doctors are more like years ago, where they spend time, and look at you, not just the symptoms. Symptoms are elusive, and mean very little unless we look at the person as a whole and their structure too.
As the current system evolved to its current status, professions like chiropractic that once were considered alternative became further embraced by the public, to the dismay of the medical establishment. Many medical doctors began referring to alternative providers and some hospitals even established departments devoted to complementary care. What is unique about most complimentary providers is that they tend to be more holistic, and look at the entire body, not just the symptoms.
An even bigger problem for most healthcare consumers is the war of ideas on who to choose and visit to resolve our problems. Do we go traditional, or alternative, with traditional being part of the expensive united states healthcare monopoly which is heavily lobbied in the congress and senate via the American Medical Society, individual provider groups and by the drug companies too. Their combined power has cemented our healthcare system into what it is today and required us to have insurance simply because not having it would financially wipe out most families. Contrast this with most complimentary healthcare providers who like the doctor of old is affordable and is cost effective.
Fixing the problem is essential for healthcare reform to be effective, otherwise, we are a country will be consumed by healthcare costs, many of which are systemic because of overspecialization but also because of the overreliance on drugs which cure nothing (but offer temporary relief) and tests which are used because the art of manual diagnosis by hand is a lost art to many doctors. The problem is further exacerbated because they have little knowledge of the musculoskeletal system, giving rise to classifications such as Fibromyalgia which has not helped people with chronic pain find solutions, it has solve many on taking Lyrica though.
A tighter integration of complimentary providers is also mandatory because they have the skills the traditional healthcare system in the monopoly does not have, even with the most powerful drug. The problem is, we are mechanical beings, and you cannot fix a mechanical problem with a drug.
How do we fix this?
1. Is it time we recognize there is a healthcare monopoly that is ideologically based which needs to be tempered. Not everything including aging is a disease and it would be best if our focus turned to wellness, rather than sickness.
2. More fully embrace complimentary healthcare providers and medical providers need to refer and work with these providers more.
3. Begin to retrain and teach new doctors about treating the body as the sum of its parts and systems, rather than giving the right drug.
4. As doctors become more holistic, they need to relearn how to diagnose by hand, and the practice of well care needs to be defined and rethought as to what prevention really is (it is not fear motivation which drives much of our Lipitor sales).
5. We need to stop drug companies from advertising drugs on primetime television. Most primary doctors now have patients telling them what condition they have and requesting certain drugs, even with all the side effects that are talked about in the ads.
6. We need to rethink care for the elderly and make it about comfort and function, rather than diseases. Aging is not a disease and like it or not, we all have an expiration date. Nobody knows when that is but we all want to live full and productive lives, even when we are older. Somehow, this idea has been hijacked by big pharma to include a vial of prescriptions for all our ailments as well, with the side effects to go with.
Of course, this is just a start, however, we really need to allow competition in healthcare to thrive and it cannot do so in the current monopoly involvement which will surely sooner than later make healthcare wholly unaffordable.
Maybe the system has to collapse for reform to truly take place and people no longer have health insurance?
What do you think? As always, I value your opinion.