A doctor who’s in the thick of the current health-care debate made a crucial point when he told me that the real issue shouldn’t be limited to medical insurance reform rather an entire medical-care reform. It’s been rightly said that the most expensive technology in American medicine is the doctor’s pen, because with a flourish of the hand he can order an unnecessary test or surgery. Some kind of insurer must pay for that, so simply providing more coverage will not bring healthcare costs to economically sustainable levels, nor will it ensure better health to society.
It’s estimated that 2.5 million unnecessary surgeries are performed each year, with hysterectomies, heart bypass grafts, lower back surgery, and angioplasty leading the list. Just two procedures alone, coronary artery bypass grafting (CABG) — known in the trade as cabbage — and balloon angioplasty cost $100 billion annually. With long waiting lists for CABG, you’d think it was vital for prolonging the lifespan of heart patients, but that’s a mistake. Current statistics suggest that about 3% of bypass surgeries extend life expectancy, with angioplasty scoring even lower at zero percent.
On all sides the "more is better" cult cripples and bankrupts the American health-care system. If you pay your doctor a visit tomorrow, you have a 43 percent chance of being given an unnecessary test. Stress-related chest pains that are muscular in origin can still wind up leading to a battery of expensive cardiac tests, including risky catheterization. If you have a cold or flu, there’s a 73 percent chance that you will be prescribed an antibiotic, which is useless against viruses, including cold and flu viruses, but which carry risks of allergic reactions and other side effects, not to mention weakening of the immune system.
The U.S. ranks 37th in overall health system performance in the world by the WHO while paying far and away the biggest bill. What we need is not more unnecessary tests, which cost an estimated $700 billion dollars a year, but more intelligence. The Obama administration has rightly focused on the three main points of reform:
1. Provide coverage for the 47 million citizens who don’t have insurance. Their health care is being paid for through public funds when the final bill comes due — no one gets treated for free — so it’s absurd to hide the cost when it can be borne by those who need the care and have a duty to pay for it.
2. Provide a public option so that private insurers don’t have the profits game entirely to themselves. Not only will a public option be cheaper, but it starts to remove the cutthroat profit motive in healthcare insurance to a more sensible and ethical motive of improving people’s health and wellbeing.
3. Bring down medical costs, which involves two main fronts of attack. First, stop the "more is better" ethic (or rather, lack of ethics) that is tied to doctors’ profit motive. Second, bring malpractice coverage and lawsuits into line with reality, since many medical tests are motivated by physicians protecting themselves rather than protecting the patient’s health.
A great deal of fear and misinformation has been stirred up recently about end of life care in regards to health care reform. From my experience as a physician, efforts of extend life indefinitely through resuscitation and respirators usually only extends the patient’s suffering and extends the hospital bill thousands of dollars a day. While there are important exceptions, nevertheless it is vital that patients have the opportunity to discuss and make these critical decisions for themselves before they are incapacitated and force their families into a decision fraught with guilt and uncertainty.
Anyone who wants to delve into the truly dismal state of health-care economics has a wealth of sources at hand. Read the excellent articles now online at the Atlantic Monthly and The New Yorker magazines for a starter. You will quickly realize that this isn’t an issue where the already insured are altruistically passing reform to benefit "them," the incapacitated elderly, the chronically ill, and the under-insured, all of whom have the smallest voice in Congress while health-care lobbyists actually outnumber members of Congress six to one. We have arrived at a generational crossroads where wasteful, inefficient medicine meets an aging population. We must make it through to the other side as a whole nation.
Otherwise, consider what looms ahead. The present generation of young children might become the first to live shorter lives than their parents thanks to runaway childhood obesity and lack of exercise. Fast foods continue to zoom in popularity, and sodas and sugary drinks are now the main source of calories in the American diet . Health-care costs could cripple American industry by amounting to 50% of overhead by mid-century. Even if those dire possibilities don’t faze you, consider one of Pres. Obama’s most basic points: compared to other countries, the richest nation in the world is paying more for less when it comes to health care. That alone is reason enough to quash the myth of "more is better" right now, while we have the best chance of real reform.
Published in the San Francisco Chronicle
Dear Deepak,
Another excellent article !!
AMEN!
I would add that we all need to be our own advocates in our doctor's offices, and remember that we have a choice and a voice when it comes to what happens to us over the course of an illness/injury/pregnancy, etc. Pausing and quieting the mind for a moment when we receive feedback regarding our conditions will slow the pace of the dialogue and allows for the best outcome for each individual to take shape.
I mean, really…the numbers that are referenced in this article are staggering. I don't know about anyone else, but I have to ask myself what part I play in this picture and what lies within my power to change!
2 paul gopal grace I think you are a really kind person and good soul.
and 2 C.P. I have always advocated for my health and for those I love. If I'm not happy I have taken it to politicians and to ombudsman-there are good people there and they are just people too and just need to be talked to. It really can be that easy. Its about the change of the inside of our character, to following our heart.
Dear Deepak,
Brilliant! What if these doctors and those in the health care asked themselves, "What is my intention?"
Love,
Bobby
dear deepak,
i think all educated persons irrespective of country can learn from this article.
Wish you love, peace and happiness.
Trisha
Deepak..only more can be more..as the salacious appetite is never satsfied..the Wheel has it's continuation of its inflation and depression…only better is better and cannot fit in the same category as more..as apples are apples….enjoy man of Spirit and Soul*
May you live in peace and harmony surround you always(+)
Dom*
Thank you Dr. Chopra for standing up for "healthcare reform". Your article contains the exact and true information that needs to be spread throughout this land! May you always be blessed. You are an inspiration to many. Love and Peace from Elanalee
Dr. Chopra's article is an eye opener and a 'shocker' when you read ' If you pay your doctor a visit tomorrow, you have 43 percent chance of being given an unnecessary test' !! My freind has just a few hours ago undergone an angioplasty at a reputed heart care centre, and as he had no health Insurance , his own hard earned money was expended for the treatment.
I think the Insurance virus is largley to be blamed to this rut in medical treatment. Here in India once the medical practioner gets to know that you are covered by Health Insurance, his doctor's pen merrily writes down several tests -, for which he gets a good percentage cut, many times more than his consultation fee, from the diaognestic centre, and the patient also does not mind, as he does not have to foot the Bills. He feels a sense of being pampered, much like a 'spa' treatment.
I agree with everything you have said in this post, but have a question. We have heard plenty about health care reform from politicians and citizens, but have heard little from real doctors. While the whole of the healthcare reform debate seems to be going on between politicians and people already covered by insurance, it seems to me that the focus should be firmly placed on Healthcare professionals, not insurance companies, and real patients. My mother is a nurse, and lost faith in the healthcare industry when HMO's became the deciding factor in a patients care with a doctors opinion running a distant second. Also, patients are at the mercy of the insurance companies whims, making it impossible for a patient to have any sort of control over their own treatment. If you refuse to have a test or surgery you feel is unnecessary, you run the risk of being denied for any further treatment.
As a doctor, aside from making it clear that the emphasis needs to be more on preventive care, what, in your opinion, needs to happen in regards to healthcare reform? What do you feel would allow you the freedom to provide the best medical care to your patients?
Thank you Deepak! I agree with all especially "The present generation of young children might become the first to live shorter lives than their parents thanks to runaway childhood obesity and lack of exercise. Fast foods continue to zoom in popularity, and sodas and sugary drinks are now the main source of calories in the American diet ."
And WHY do they serve this crap in nursing and old age homes?! I mean, I know everyone is on a budget, but my partner says he thinks it is mostly a cultural mindset and I would agree.
With all the shouting about health care reform lately, part of what needs to happen is for people to TAKE RESPONSIBILITY FOR DIET AND LIFESTYLE CHOICES. No doctor can do this for us.
thanks again, Jas/Lisa
Tinkerbell-this statement" If you refuse to have a test or surgery you feel is unnecessary, you run the risk of being denied for any further treatment." made me wince.
Whose body is it anyway?!
I would never choose to have a test or especially surgery that I felt unnecessary, just to be "in" with insurers, who, by the way, probably care more about their profits and bottom-line than they do about your very personal health/body.
It is YOUR life, it is your choice, don't give away your power.
IMveryH Opinion, said with love, Jas/Lisa
I feel the same as you do about this, Jas. It is MY body, but it seems that with the current system, if you assert your rights, you get no help.
Not to get into too much detail, but I have a chronic autoimmune disorder, and had some neurological complications. It was recommended that I undergo a very invasive and risky test, which I, and my mother, who is a nurse, felt was unnecessary. I would rathered have had a less invasive, less expensive, yet more conclusive treatment, and suggested it. I was told that I was being noncompliant, and that if I continued to be such a difficult patient, I should find myself another doctor. This, in conjunction with having been laughed at for using herbal and holistic medicine when possible (which have been more effective than conventional meds for me)has me now searching for another doctor. But I feel as though I am just as likely to find more of the same. Not just because of the doctors, but also because of an insurance companies "protocol".
It is my life, and I chose to do what I felt was right, but it seems that all the power belongs to non-medically trained executives whose only concern is the bottom line, not the health and well being of patients. What has happened to the Hypocratic Oath?
Taken With Love, AND Thanks, tinkerbell/Margie
Let us live our lives in such a way we never require the services of doctors or lawyers.
Let us daily increase in: wisdom, love, gratitude, reverence, healing, peace, joy, happiness, laughter and prosperity.
Love and Blessings X 10,
Ed
Ed, I agree with you 100% on this….it is only possible if we search within and continuosly reassure ourselves of well being… and as Abraham from Abraham-Hicks.com says it is the collective consciousness that people keep squawking about health costs, malpractice, medicare and medicaid fraud and large costly drugs that people keep showing up with themselves on the news at night..fortunately I do not watch the news but if everyone would clamour on this and concentrate on well being the subconscious would take a turn for the best and offer people their own paradise in their subjective reality..one can only hope.
Thanks for your comment…it is a good one…enjoy*
May you live in peace and harmony surround you always(+)
Dom*
Nice comment Ed…..
Thank you Deepak for your post.
As a physician myself, I wholeheartedly agree with the need for change in our medical system and health philosophy, not just insurance reform. Having practiced outside of the reach of insurance companies for several years now, I think it is incumbent upon those of us in the healthcare provider role to take a stand.
The insurance industry is a major contributor to the problem but I agree the issue is more systemic. To me, this whole discussion is indicative of the fact that we cannot rely on the western medical model alone. Rather, we must embrace a more holistic philosophy as a society, as patients, and as practitioners.
Thanks Dom and Seema,
Not an original thought, as I don't have such but it comes to mind every time I hear a personal medical or legal horror story. And now this entire who should pay for medical mass murder debate is creating headaches for everyone.
Let us daily increase in: wisdom, love, gratitude, reverence, healing, peace, joy, happiness, laughter and prosperity.
Love and Blessings X 10,
Ed
I completely agree with Deepak. Good article
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