Friday, November 15, 2013

It's Broken...so Let's Fix It!

Oh my! the furor around the Affordable Care Act is mounting...and I
am increasingly frustrated with the smoke screen being constructed
by the brouhaha over the inoperable web site, over the numbers of
people having their insurance program canceled, over the members
of Congress who continue to take a do-nothing stance regardless the
issue.

I say "smoke screen" because it seems that no one...NO ONE...is
addressing the real problem with our health care system. (NO, it is
emphatically not the finest in the world, in spite of what we have
been led to believe; hence, our position as 22nd in life expectancy
among the countries of the world. That's right- TWENTY-SECOND.)
And the real problem, as I see it, as I have long seen it, is the COST
of health care...which is far, far more than in most developed,
industrialized nations for the same procedures, for the same drugs.

Fellow Americans, this so-called "best" health care system, which
in reality is far over-priced and which doles out procedures and
medications with a far-too-liberal hand, is not as effective in
helping us to maintain our health and longevity as those in Japan,
Switzerland, Sweden, Australia, France, Iceland, Italy, Austria,
Spain, Norway, Luxembourg, Greece, New Zealand, Germany,
Denmark, Finland, the Netherlands, Canada, Belgium, the U.K.,
or Ireland. And when are we going to admit that and look to these
neighbors and allies of ours for some words and suggestions of
wisdom?

Now, I know that one of the earliest objections being voiced when
a health care insurance system was first being discussed was the
possible regulation of procedures...like organ transplants, cardiac
bypasses, joint replacements, etc. And the alarmists began crying,
"Death panels! Death panels!"...effectively rallying many ordinary
citizens to oppose any control of health care spending whatsoever.
But should we really be paying the hundreds of thousands of
dollars such procedures cost for the elderly? for those people for
whom the cost/benefit ratio would be incredibly small?

I am not an ageist. After all, I have long been a "senior citizen"
myself. But when did the notion of keeping people alive at all costs
and for as long as possible supercede giving loving, compassionate
elder care in life's waning years so that people can live with a
quality of life which has meaning rather than focusing on the
number of years one lives? When did the idea of the need to "do
everything" medically possible for one's parents or grandparents
or aunts or uncles take the place of the family supporting that loved
one with tender care without use of machines or tubes or on-going
medical "intervention"? Or is all of this insistence really yet another
smoke screen for the fact that we are so terribly afraid of death?

Now, I realize I'm stepping on toes here. Well, so be it. Someone
has to be bold enough to say that our health care system is
broken...and it is not just because of lack of insurance coverage.
Back in the "good old days" when I was in hospital nursing, there
were far fewer nosocomial infections (those which are contracted
from being in the hospital and not from the illness/condition which
brought one there.) There were far fewer medication errors and
far more interpersonal contact between doctors and nurses and
patients and families.

And in the ensuing years, as drug companies and insurance
companies have usurped more and more power...as popping a pill
has become seen as the solution to so many health problems...as
emphasis on good diet and exercise and stress reduction has
become big business but seemingly not the business of the
physician...our overall national health has deteriorated. And woe
to the one who dares to say that far too many of our health
problems are those we bring upon ourselves.

Actually, it is incorrect to call what we have a "health care system"
at all. It is an "unhealthy care system", since the promotion of good
health has fallen by the wayside in the wake of a plethora of drug
"solutions" to our illnesses. And the focus on the "numbers" with
regard to cholesterol and blood sugar has resulted in more and more
people being prescribed these medications which, all too often, have
proven- in the long run- to do more harm than good.

What we excel in here in the United States is emergency care, due
in great part to the skills and techniques learned from the battlefield
care given during the Korean War and the Vietnamese War. Those
surgeons and nurses on the front lines perfected life-saving
emergency techniques which are still being practiced in ERs all
over our country today. But most of our health problems are not
of the emergency type; they are chronic in nature and require a
very different approach.

Over the past twenty years or so, a lot of lip service has been given
to "Holistic Medicine" and there are a few hospitals who have gone
so far as developing multi-disciplinary departments to address the
whole patient...the entirety of whom is not just physical but also
mental, emotional, and spiritual. However, such departments are
few and far between and are thus available to only a very few.
Why doesn't each medical practice or clinic have on staff a
massage therapist, a nutritionist, a social worker, and a spiritual
director? Why don't our insurance programs cover complementary
therapies like acupuncture, therapeutic massage, and chiropractic
care? Why will my Medicare pay for a colonoscopy but not pay for
visits to an acupuncturist (which costs far less, I might add). And
why will it not pay for home health care and equipment so I could
be cared for at home during my declining years but will cover the
far greater cost of interring me in a nursing home?

So if you want to get angry about and complain about anything re:
health care in our country today, why not get serious about it and
look at the cost of care? Why not write your members of Congress
and let them know that simply covering everyone by means of
insurance of one type or another is not the answer? That the
system will only be fixed by a complete and total overhaul, which
will include wresting so much power from the hands of Big Pharma
and Big Insurance. Then take the further important- vitally
important- step of taking responsibility for your own health and
health care by ASKING QUESTIONS...BECOMING INFORMED...
LIVING WITH INTENTION. If we each and all did this, perhaps the
number of years we live would be far less important than the
quality of life in those years.
 

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